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Pharm NUR140 > Exam 4 Blueprint Based Cards > Flashcards

Exam 4 Blueprint Based Cards Flashcards

1
Q

Hypoglycemia Signs and Symptoms

A

Shakiness and Dizziness

Sweating

Hunger

Headaches

Muscle weakness

Blurry or double vision

Convulsions or Seizures

Unconsciousness

Death

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2
Q

Hyperglycemia Signs and Symptoms

A

Frequent urination

Increased thirst

Fruity-smelling breath

Dry mouth

Shortness of breath

Abdominal pain

Coma

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3
Q

What is the Somogyi Effect?

A

The Phenomenon occurs when you take insulin before bed and wake up with high blood sugar levels

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4
Q

Blood Glucose Diagnostic Testing

A

Blood test,

Glucose Test,

Hemoglobin A1C,

Clinical urine tests

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5
Q

Glyburide (DiaBeta) MOA

A

Hypoglycemia action of glyburide results from the stimulation of pancreatic beta cells

Drug is Protein bound

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6
Q

Glyburide (DiaBeta) Adverse Effects

A

Hypoglycemia,

Anorexia,

Nausea and Vomiting,

Heartburn,

Metallic taste in the mouth

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7
Q

Glyburide (DiaBeta) Patient Teaching

A

Teach about diabetes management

Teach patients and families the signs and symptoms of hypoglycemia

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8
Q

Glyburide (DiaBeta) Nursing Actions

A

Administer before first main meal of the day

Monitor the patient’s blood glucose levels periodically throughout therapy to detect hypoglycemia.

Monitor patients with renal and hepatic impairment for signs of adverse effects

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9
Q

Metformin (Glucophage) MOA

A

Decreases hepatic glucose production,

Decreases intestinal absorption of glucose,

Improves insulin sensitivity by increasing peripheral glucose uptake

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10
Q

Metformin (Glucophage) Adverse Effects

A

Anorexia,

Nausea and Vomiting,

Weight loss,

Abdominal discomfort,

Dyspepsia,

Flatulence,

Diarrhea,

Metallic taste sensation

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11
Q

Metformin (Glucophage) Nursing Actions

A

Administer twice a day with morning and evening meal.

Adherence with recommended diet and daily exercise help in control of type 2 diabetes

Taking the drug at mealtimes and using gradual dosage increments minimize these effects

Monitor blood glucose levels:
Fasting Glucose
Hemoglobin A1C

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12
Q

Metformin (Glucophage) Patient Teaching

A

Teach patients to take with meals, morning and evening

Emphasize that patients should not use alcohol while taking metformin

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13
Q

Repaglinide (Prandin) MOA

A

Repaglinide lowers blood glucose by stimulating the release of insulin from the beta islet cells of the pancreas.

This depolarizes the beta cells, opening the cells’ calcium channels,.

The resulting calcium influx induces insulin secretion.

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14
Q

Rosiglitazone (Avandia)

MOA

A

Rosiglitazone improves glycemic control by improving insulin sensitivity.

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15
Q

Pioglitazone (Actos) MOA

A

Pioglitazone decreases insulin resistance in the periphery and in the liver resulting in increased insulin-dependent glucose disposal and decreased hepatic glucose output.

Unlike sulfonylureas, pioglitazone is not an insulin secretagogue.

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16
Q

Acarbose (Precose) MOA

A

Acarbose is a complex oligosaccharide that delays the digestion of ingested carbohydrates, thereby resulting in a smaller rise in blood glucose concentration following meals..

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17
Q

Glipizide MOA

A

Glipizide partially blocks potassium channels among beta cells of pancreatic islets of Langerhans.

By blocking potassium channels, the cell depolarizes, which results in the opening of voltage-gated calcium channels.

The resulting calcium influx encourages insulin release from beta cells.

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18
Q

Glipizide Drug Class

A

Sulfonylureas

Second generation

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19
Q

Glipizide Adverse Effects

A

Hypoglycemia

Nausea and Vomiting

Epigastric discomfort

Heartburn

Anorexia

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20
Q

Glipizide Drug-Drug Interactions

A

Beta-blockers

Alcohol

Any drug that acidifies urine

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21
Q

R Insulin MOA

A

Injected insulin mimics the effect of endogenous insulin

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22
Q

R Insulin Indications

A

All types of diabetes mellitus

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23
Q

R Insulin Contraindications

A

Hypoglycemia

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24
Q

R Insulin Drug-Drug Interactions

A

Alcohol,

Beta blockers,

Dobutamine,

Niacin,

MAOIs,

Thiazide Diuretics,

Tetracycline

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25
Q

R Insulin Nursing Actions

A

Evaluate ability to administer insulin.

