Mod 5 - Corticosteroids and Meds to Manage Diabetes

Question 1

what are adjuvant analgesics

Answer 1

drugs with a primary action other than pain but have analgesic properties in some painful conditions

Question 2

what can be developed from long term corticosteroid use

Answer 2

corticosteroid-induced diabetes

Question 3

what happens when the inflammatory response is activated

Answer 3

swelling, warm, red,
normal body process
stimulates nerve fibers causes pain

Question 4

when is the inflammatory process not helpful

Answer 4

when it is longterm

• arthritis
• fibromyalgia
• COPD

Question 5

what do prostaglandins have a role in

Answer 5

helping with the chain of events leading to inflammation
production of pain and fever
blood clotting

Question 6

what is the main action of an NSAID

Answer 6

inhibit prostaglandin action by blocking COX1 and COX2

Question 7

what does COX1 do

Answer 7

present in many tissues, invloved in blood clotting, protecting stomach, maintaining sodium and water balance in kidneys

Question 8

what does COX2 do

Answer 8

more active at site of trauma

Question 9

what do the adrenal glands do

Answer 9

during normal sleep (diurnal rhythm) or during stress, they release corticosteroids

Question 10

what are the effects of glucocorticoids (cortisol)

Answer 10

powerful metabolic effects/stress response
glucose metabolism
reduce inflammation
suppression of the immune system
influence sleep pattern and mood
dec. bone formation and inc. bone breakdown
inc. calcium excretion
cause lipogenesis (formation and storage of fat in body)

Question 11

what are the effects of mineralocorticoids (aldosterone)

Answer 11

retention of sodium and water and excretion of potassium; essential for maintenance of fluid and electrolyte balance, blood pressure, and blood volume

Question 12

what is the class of ibuprofen

Answer 12

NSAID

Question 13

ibuprofen use

Answer 13

treat mild-mod pain and fever, anti-inflammatory

Question 14

ibuprofen action

Answer 14

inhibits prostaglandin synthesis by blocking COX1 and COX2

Question 15

ibuprofen OE

Answer 15

GI upset, ulcers, inc. bleeding, kidney failure, allergic rxn

Question 16

ibuprofen considerations

Answer 16

dont give if have bleeds, take with food, hydrate, monitor liver fn
alergic rxn,

Question 17

prednisone class

Answer 17

corticosteroids

Question 18

prednisone uses

Answer 18

anti-inflammatory

Question 19

prednisone action

Answer 19

suppresses inflammation and normal immune response by inc cortisol and dec aldosterone (cortisol and aldosterone properties)

Question 20

prednisone OE

Answer 20

sleep and mood disturbance
dec bone density
hypercalcemia
immunosuppression (mask infection)
gain weight (rounded back and moon face)
diabetes (hyperglycemia)
mineral
-inc. Na+ so hypernatremia
-inc. BP
-hypokalemia
-weight gain with fluid

Question 21

prednisone considerations

Answer 21

dont stop abruptly
may require concurrent treatment for osteoporosis or inc BG
monitor for adrenal suppression
immune suppression
fluid retension
intake/out ratio
take with food
tough to tolerate but weigh benefit and risk
give in the morning bc normal levels are high 5-9am

Question 22

beta cells release ____ to _____ blood glucose

Answer 22

insulin, decrease

Question 23

alpha cells release _____ to _____ blood glucose

Answer 23

glucagon, increase

Question 24

insulin action

Answer 24

reacts with specific receptor sites, primarily to facilitate the transfer of glucose into cells for cellular metabolism, promotes the storage of glucose as glycogen, inhibits gluconeogenesis

Question 25

insulin OE

Answer 25

hypoglycemia and associated symptoms

Question 26

how can diabetes meds work

Answer 26

replace insulin stimulate pancreas to secrete more insulin stimulate liver to produce less glucose and store more glucose increase receptors increase receptor sensitivity

Question 27

the main differences in the various types of insulin are with the ____, _____, and ______

Answer 27

onset, peak, duration

Question 28

basal =

Answer 28

long acting

Question 29

when would you give basal insulin

Answer 29

breakfast, supper, or bedtime, could be 1 or 2 a day

Question 30

prandial (bolus) =

Answer 30

with meals and rapid or short

Question 31

only one type of diabetes can use sulfonylurea, which one and why

Answer 31

type 2 becuase you have to have functioning pancreatic cells

Question 32

insulin class

Answer 32

prancreatics (antidiabetes, hormone)

Question 33

insulin use

Answer 33

decrease blood glucose, control hyperglycemia

Question 34

insulin action

Answer 34

stimulate glucose uptake in skeletal muscle and fat, inhibit hepatic glucose production, promotes storage of glycogen in liver.

Question 35

insulin OE

Answer 35

hypoglycaemia (shakiness, dizziness, sweating, hunger, fast heart rate, inability to concentrate

Question 36

insulin considerations

Answer 36

different kinds, when to give, monitor for hypoglycemia

Question 37

glyburide class

Answer 37

sulfonylurea

Question 38

glyburide uses

Answer 38

PO control of bg in type 2, when diet fails

Question 39

glyburide action

Answer 39

dec. blood glucose by stimulating release of insulin from pancreas and increasing the sensitivity to insulin at receptor sites

Question 40

glyburide OE

Answer 40

hypoglycemia

Question 41

glyburide considerations

Answer 41

dont give with type 1 diabetes, do not take if unable to eat, monitor for hypoglycemia

Question 42

metformin class

Answer 42

biguanides

Question 43

metformin uses

Answer 43

management of type 2 diabetes

Question 44

metformin action

Answer 44

dec. hepatic glucose production, dec. intestinal glucose absorption, increase sensitivity to insulin

Question 45

metformin OE

Answer 45

hypoglycemia

Question 46

metformin considerations

Answer 46

monitor for hypoglycemia, for diet/exercise regime to prevent hyperglycemia or hypoglycemia

Question 47

glucagon class

Answer 47

glucose elevating agent (hormone)

Question 48

glucagon uses

Answer 48

treat severe hypoglycemia

Question 49

glucagon action

Answer 49

increase serum bg

Question 50

glucagon OE

Answer 50

hyperglycemia

Question 51

glucagon considerations

Answer 51

with type 1 always give oral carb snack asap, tell family when to use it too, teach S+S of glucagon, used in emergencies when oral glucose is not applicable