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Pharm > Mod 5 - Corticosteroids and Meds to Manage Diabetes > Flashcards

Mod 5 - Corticosteroids and Meds to Manage Diabetes Flashcards

1
Q

what are adjuvant analgesics

A

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

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2
Q

what can be developed from long term corticosteroid use

A

corticosteroid-induced diabetes

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3
Q

what happens when the inflammatory response is activated

A

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

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4
Q

when is the inflammatory process not helpful

A

when it is longterm

  • arthritis
  • fibromyalgia
  • COPD
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5
Q

what do prostaglandins have a role in

A

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

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6
Q

what is the main action of an NSAID

A

inhibit prostaglandin action by blocking COX1 and COX2

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7
Q

what does COX1 do

A

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

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8
Q

what does COX2 do

A

more active at site of trauma

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9
Q

what do the adrenal glands do

A

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

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10
Q

what are the effects of glucocorticoids (cortisol)

A

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)

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11
Q

what are the effects of mineralocorticoids (aldosterone)

A

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

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12
Q

what is the class of ibuprofen

A

NSAID

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13
Q

ibuprofen use

A

treat mild-mod pain and fever, anti-inflammatory

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14
Q

ibuprofen action

A

inhibits prostaglandin synthesis by blocking COX1 and COX2

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15
Q

ibuprofen OE

A

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

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16
Q

ibuprofen considerations

A

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

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17
Q

prednisone class

A

corticosteroids

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18
Q

prednisone uses

A

anti-inflammatory

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19
Q

prednisone action

A

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

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20
Q

prednisone OE

A 
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
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21
Q

prednisone considerations

A

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

22
Q

beta cells release ____ to _____ blood glucose

A

insulin, decrease

23
Q

alpha cells release _____ to _____ blood glucose

A

glucagon, increase

24
Q

insulin action

A

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

25
Q

insulin OE

A

hypoglycemia and associated symptoms

26
Q

how can diabetes meds work

A

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

27
Q

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

A

onset, peak, duration

28
Q

basal =

A

long acting

29
Q

when would you give basal insulin

A

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

30
Q

prandial (bolus) =

A

with meals and rapid or short

31
Q

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

A

type 2 becuase you have to have functioning pancreatic cells

32
Q

insulin class

A

prancreatics (antidiabetes, hormone)

33
Q

insulin use

A

decrease blood glucose, control hyperglycemia

34
Q

insulin action

A

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

35
Q

insulin OE

A

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

36
Q

insulin considerations

A

different kinds, when to give, monitor for hypoglycemia

37
Q

glyburide class

A

sulfonylurea

38
Q

glyburide uses

A

PO control of bg in type 2, when diet fails

39
Q

glyburide action

A

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

40
Q

glyburide OE

A

hypoglycemia

41
Q

glyburide considerations

A

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

42
Q

metformin class

A

biguanides

43
Q

metformin uses

A

management of type 2 diabetes

44
Q

metformin action

A

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

45
Q

metformin OE

A

hypoglycemia

46
Q

metformin considerations

A

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

47
Q

glucagon class

A

glucose elevating agent (hormone)

48
Q

glucagon uses

A

treat severe hypoglycemia

49
Q

glucagon action

A

increase serum bg

50
Q

glucagon OE

A

hyperglycemia

51
Q

glucagon considerations

A

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

Pharm (9 decks)

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