pharm final- endocrine and GI Flashcards
Glucophage (metformin) class
biguanides
Glucophage (metformin) MOA
Decrease intestinal absorption of glucose; Increase use of glucose by muscle and fat cells. Decrease hepatic glucose production.
Glucophage (metformin) nursing implications
Avoid use of alcohol
IV dye caution Be aware of shellfish and iodine allergies, toxic to the kidneys (increases risk of developing renal problems after dye procedure
GI side effects
insulin therapy
Given as sub-q injection or IV infusion
Goal is get HbA1c below 6.0
insulin therapy
Given as sub-q injection or IV infusion
Goal is get HbA1c
Humalog (lispro)
rapid acting
clear
aspart (NovoLog)
rapid acting clear
regular insulin
short acting
clear
Humulin R
short acting
clear
NPH insulin
intermediate acting
cloudy
levemir (detemir)
long acting
clear
levemir
long acting
clear
Lantus
basal, 24 hour acting
clear
Lantus is administered at bedtime
rapid acting onset peak duration
onset 10-15 min
peak 1 hr
duration 2-4 hr
short acting onset peak duration
onset 1/2-1 hr
peak 2-4 hr
duration 5-7 hr
intermediate acting onset peak duration
onset 1-1.5 hr
peak 4-12 hr
duration up to 24 hr
long acting onset peak duration
onset 3-4 hr
peak none for lantus; 3-14 for detemir
duration 24-36 hr
treatment for hypoglycemia
Moderate: 4oz fruit juice Lifesavers, candy, honey, syrup Repeat if no relief in 15 minutes Follow up with a protein Type I should carry CHO source IV glucagon Frequently recheck BS levels
if hypoglycemia is left untreated
Decrease glucose to the brain->seizures
If unresponsive or unable to swallow need to give D50 IV over 10 minutes or IM glucagon, or buccal CHO source
Do not give oral if unresponsive
Always treat as if hypoglycemia
Levothyroxine (Levothroid; Synthroid) nursing implications
Lifelong therapy
Do not alter brand of medication (Not every thyroid preparation is the same, blood levels need to be drawn)
Take routinely same time in the morning.
Best absorbed on an empty stomach.
glucocorticoids
aka corticosteroids
anti-inflammatory, maintain glucose levels, decrease immune response,
mineralocorticoids
retain sodium (maintain volume status), potassium gets released ex aldosterone
uses for corticosteroids
Anti-inflammatory: exacerbation of COPD, inflammatory bowel disease, dermatologic reactions, hypersensitivity reactions, spinal cord injuries. Short term use.
Autoimmune disease: lupus, myasthenia gravis, Guilliane-Barre, arthritis (long term use)
Anti-rejection in transplants
Replacement therapy-Addison’s disease
SE of long term corticosteroid use
“Buffalo hump” and “moon face” Deposit of adipose tissue Mask symptoms of infection Thin extremities Bruise easily Emotional liability Elevated blood sugar Possibility of GI bleed Acne Osteoporosis Takes calcium out of the bone and puts it in the blood Facial hair growth Mood swings Poor wound healing