Monitor fasting blood glucose and hemoglobin A1C levels.

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26
Q

R Insulin Patient Teaching

A

Discuss how to administer insulin properly,

Discuss storage of insulin,

Discuss side effects of therapy

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27
Q

Levemir Insulin Nursing Interventions

A

Levemir (insulin detemir) cannot be mixed in solution with any other drug, including other insulins

Levemir is given in the evening.

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28
Q

Levemir Insulin Patient Teaching

A

Rotate injection sites regularly

Monitor urine or blood levels for ketones and glucose

Wear medical alert tag

Avoid alcohol

Report fever, sore throat, vomiting, hypoglycemic or hyperglycemic reactions, rash

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29
Q

Glucagon MOA

A

Increases blood glucose levels by stimulating glycogenolysis in the peripheral tissues

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30
Q

Glucagon Indications

A

Hypoglycemia (first line of defense)

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31
Q

Glucagon Contraindications

A

Pregnancy Category B

Hypersensitivity,

Heart disease,

Migraines,

Glaucoma

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32
Q

Glucagon Adverse Effects

A

Hypotension,

Respiratory distress,

Nausea and Vomiting

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33
Q

Glucagon Drug-Drug Interactions

A

Blood thinners (Warfarin),

Beta-Blockers

Thiazide Diuretics

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34
Q

Glucagon Nursing Interventions

A

Administer supplemental carbohydrates ASAP once consciousness has been achieved

Use reconstituted glucagon immediately

A dose of 0.5 to 1.0 mg is usually effective

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35
Q

Glucagon Patient Teaching

A

Emphasize to patients and family members measures to prevent hypoglycemic reactions from insulin.

Instruct family members in the proper technique for emergency administration of glucagon.

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36
Q

Portable Insulin Pump Function

A

small, computerized devices that mimic the way the human pancreas works by delivering small doses of short acting insulin continuously (basal rate)

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37
Q

Portable Insulin Pump Use

A

used to deliver variable amounts of insulin when a meal is eaten (bolus)

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38
Q

Novolog Onset

A

10-20 minutes

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39
Q

Novolog Peak

A

40-50 minutes

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40
Q

Novolog Duration

A

3-5 hours

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41
Q

Humalog Onset

A

15-30 minutes

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42
Q

Humalog Peak

A

30-90 minutes

43
Q

Humalog Duration

A

3-5 hours

44
Q

Novolin R Onset

A

30 minutes - 1 hour

45
Q

Novolin R Peak

A

2-5 hours

46
Q

Novolin R Duration

A

5-8 hours

47
Q

Humulin N Onset

A

1-2 hours

48
Q

Humulin N Peak

A

4-12 hours

49
Q

Humulin N Duration

A

18-24 hours

50
Q

Novolin N Onset

A

1-2 hours

51
Q

Novolin N Peak

A

4-12 hours

52
Q

Novolin N Duration

A

up to 24 hours

53
Q

Insulin Glargine (Lantus, Basaglar, Toujeo) Onset

A

1 - 1.5 hours

54
Q

Insulin Glargine (Lantus, Basaglar, Toujeo) Peak

A

Does not have a peak time.

Insulin is delivered at a steady rate

55
Q

Insulin Glargine (Lantus, Basaglar, Toujeo) Duration

A

up to 24 hours

56
Q

Thyroid Hormones

A

Tetraiodothyronine or levothyroxine (T4)

Triiodothyronine or liothyronine (T3)

57
Q

Thyroid Hormone Function

A

Removes iodine from the blood, concentrates it, and prepares it for attachment to tyrosine, an amino acid

58
Q

What is PTH?

A

The parathyroids produce a hormone called parathyroid hormone (PTH).

