HARD TIME Flashcards
Which antiparkinsonian drug is contraindicated in hot weather/ exercise?
Benztropine/ antichollinergic
Which antiparkinsonian drug is contraindicated in angle-closure glaucoma?
Levodopa (DOPAMINE REPLACEMENT DRUGS)
Which antiparkinsonian drug is contraindicated in ischemic/ PVD and erythromycin?
bromocriptine (non dopamine dopamine receptor agonists)
Which antiparkinsonian drug is contraindicated to antichollinergic drugs?
amantadine and antichollinergic (benztropine)
What is contraindicated to selegiline and rasagiline?
Meperidine
Which antihyperglycemic medication can cause hypoglycemia when given with DPP4 enzymes?
Sulfonylureas
Which antihyperglycemic medication increases HDL and LDL?
Sodium-glucose cotransporter 2 inhibitor (dapagliflozin)
Drugs that cause hyperglycemia when given with insulin? (antagonizes insulin)
corticosteroids
diuretics
sympathomimetic
niacin
thyroid drugs
Drugs that cause hypoglycemia when given with insulin?
alcohol
sulfa antibiotics
anabolic steroids
MAOIs
salicylates
Drugs that mask hypoglycemia symptoms when given with INSULIN?
non-selective beta blockers
Functions of the drug INSULIN
metabolize carbohydrates, fats, and proteins
stores glucose in the liver
convert glycogen into fat stores
substitute for endogenous insulin
Does not reverse defects in insulin receptors
OA and malnourished patients may adversely affect which antihyperglycemic medication?
Biguanides
What is important to note when giving sulfonylureas and glinides?
Baseline glucose
Conditions that may predispose patients to hypoglycemia [drop in caloric intake, alcohol use, exercise]
Allergy to sulfonamides
Not allowed in patients with type 1 diabetes
What is a major contraindication in thiazolidinediones/ glitazones?
Class III or IV heart failure
Contraindication for a glucosidase inhibitor
IBS
Malabsorption
Incretin mimetics are used to treat?
Typer 2 diabetes
Poor control with metformin, sulfonylutreas, or glitazones
Glucagon injection may induce?
vomiting so assess for LOC and prevent aspiration
If insulin is is to be used within 1 month
it may be stored at room temperature
administer at room temperature
angle to administer insulin?
90 degrees unless they are emaciated (thin) do 45 degrees
Injecting air into vial process of mixing insulin?
Inject air into intermediate-acting acting then into rapid-acting
BUT always draw up rapid/ regular acting insulin first then intermediate acting (clear before cloudy)
If lispro is mixed with NPH, when would you give it?
give combination 15 minutes before meals because lispro has an onset of 10 to 15 minutes.
When to give (meals) in intermediate-acting insulin with an onset of 1 to 2 hours?
meals should be given 30 to 45 minutes prior to administration
In hospital settings, give insulin when?
when tray arrives
How often to check glucose when a patients is on SC?
every 4 hours, 6, or several times per day to obtain fasting/ preprandial glucose levels
Used in variable caloric intake, drastic changes to glucose levels due to infections/ stress, receives TPN
Insulin in BBT
Long acting
Rapid acting
Oral antihyperglycemic are usually given __ minutes before meals?
30 minutes
Glitazones adverse effect
It causes weight gain/ edema so weigh patients
Incretin mimetics (exenatide) are not given with?
Insulin
Sitagliptin (DPP 4 I) is not given with?
May be given with or without?
Insulin
Food
Key diagnostic criterion of hyperglycemia
Fasting glucose: greater than 7mmol/L
Non-fasting glucose: greater than 11.1 mmol/L
A1C of equal to/ greater than 6.5%
[A1C of 6.5% is the threshold for micro and macrovascular complications]
Diabetes Canada Reccomends
A1C of less than 7%
F PG of 4 to 7 mmol/L
2 hour postprandial of 5 to 10 mmol/L