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Pharm > Exam 3 > Flashcards

Exam 3 Flashcards

1
Q

Hyperglycemia lab values

A

Fasting BS >126 my/dL
Nonfasting BS. >200 my/dL
A1c. . >6.5%
Pre-DM. A1c. 5.7 - 6.5%

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2
Q

Diabetic Ketoacidosis level
DKA

A

Blood glucose. >500mg/dL

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3
Q

Symptoms of Hypoglycemia

A

Irritability
Shaky
+ Pulse
Weakness
Confusion
Tremor
Sweating
Hypothermia
Seizures
Death

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4
Q

Hypoglycemia blood level

A

Blood glucose. <50 my/dL

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5
Q

Treatment for Hypoglycemia

A

Dextrose IV
Glucagon IM, Sub Q
Oral glucose gel or tablets

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6
Q

Types of Rapid Acting Insulin

A

aspart (NovaLog) -clear
lispro (Humlog) -clear
gluslisine (Apidra) -clear

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7
Q

Onset, Peak, Duration Rapid Acting

A

Rapid onset 15 min
Peak 1-2hrs
Shortest duration 3-5hrs
Keep food in the room

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8
Q

Nursing Implications for Rapid Acting Insulin

A

Sub Q
Insulin Pump
5 min before meals
Keep food in room

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9
Q

Types of Short Acting Insulin

A

Regular Insulin (Humulin R, Novolin R) clear

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10
Q

Onset, Duration, Peak for Short Acting Insulin

A

Onset 30-60min (double of rapid)
Peak- 2.5 hrs
Duration 6-10 hrs

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11
Q

Nursing Implications for short acting

A

Sub Q
IV
30 min before meals
Sliding scales
Don’t adjust levels quickly 30-50/hr

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12
Q

Types of Intermediate Acting Insulin

A

insulin isoprene suspension (NPH)
Humulin N
Novolin N
All cloudy

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13
Q

Onset and Peak for Intermediate Acting Insulin

A

Onset 1-2 hrs
Peak of 4-8 hrs

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14
Q

Nursing Implications

A

Sub Q
30-60 min before meals
Often premixed with regular insulin

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15
Q

Types of Long Acting Insulin

A

glargine (Lantus) clear -most common
detemir (Levemir) cloudy
degludec (Tresiba) cloudy

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16
Q

Onset of Long Acting Insulin

A

Onset 1-2 hrs
Give at night to stabilize sugars

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17
Q

Nursing Implications for Long acting insulin

A

Sub Q
Once day dosing at night
Don’t mix injection

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18
Q

Combination Insulin

A

NPH & Regular (Humulin 70/30, Novolin 70/30)

NPH & Regular (Humulin 50/50)

Lispro Protamine & Lispro
(Humalog Mix 75/25) Food in room

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19
Q

Insulin Storage

A

Room Temp for 90 days
Avoid sun & heat
Refrigerator if more than 90 days
Check color (abnl cloudiness)

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20
Q

Define Lipohypertrophy

A

Scar tissue- rotate sites

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21
Q

With the Insulin Pump the needle is changed

A

Needle changed every 3 days

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22
Q

A large amount of what is dangerous in children?

A

Iron

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23
Q

Fat soluble vitamins

A

A, D, E, & K

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24
Q

Water soluble vitamins

A

B & C

25
Q

Hypervitaminosis occurs mostly in what type of vitamins?

A

Fat soluble
(A, D, E, K)

26
Q

Vitamin A

A

aka retinol
Fat soluble
Helps adapting to dim light
For bone growth and teeth

Low Vit A- night blindness, dry skin

Toxicity- Can cause birth defects
- + risk of hip fx
- watch for cirrhosis & hep

27
Q

Vitamin D

A

Regulates metabolism of calcium & phosphorus
Fat soluble
Sun exposure

Deficiency- Rickets & osteomalacia
toddlers bones are soft

Toxicity- hypercalcemia, HTN, anorexia

28
Q

Vitamin D levels and dosing

A

50 ng/mL
D2 (ergocalciferol) plant based
D3 (calcifedol) animal source

29
Q

Vitamin E

A

aka Alpha-Tocopherol
Fat soluble
+ risk for bleeding
Not indicated for 50yrs +

Deficiency- preemies
Toxicity- difficult to reach

30
Q

Vitamin K

A

aka phytonadione
Fat soluble
For synthesis for PT & other clotting factors
Food source- green leafy vegetables