59
Q

PTH Function

A

Raises the blood calcium level by breaking down the bone and causing calcium release which increases the body’s ability to absorb calcium from food

60
Q

Hypothyroidism Signs & Symptoms

A

Dry and Coarse Skin,

Fatigue,

Weight Gain,

Bradycardia,

Depression,

Muscle Weakness,

Increased sensitivity to cold,

Hypotension

61
Q

Hyperthyroidism Signs and Symptoms

A

Moist & Thin Skin, Insomnia, Weight Loss, Tachycardia, Restlessness, Hyperactive Reflexes, Heat intolerance, Systolic Hypertension

62
Q

Levothyroxine (Synthroid) Pharmacotherapeutics

A

Used as a replacement therapy for hypothyroidism

63
Q

Levothyroxine (Synthroid) Pharmacokinetics

A

Administered: Oral,

Metabolism: Liver,

Excreted: Bile,

Onset: 6-8 hours

64
Q

Levothyroxine (Synthroid) Pharmacodynamics

A

Acts as a replacement for natural thyroid hormone

65
Q

Levothyroxine (Synthroid) Contraindications and Precuations

A

Hypersensitivity,

Thyrotoxicosis,

Acute MI complicated by hypothyroidism

66
Q

Levothyroxine (Synthroid) Adverse Effects

A

Hypertension,

Tachycardia,

Arrhythmias,

Anxiety,

Headache,

Nervousness,

GI irritation,

Sweating,

Heat intolerance

67
Q

Levothyroxine (Synthroid) Drug Interactions

A

Many drugs including: antacids, anticonvulsants

68
Q

Levothyroxine (Synthroid) Maximizing Therapeutic Effects

A

Replacement therapy is a lifelong occurrence, During drug therapy, monitor cardiovascular response and serum thyroid function

69
Q

Levothyroxine (Synthroid) Minimizing Adverse Effects

A

Young adults without evidence of CAD can begin a full replacement dose

70
Q

Levothyroxine (Synthroid) Patient and Family Education

A

Explain the purpose of drug therapy, Advise patients to avoid OTC drugs

71
Q

Levothyroxine (Synthroid) Ongoing Assessment and Evaluation

A

Monitor serum thyroid hormone levels periodically

72
Q

Methimazole (Tapazole) Pharmacotherapeutics

A

Palliative treatment of hyperthyroidism

73
Q

Methimazole (Tapazole) Pharmacokinetics

A

Administered: Oral,

Metabolism: Liver,

Excreted: Kidneys

74
Q

Methimazole (Tapazole) Pharmacodynamics

A

Inhibits the synthesis of thyroid hormones

75
Q

Methimazole Contraindications and Precautions

A

Hypersensitivity to the drug

76
Q

Methimazole (Tapazole) Adverse Effects

A

Hives, Itching, Rash, Fever, Arthralgia, Joint swelling, Vertigo, Drowsiness, Nausea and Vomiting, Altered taste sensation

77
Q

Methimazole (Tapazole) Drug Interactions

A

Beta-Blocking Agents, Theophylline, Warfarin

78
Q

Methimazole (Tapazole) Maximizing Therapeutic Effects

A

Ensure drug is being administered appropriately

79
Q

Methimazole (Tapazole) Minimizing Adverse Effects

A

During drug therapy arrange for periodic blood tests to monitor for hematologic and thyroid functions, Monitor the patient’s bone marrow function

80
Q

Methimazole (Tapazole) Patient and Family Education

A

Explain purpose of therapy, If drug is taken in divided doses instruct patients to taken them every eight hours around the clock

81
Q

Methimazole (Tapazole) Ongoing Assessment and Evaluation

A

Monitor serum thyroid hormone levels periodically to evaluate the effectiveness of MMI and to assess the need for replacement thyroid hormone because the thyroid gland is suppressed

82
Q

Lugol’s Solution (Strong Iodine Solution) Action

A

Reduces the size and vascularity of the thyroid gland

83
Q

Lugol’s Solution (Strong Iodine Solution) Indication

A

Reduce Thyroid Storm Use before surgery

84
Q

Radioactive Iodine Therapy (Iodine 131) Indications

A

Thyroid Cancer, Alternate for patients who cannot have surgery

85
Q

Radioactive Iodine Therapy (Iodine 131) Pregnancy Category

A

X (Contraindicated)

