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828 Dosage Forms > Endocrine System and Related Devices > Flashcards

Endocrine System and Related Devices Flashcards

1
Q

Biggest disease with the endocrine gland

A

Type 2 diabetes

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2
Q

Endocrine System

A
  • Complex regulatory system that releases hormones that act as chemical “messengers” into the bloodstream
  • Hormones are responsible for regulating the metabolic effects of the body’s cells (Nerve impulses and regulatory factors play a role in negative feedback to control the levels of specific hormones)
  • Disorders may occur with overactivity or underactivity of endocrine glands and organs (Common endocrine disorders typically involve carbohydrate metabolism and thyroid function)
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3
Q

Disease state overview - Basic pathophysiology

A

-Chronic disorder characterized by increased FBG levels:

-Associated with abnormalities in carbohydrate, fat, and protein metabolism
-Longstanding, uncontrolled diabetes can lead to renal, ocular, and neurologic, and cardiovascular complications
Nephropathy
Retinopathy
Neuropathy

-Type 1 vs Type 2

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4
Q

Diabetes Type Prevalence

A
  • Type 1: Diagnosed early on, have no insulin, 10%

- Type 2: 90%, typically associated with lifestyle factors

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5
Q

Nephropathy

A

Kidney disfunction/problems

  • Worsening renal function
  • Dialysis
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6
Q

Retinopathy

A

Eye problems

  • Blurry vision
  • Blindness
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7
Q

Neuropathy

A

Nerve problems

  • Burning
  • Numbness
  • Amputations
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8
Q

Islets of Langerhans broken down into

A
  • Beta cells: insulin

- Alpha cells: glucagon

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9
Q

Type 2 Common Signs and Symptoms

A
  • polyuria
  • polydipsia (increased thirst)
  • polyphagia (increased hunger)
  • neuropathy
  • nephropathy
  • retinopathy
  • fatigue
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10
Q

Polyphagia: Why do you get hungry when you suffer from type 2 diabetes?

A

Your body is unaware that you have eaten. It is not capable of utilizing the sugar from the food because of the improper utilization of insulin.

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11
Q

Polydipsia: Why do you get hungry when you suffer from type 2 diabetes?

A

The body’s really thrown off. Example, too much sugar in the blood.

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12
Q

What does insulin do?

A
  • hormone that decreases blood glucose levels
  • inhibits glycogenolysis (break down of glycogen) because we don’t need more
  • stimulates lipogenesis
  • increases glycogenesis (want to form glucose storage)
  • secreted at a basal rate of 1 unit/hr
  • additional 5 - 10 units when BG>= 100
  • glucagon released when BG <100 mg/dl
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13
Q

Special populations: Children

A
  • Type 1 diabetes
  • Onset typically in adolescence or earlier
  • failure of beta cells to produce insulin
  • requires insulin treatment
  • honeymoon phase
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14
Q

Special populations: Elderly

A
  • glucose intolerance may increase with age due to decrease in insulin-mediated glucose metabolism
  • FBG increases 1 -2 mg/dl per 10 yoa >= 30 yoa
  • PPG 8 - 20 mg/dl per 10 yoa >= 30 yoa
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15
Q

Special populations: Pregnancy

A
  • progesterone, cortisol, and prolactin can impair glucose uptake
  • gestational diabetes (OGTT, Diet vs medication use, Targets: FBG < 95 mg/dl - 1 hr PPG < 140 mg/dl; 2hr PPG < 120 mg/dl)
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16
Q

ADA Goals of Treatment for Type 2 Diabetes

A
  • A1C < 7% for most patients
  • Preprandial (b4 someone eats): 80 - 130 mg/dl
  • 1 - 2 hour post prandial: < 180 mg/dl
  • Bedtime: 100 - 140 mg/dl
  • healthy to have blood sugar less than 154 (30 mg/dl change when change 1% point for A1C)
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17
Q

