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Pharm > Glucose > Flashcards

Glucose Flashcards

1
Q

What are examples of short acting insulins?

A

Insulin lispro
Insulin aspart
Insulin glulisine

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2
Q

What insulin is intermediate?

A

Isophane insulin suspension

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3
Q

Which insulins are long acting?

A

Regular insulin
Insulin glargine
Insulin determir

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4
Q

What does regular insulin do?

A

Replaces endogenous insulin to lower blood sugar

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5
Q

Why do you rotate a site with children who take regular insulin?

A

Lipodystrophy

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6
Q

What do viral infections cause in children with diabetes?
Bacterial/chronic?

A

Hypoglycemia
Hyperglycemia

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7
Q

What are some important things to know about older adults who take regular insulin?

A

Worsening renal function can cause hypoglycemia
Hepatic impairment can cause hypoglycemia too

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8
Q

Regular insulin assessment

A

A1C
Check injection site (dimpling if sites aren’t rotated)

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9
Q

Symptoms of hyperglycemia?

A

Polyuria
Polydipsia
Polyphagia

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10
Q

What decreases the absorption of insulin?

A

Lesions from injection
Limb with low blood flow
Injecting cold insulin

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11
Q

What increases the absorption of insulin?

A

Using limb that insulin was injected in

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12
Q

What drug class is Glipizide?

A

Sulfonylureas

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13
Q

What does glipizide do?

A

Stimulates the release of insulin from beta cells in the pancreas

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14
Q

Adverse effects of glipizide?

A

Hypoglycemia
Leukopenia
Thrombocytopenia
Anemia

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15
Q

Contraindications for glipizide?

A

Severe renal/hepatic impairment
Allergy to sulfa based meds
Not for type 1 diabetes

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16
Q

Monitoring for glipizide?

A

Glucose levels
A1C
CBC
anemia, leukopenia, thrombocytopenia

17
Q

Glipizide teaching

A

Take 30 minutes before breakfast

18
Q

Meds that increase insulin requirements

A

Steroids
Epi
Levothyroxine
Thiazide diuretics
Birth control pills/estrogens

19
Q

Other things that increase insulin requirements

A

Acute infection
Hypokalemia
Hyperadrenocorticoism
Hyperparathyroidism

20
Q

Things that decrease insulin requirements

A

Dx of steroids, epi, levothyroxine, thiazide diuretics
Hypothyroidism

21
Q

What drug class is Metformin in?

A

Biguanide

22
Q

What does metformin do?

A

Reduces glucose production in the liver
Decreases intestinal absorption of insulin which increases insulin sensitivity

23
Q

Special age considerations for metformin?

A

Children need a gradual dose increase

BBW: don’t give to those over 80 due to lactic acidosis risk

24
Q

Metformin considerations for renal disease?

A

Dx at least 48 hours before radiographic study with CONTRAST and assess renal function

Taking Metformin during radiographic study can cause lactic acidosis and renal failure

25
Q

Adverse effects of Metformin?

A

Lactic acidosis

26
Q

Who can’t have Metformin?

A

Diabetes w/fever
Liver impairment
Severe infection/trauma
Major surgery
Acidosis
Pregnancy
Respiratory insufficiency
Conditions that cause LA

27
Q

Metformin drug interactions?

A

Furosemide
Sulfonylureas (glipizide)
Alcohol
Vanco

All increase risk of hypoglycemia

28
Q

Metformin assessment

A

A1C numbers improving
Skin (itching/rash)
N/v

Long term: liver and renal function, lactate and glucose levels

29
Q

Signs of lactic acidosis

A

Drowsiness, respiratory distress
Levels under 7.35
Hypotension and bradycardia

30
Q

Metformin teaching

A

Decrease dose or increase food intake when vigorously exercising

Dx 48 hours before study with contrast

31
Q

What drug class is Sitagliptin?

A

Dipeptidal peptidase 4 inhibitor

32
Q

What does sitagliptin do

A

Promotes glycemic control by increasing/lengthening release and of insulin and decreasing hepatic glucose production

33
Q

What is sitagliptin used for?

A

DM II with exercise and diet
Can be used with metformin

34
Q

Caution consideration with sitagliptin?

A

Caution with renal imx because it’s excreted renally

35
Q

Adverse effects of sitagliptin

A

Acute pancreatitis
Acute renal failure
Upper respiratory infection

36
Q

Contras for sitagliptin

A

Type 1 diabetes
Insulin use
Ketone production in urine
End stage renal disease

37
Q

Sitagliptin assessment

A

A1C

Stomach pain and elevated amylase and lipase levels (pancreatitis)

Renal function

38
Q

Sitagliptin teaching

A

Report abdominal pain and signs of heart/renal failure

Pharm (9 decks)

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