Medications: Endocrine Flashcards
What is the trade name for Levothyroxine?
Synthroid
What is the generic name for Synthroid?
Levothyroxine
How does Levothyroxine (Synthroid) work in the body?
Levothyroxine (Synthroid) is an exogenous hormone
Levothyroxine (Synthroid) is a synthetic preparation of thyroxine (T4)
When in the body, it converts into T3
What time of the day is Levothyroxine (Synthroid) administered? Why is it administered at this time?
Given early in the morning on an empty stomach
Must be given 30-60 minutes before food ingested so it is absorbed fully
What route is Levothyroxine (Synthroid) given?
Administered via PO route
Why is Levothyroxine (Synthroid) given?
To treat hypothyriodism
It is the drug of choice for thyroid hormone replacement
What kind of dose of Levothyroxine (Synthroid) is the patient started on initially (low dose or high dose)? Why?
Started on a low dose
Gradually increased
This is done to prevent hyperthyroidism from occurring
What education regarding signs ang symptoms does the nurse need to provide when a patient begins Levothyroxine (Synthroid)?
Watch out for s/s of hyperthyroidism
S/S include: tachycardia, angina (chest pain), palpitations, tremors, nervousness, hyperthermia, heat intolerance, sweating
Notify provider ASAP if these s/s occur
If a patient experiences hyperthyroidism s/s when taking Levothyroxine (Synthroid), what needs to occur?
Patient must notify provider
Provider will decrease the dose
What is the drug class of Levothyroxine (Synthroid)?
Thyroid Hormone Replacement
What is the drug class for Metformin (Glucophage, Fortamet)?
Biguanide
Name a medication that falls under the drug class Biguanide.
Metformin (Glucophage, Fortamet)
What are trade names for Metformin?
Glucophage
Fortamet
What is the generic name for Glucophage or Fortamet?
Metformin
How does Metformin (Glucophage, Fortamet) work?
It decreases the glucose produced by the liver
It increases the amount of glucose uptake by the muscles
Does Metformin (Glucophage, Fortamet) directly decrease blood sugar? Is there a direct risk for hypoglycemia?
No it does not. It does not increase insulin production or release.
No direct risk for hypoglycemia
How is Metformin (Glucophage, Fortamet) administered? When is it given?
PO
Daily or multiple times a day
What is one reason Metformin (Glucophage, Fortamet) is given?
To help control blood sugar and Hgb A1C levels in the patient with Diabetes Mellitus Type Two
Can a patient with Diabetes Mellitus Type One take Metformin (Glucophage, Fortamet) for blood sugar control? Why or why not?
No.
The patient with Diabetes Mellitus Type One must take exogenous insulin to survive.
What organ can Metformin (Glucophage, Fortamet) damage? What labs need to be monitored?
It can damage the kidneys
Monitor BUN, Crt, eGFR
Must assess these labs prior to starting the medication and while taking it.
If the patient has a diagnostic imaging test with IV contrast scheduled, what must the nurse do regarding scheduled Metformin (Glucophage, Fortamet) to be given?
Contact physician. Do not give Metformin (Glucophage, Fortamet). It will damage the kidneys.
Name medications that fall under the drug class Sulfonylureas
Glipizide (Glucotrol)
Glimeperide (Amaryl)
Glyburide (Micronase)
The medications Glipizide (Glucotrol), Glimeperide (Amaryl), Glyburide (Micronase) fall under what drug class?
Sulfonylurea
How does a Sulfonylurea work?
It stimulates the pancreas to secrete insulin
It increases insulin receptor sensitivity within the tissues/cells
How and when is a Sulfonylurea given?
PO
Daily or multiple times a day
Can a patient with Diabetes Mellitus Type One take a Sulfonylurea for blood sugar control? Why or why not?
No
There is no insulin within the pancreas so the Sulfonylurea will not work
The type one diabetic must take exogenous insulin for survival
What is one reason a Sulfonylurea is given?
To control glucose levels in the patient with Diabetes Mellitus Type Two
Does a Sulfonylurea directly decrease blood sugar? Is there a direct risk for hypoglycemia?
It can decrease blood sugar due to its alteration of insulin release.
The patient can become hypoglycemic
Name medications that fall under the drug class Rapid-Acting Insulin
Insulin Lispro (Humalog) Insulin Aspart (Novolog)
The medications Insulin Lispro (Humalog) and Insulin Aspart (Novolog) fall under what drug class?
Rapid Acting Insulins
How does exogenous insulin work?
It is given to control and lower blood glucose throughout the day
What is the onset of Rapid Acting Insulin?
5 to 20 minutes
What is the peak of Rapid Acting Insulin?
30 minutes to 3 hours
What is the duration of Rapid Acting Insulin?
2 to 5 hours
When is the patient most at risk for hypoglycemia after an insulin injection? (onset, peak or duration?)
During the peak of the medication/insulin
What is the onset of Short Acting Insulin?
30 minutes
What is the peak of Short Acting Insulin?
2 to 5 hours
What is the duration of Short Acting Insulin?
5 to 8 hours
What route is insulin administered?
Subcutaneously
What information must the nurse know before administering any type of insulin?
The nurse must know the patients current blood sugar
The nurse must know what the onset, peak, duration of the insulin is
Name medications that fall under the drug class Short-Acting Insulin
Regular Insulin (Novolin R or Humulin R)
The medication Regular Insulin (Novolin R or Humulin R) falls under what drug class?
Short Acting Insulin
What is the only insulin drug class/type that can be given intravenously?
Drug Class: Short Acting Insulin
Insulin Name: Regular Insulin (Novolin R or Humulin R)
When is Rapid Acting Insulin or Short Acting Insulin given? What must the nurse keep in mind before/while administering this medication?
When the patient is hyperglycemic, usually with a blood sugar greater than 150 mg/dL
The nurse should ensure food is present so the patient can avoid becoming hypoglycemic
Can be given AC (before meals) and HS (at night/before bed)
Can be given q6hours for a patient who needs more aggressive blood glucose control
What insulin drug classes fall under “Bolus Insulin” or “Meal Time Insulin”
Rapid Acting Insulins
Short Acting Insulins
What insulin drug classes fall under “Basal Insulin” or “Daily Control Insulin”
Intermediate Acting Insulin
Long Acting Insulin
Why are Intermediate Acting Insulin and Long Acting Insulin given?
Manage blood glucose levels long-term (i.e. over the span of a day)
Keeps blood sugar at a steady level throughout the day
Can Intermediate Acting Insulin and Long Acting Insulin be given when blood sugars are within normal limits? When would the nurse hold these medications?
Yes, they can be given when blood sugars are in normal limits. It is important to ensure the patient eats.
Hold these medications if hypoglycemia is present.
Name medications that fall under the drug class Intermediate-Acting Insulin
NPH Insulin (Novolin N or Humulin N)
The medication NPH Insulin (Novolin N or Humulin N) falls under what drug class?
Intermediate Acting Insulin
What is the onset of Intermediate Acting Insulin?
1 to 2 hours
What is the peak of Intermediate Acting Insulin?
6 to 12 hours
What is the duration of Intermediate Acting Insulin?
18 to 26 hours
When are Intermediate Acting Insulin and Long Acting Insulin given?
Once or twice a day (Usually morning and/or night)
Name medications that fall under the drug class Long-Acting Insulin
Insulin Glargine (Lantus)
The medication Insulin Glargine (Lantus) falls under what drug class?
Long Acting Insulin
What is the onset of Long Acting Insulin?
1 to 2 hours
What is the peak of Long Acting Insulin?
No peak
What is the duration of Long Acting Insulin?
Up to 24 hours
