Medication Exam - Endocrine and GU Drugs

Question 1

Humulin R - insulin - rapid acting - bolus

Clear

Humulin N - insulin - intermediate acting - basal

Cloudy

Treatment of Type 1 DM

Answer 1

Rotate injections - reduce lipodystrophy

Best is abdomen

Avoid injecting SC tissue adjacent to main muscles being used in exercise

Store unopened insulin in fridge

Room temp for 28 days -in use vials and cartridge

Avoid freezing and direct sunlight

When mixing: R and N may be premixed and stored together - always draw Quick acting insulin first

Monitor hypo and hyperglycemia

Question 2

Oral hypoglycemics - Merformin - Biguanide

Often first drug to prescribe

Type 2 DM

AE:
Nausea
Diarrhea
Lactic acidosis

Answer 2

Take with food

Monitor lactic acidosis (very rare) - accumulation of serum lactate - lowers pH of blood

Monitor for weakness, malaise, fatigue, myalgia, heavy laboured breathing

Question 3

Oral hypoglycemic - Sulfonurea - Glyburide

AE:
Hypoglycemia
Wt gain
Nausea
Radh
Hepatotoxicity

Answer 3

Don’t take alcohol

Avoid in elderly - more susceptible to hypoglycemia

Question 4

Diabetes monitoring

Answer 4

BGM - take at right time

Hemoglobin A1C every 3 mos

Monitor for signs of hypo and hyperglycemia

BP and pulse

Kidney fxn - nephropathy complications

Vision

Liver enzymes - some meds cause hepatotoxicity

Educate lifestyle modifications

Ensure insulin and meds are given appropriately

Question 5

Prednisone - Corticosteroid - immediate acting

Use short term whenever possible

Monitor head to toes

Watch for secondary infection

Monitor electrolytes, kidney fxn (SCr), liver enzymes and BG

Answer 5

AE: 
Nausea
HTN
Hyperglycemia
Insomina
Psychosis
Redistribution of fat
Osteoporosis
Easy bruising
Edema
Infections
HPA AXIS suppression

Question 6

Hydrocortisone

Answer 6

Short acting corticosteroid