86
Q

Calcitonin Salmon (Miacalcin) Pharmacotherapeutics

A

Treatment of symptomatic Paget disease

87
Q

Calcitonin Salmon (Miacalcin) Pharmacokinetics

A

Administered: SC, IM, or Intranasal, Metabolism: Kidneys, Excreted: Kidneys

88
Q

Calcitonin Salmon (Miacalcin) Pharmacodynamics

A

A synthetic polypeptide with essentially the same actions as calcitonin

89
Q

Calcitonin Salmon (Miacalcin) Actions

A

Inhibits bone reabsorption, Lowers elevated serum calcium in children and patients with Paget’s disease, Increases the excretion of filtered phosphate, calcium, and sodium by the kidneys

90
Q

Calcitonin Salmon (Miacalcin) Contraindications and Precautions

A

Pregnancy Category: C,

Should not be used during lactation,

Should not be used with a known allergy to salmon or fish products,

Be used with caution in patients with renal dysfunction and pernicious anemia

91
Q

Calcitonin Salmon (Miacalcin) Adverse Effects

A

Flushing of face and hands,

Nausea and Vomiting

Local inflammatory reactions at the injection site,

Nasal irritation if the nasal form is used

92
Q

Calcitonin Salmon (Miacalcin) Drug Interactions

A

No clinically important reactions

93
Q

Calcitonin Salmon (Miacalcin) Maximizing Therapeutic Effect

A

Ensure adequate hydration

Provide comfort measures and analgesics

94
Q

Calcitonin Salmon (Miacalcin) Minimizing Adverse Effects

A

Rotate injection sites and monitor for inflammation

Monitor serum calcium regularly

95
Q

Calcitonin Salmon (Miacalcin) Patient and Family Education

A

Discuss adverse effects and how to avoid them Discuss warning signs of problems Discuss need for regular evaluation if used for longer than recommended

96
Q

Calcitonin Salmon (Miacalcin) Ongoing Assessment and Evaluation

A

Monitor patient response to drug

Evaluate the effectiveness of the teaching plan

Monitor the effectiveness of comfort measures and compliance with the regimen

97
Q

In which of the following ways does the thyroid gland use iodine found in the body? A. To stimulate the production of TSH B. To produce the thyroid hormones C. To regulate parathyroid production D. To destroy part of the thyroid gland

A

B. To produce the thyroid hormones

The thyroid gland uses iodine to produce the thyroid hormones that regulate body metabolism. Control of the thyroid gland involves an intricate balance among TRH, TSH, and circulating levels of thyroid hormone.

98
Q

Paget’s Disease is a genetically-linked disorder. It’s a condition that involves overactive osteoclasts that are eventually replaced by enlarged and softened bony structures. WHAT ARE THE CLINICAL MANIFESTATIONS OF PAGET’S DISEASE? A. Deep bone pain B. Increased hearing acuity C. Increased visual acuity D. Cardiac arrhythmias

A

A. Deep bone pain

Patients who have Paget’s Disease report deep bone pain, headaches, and hearing loss and usually have cardiac failure and bone malformation

99
Q

True or False The hormones PTH and calcitonin work together to maintain a delicate balance of serum calcium levels in the body and also to keep serum calcium levels within normal range

A

True

Renal tubular phosphate reabsorption is balanced by calcium secretion into the urine, which causes a drop in serum calcium which in turn stimulates PTH secretion.

100
Q

What percentage of the US population has diabetes mellitus? A. 3% B. 7% C. 14% D. 21%

A

B. 7%

Diabetes mellitus is a common chronic disease that affects 20.8 million people in the United States, or 7% of the population

101
Q

What Subcutaneous site provides the most rapid absorption of insulin therapy? A. Arm B. Abdomen C. Buttocks D. Thigh

A

B. Abdomen

The most rapid absorption occurs when administration is into the abdominal SC layer. It is as much as 50% faster than other routes.

The next most rapid is into the (A) arm, followed by the (D) thigh, and finally the (C) buttocks.

102
Q

True or False The mechanism of action of GLYBURIDE is the decreased production of insulin by the liver, which results in decreased blood glucose levels.

A

False

The mechanism of action of glyburide is the stimulation of the beta cells in the pancreas. The hypoglycemic action of glyburide results from the stimulation of pancreatic beta cells.

103
Q

What is the usual dose given of glucagon? A. 0.5-1 mg B. 2.5-5 mg C. 7.5-10 mg D. 12.5-15 mg

A

A. 0.5-1 mg

Pharm NUR140 (5 decks)

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