Deficiency- + risk of bleeding
Infants + risk of intracranial hemorrhage

31
Q

Vitamin K routs

A

IM - newborns
Orally- stabilizes ♥️ plaque
IV- careful! Risk for HTN, Dyspnea cardiac arrest
Reduces warfarin and Coumadin

32
Q

Water soluble vitamins

A

B1= Thiamine
B2= Riboflavin
B3= Niacin
B5= Pantothenic Acid
B6= Pyridoxine
B7= Biotin
B9= Folate
B12= Cobalamin
C= Absorbic Acid

33
Q

Vitamin C

A

aka ascorbic acid
Water soluble
Production of collagen, absorption of iron
Deficiency- Scurvey, lose teeth, gingivitis, poor wound heeling
Adverse- nausea, abd cramps, renal stones

34
Q

metformin

A

aka Glucophage
DM Rx
Give during meals

If taken with Iodine contrast= renal failure & lowes ox in cells
-Stop rx 48hrs before & after procedure

35
Q

glipizide

A

aka Glucotrol
DM rx
30 min before meals
In Sulfa family
Watch for Jaundice & weight gain

36
Q

repaglinide

A

aka Prandin
DM rx
Skip the rx if you skip meal

37
Q

pioglitazone

A

aka Actos
DM RX
side effects- edema & weight gain
Don’t give if they have ♥️ failure, liver, or kidney disease

38
Q

acarbose

A

aka Precose
DM Rx
Take with first bite of food

39
Q

procaine

A

aka Novocain
local anesthetic
Lasts 2-5 min

40
Q

lidocaine

A

aka Xylocaine, EMLA
local anesthetic
1/2 life of 90 min
Can use in combo of epinephrine

41
Q

bupivicaine

A

aka Marcaine
Local anesthetic
longest duration of 3-9hrs
Epidural for 🤰🏽
Spinal anesthesia —— HA’s

42
Q

benzocaine

A

aka Oragel
local anesthetic
Don’t use in infants

43
Q

propofol

A

aka Diprivan
IV general anesthesia
Rapid onset
decrease agitation
Don’t take at home
Killed MJ

44
Q

ketamine

A

aka Ketalar
IV general anesthesia
Disconnected from environment
Hallucinations, dilerium, combative
Use diazepam before ketamine
Less sx if younger than 15yrs old
For induction of anesthesia 🦴

45
Q

Nitrous oxide

A

Laughing gas
Not used as primary anesthetic
Doesn’t cause respiratory or cardiac depression
-Dental procedures
N/V post-op (wash face after)

46
Q

sevoflurane

A

aka Ultane
Inhaled anesthetic
Rapid onset
For inducing anesthesia
Doesn’t leave pt drowsy

47
Q

Liquids that you inhale for anesthesia have what suffix?

A

-ane

48
Q

What is Malignant hyperthermia

A

Deadly temperature
Genetically linked to anesthetic
Muscle rigidity, tachycardia

49
Q

What do you do for malignant hyperthermia

A

Give Dantrolene to relax muscles
Cool IV fluids
Cool blanket
APAP and IBU will not work

50
Q

Neuromuscular blocking drugs have what suffix?

A

-onium

51
Q

succinylcholine
(Sucks to be you)

A

aka Anectine
For tracheal intubation
Relaxes all muscles
Careful if family Hx of hyperthermia
Antidote- neostigmine

52
Q

Other neuromuscular blocking drug

A

rocuronium (Rock)
code cart
For intubation

53
Q

Vitamin B1

A

aka Thiamine
Coenzyme for carb metabolism
Deficiency- Beriberi
Wernicks encephalopathy
For alcoholics- banana bay

54
Q

Vitamin B2

A

aka rivoflavin
For en Tem reactions
Deficiency-glossitis, cracked lips

55
Q

Vitamin B3

A

aka Niacin or Nictinic Acid
- can reduce LDL
Adverse effects- vasodilation, dizziness, nausea
Deficiency- red rash in sun areas

56
Q

Vitamin B6

A

aka Pyridoxine
Peripheral neuritis (tingling)
Deficiency- Alcoholics and DM can get a red rash on face, looks like acne

57
Q

Vitamin B9

A

aka Folic Acid
For cell growth, decreases birth defects
Deficiency- neural tube defects

58
Q

Vitamin B12

A

aka cyanocobalamin
For carb metabolism and protein synthesis needed to make RBC
Deficiency- anemia

Pharm (5 decks)

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