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Pharm Test 3 > insulins > Flashcards

insulins Flashcards

1
Q

Regular insulin compatible with

A

All insulins except glargine and glulisine

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2
Q

Insuline detemir compatible with

A

Must be given alone

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3
Q

insulin isophane suspension (NPH) when do you administer

A

30-45 min after meal.

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4
Q

Adverse effects of insulin

A

shock, death, weight gain, lipodystrophy at injection site

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5
Q

Drug that antagonize hypoglycemic effect insulin

A

Corticosteroids, niacin, thiazide, loop diuretics, thyroid hormone, sympathomometics

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6
Q

which insulin should not be used in breast-feeding women

A

Insuline glargine(lantus)

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7
Q

drugs that increase insulins hypoglycemic effect

A

Alcohol, anabolic steroids, slufa drugs, MAOI,salicylates

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8
Q

how do non-slective beta blockers interact w/insulin

A

mask the tachycardia from hypoglycemia

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9
Q

when do you give reg. insulin

A

30-60 min before a meal or on a sliding scale

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10
Q

when do you give long acting insulin glargine

A

only once or twice daily dosing

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11
Q

Reg insulin: duration

A

short acting

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12
Q

Insulin Gargine (lantus) duration

A

Long-acting

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13
Q

Insulin detemir (Levemir) duration

A

Intermediate

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14
Q

Insulin idophane suspension (NPH) duration

A

current only available intermediate-acting insulin

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15
Q

Reg insulin onset, peak

A

30-60 min, 2.5hr

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16
Q

Insulin isophane suspension (NPH) onset, peak

A

1-2hr, 4-8 hr

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17
Q

insulin glargine onset, peak

A

1-2hr, none

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18
Q

most common oral drug for type 2 diabetes

A

metformin (glucophage)

19
Q

How does Metformin work

A

decrease glucose production by liver and decrease intestinal absorption of glucose and improve insulin receptor sensitivity

20
Q

Contraindications for metformin

A

renal disease (metformin excreted by kidney=accumulation and lactic acidosis) Also Alcoholics, liver disease, heart failure, cardiopulmonary disease

21
Q

AE: metformin

A

GI problems: bloating, nausea, crampin, feeling of fullness, diarrhea effects usually self-limiting less SE when start w/ low dose Decreased absorbtion of Vit B12 and folic acid

22
Q

less common SE metformin

A

metal taste in mouth and reduced vit B12 levels

23
Q

Interactions w/metformin

A

radiology dyes=renal failure and lactic acidosis, also interacts w/cimetidine, digoxin, propranolol

24
Q

pioglitazone (Actos) is what class of drug

A

Thiazolidinediones

25
Q

How does piogliazone work?

A

reduce insulin resistance by enhancing the sensitivity of insulin receptors also directly stimulate peripheral glucose uptake and storage, as well as inhibit glucose and triglyceride production in liver.

26
Q

Pioglitazone indications

A

Type 2 diabetes: high cost, lost of AE, and slow onset=reserved for pt who can’t tolerate glucose control w/ metformin

27
Q

only thiazolidinediones approved for use w/ insulin

A

pioglitazone

28
Q

AE: pioglitazone

A

increase risk for Heart fail, peripheral edema, weight gain, reduced bone mineral density, increased risk of fracture, increased MI

29
Q

interactions w/pioglitazone

A

serum concentrations inc. w/ CYP3A4 inhibitor such as erythromycin and ketoconazole

30
Q

How does arcbose (Precose) work

A

delays glucose absorption

31
Q

How do you administer arcbose (Precose)

A

must be administered w/ food

32
Q

Contraindications for arcbose (Precose)

A

many adverse GI effects. inflammatory bowel disease, intestinal obstruction, malabsorption syndrome

33
Q

AE: arcbose (Precose)

A

flatulance, diarrhea, abdominal pain NO Hypoglycemia or weight gain.

34
Q

glipizide (Glucotrol)duration

A

rapid onset, short duration

35
Q

glipizide (Glucotrol) contraindicated

A

drug allergy, type 1 brittle diabetes, NOT contraindicated for renal failure

36
Q

glipizide (Glucotrol) when to dose

A

30 min before meal

37
Q

Sitagliptin (Junuvia) indications

A

mgmt of type 2 diabetes as monotherapy or a combination but NOT with insulin

38
Q

drug interactions w/Sitagliptin (Junuvia)

A

Sulfonylurea cause hypoglycemia

39
Q

AE Sitagliptin (Junuvia)

A

none

40
Q

treat hypoglycemia with

A

Iv glucose or sub-Q glucagon

41
Q

Nurse action prior to admin glucagon

A

roll pt. to side because they will most likely vomit.

42
Q

which insulin should be withdrawn first? Reg. or NPH.

A

clear (reg or rapid acting) followed by NPH (intermediate)

43
Q

oral anti-diabetic meds administered when

A

30 min before meal

44
Q

pt. on metformin undergoing test w/contrast dye

A

must dicontinue metformin prior to test and restart after test and evaluation of renal status

Pharm Test 3 (9 decks)

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