DKA

A

Diabetic ketoacidosis

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18
Q

DM

A

diabetes mellitus

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19
Q

DPN

A

diabetic peripheral neuropathy

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20
Q

eAG

A

Estimated average glucose

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21
Q

FBG

A

fasting blood glucose

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22
Q

CrCl

A

creatine clearance

23
Q

CKD

A

chronic kidney disease

24
Q

CGM

A

continuous glucose monitor

25
Q

BG

A

blood glucose

26
Q

ADA

A

American diabetes association

27
Q

CVD

A

cardiovasular disease

28
Q

GFR

A

glomerular filtration rate

29
Q

HbA1C

A

glycosylated hemoglobin A1c

30
Q

IDDM

A

insulin dependent diabetes mellitus

31
Q

IGF

A

insulin growth factor

32
Q

IGT

A

impaired glucose tolerance

33
Q

OGTT

A

oral glucose tolerance test

34
Q

SCr

A

serum creatinine

35
Q

SMBG

A

self-monitoring blood glucose

36
Q

TSH

A

thyroid stimulating hormone

37
Q

UACR

A

urine albumin to creatinine ratio

38
Q

Glucose meter features: Measurement range

A
  • 0 mg/dL to 600 mg/dL
  • Extremely high or low readings should be verified
  • Display of high and low readings
39
Q

Glucose meter features: Whole blood vs. plasma glucose

A
  • Plasma 10-15% higher than whole blood

- Glucometers (whole blood) vs. lab draw (plasma)

40
Q

Glucose meter features: Cleaning

A

Soap and water – unless otherwise specified in instructions

41
Q

Glucose meter errors: Hematocrit

A
  • High hematocrit may cause lower glucose readings

- Anemia and sickle cell disease may impact readings

42
Q

Glucose meter errors: conditions

A
  • Altitude
  • Extreme temperatures
  • Humidity
43
Q

Glucose meter errors: Test strips

A
  • Expiration date
  • Coding
  • Specific for meter type
  • May require coding once inserted into meter
  • Keep in supplied container until ready to use
44
Q

Glucose meter errors: Control Solution

A
  • Used to check accuracy of meter and test strip
  • Each bottle of control solution has specific instructions for use
  • Solution contains a known glucose level
  • If results match known range then meter are strip are working correctly
45
Q

Lancet

A
  • Provides adjustable force needed for lancet
  • May contain components for both fingertip and alternate site testing
  • Reusable
  • Used to pierce skin and obtain blood for testing
  • Disposable
  • Replace after one use
46
Q

Fingertip

A

-use colored cap on lancing device

  • always use finger tip to test if:
  • Concern of hypoglycemia
  • Patient unaware of hypoglycemic symptoms
  • Alternate site results do not match how the patient feels
47
Q

Alternate site

A
  • use clear cap on lancing device
  • palm or forearm are acceptable sites
  • results may be different than at fingertip when glucose levels are changing rapidly
48
Q

Syringes

A
  • Most syringes come with needle attached
  • Available in a variety of lengths and gauges
    • -½ cc (50 units), 1 cc (100 units)
    • -27 g, 28 g, 29 g, 30 g, 31 g
    • -The higher the gauge number, the thinner the needle
  • Intended for one time use
49
Q

Pen needles

A
  • Some diabetes medications are available in a ready to use pen
  • Needles need to be attached directly to pen
  • Intended for one time use
  • Do not store pen with needle attached
50
Q

Purpose of foot exams

A
  • Early identification of risk
  • Early detection, diagnosis, and referral for problems including ulceration, infection and painful neuropathy
  • Early intervention and treatment to prevent problems from worsening
  • Teach self-management and preventive foot care strategies (appropriate foot wear)
51
Q

8 Questions to Collect and Assess

A
  • How often do you check your sugars? Before or after you eat?
  • What kinds of foods do you eat for each meal?
  • Which foods tend to make your sugars go high?
  • At what levels do you want to see your sugars?
  • How do you feel when your sugars are really high?
  • How do you feel when your sugars are really low?
  • What do you do when your sugars are really high or low?
  • Whats your understanding of how high blood sugars affect you?
52
Q

Thyroid Hormone

A
  • Decreased levels of thyroid hormone stimulate the hypothalamus to release thyrotropin-releasing factor, which triggers the release of thyroid-stimulating hormone (TSH) from the pituitary
  • TSH causes the release of triiodothyronine (T3) and thyroxine (T4)
  • Responsible for the regulation of metabolic rate, growth and development of children, and reactivity of the nervous system
  • 100 mcg/day of iodide necessary for normal thyroid hormone production (equivalent to 1 gm of salt)
53
Q

Hypothyroidism

A
  • HIGH TSH
  • weight gain
  • cold/cold intolerance
54
Q

Hyperthyroidism

A
  • LOW TSH
  • tachcardia
  • increased systolic bp
  • irritability

828 Dosage Forms (8 decks)

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