pharm final- endocrine and GI

Question 1

Glucophage (metformin) class

Answer 1

biguanides

Question 2

Glucophage (metformin) MOA

Answer 2

Decrease intestinal absorption of glucose; Increase use of glucose by muscle and fat cells. Decrease hepatic glucose production.

Question 3

Glucophage (metformin) nursing implications

Answer 3

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

Question 4

insulin therapy

Answer 4

Given as sub-q injection or IV infusion

Goal is get HbA1c below 6.0

Question 5

insulin therapy

Answer 5

Given as sub-q injection or IV infusion

Goal is get HbA1c

Question 6

Humalog (lispro)

Answer 6

rapid acting

clear

Question 7

aspart (NovoLog)

Answer 7

rapid acting clear

Question 8

regular insulin

Answer 8

short acting

clear

Question 9

Humulin R

Answer 9

short acting

clear

Question 10

NPH insulin

Answer 10

intermediate acting

cloudy

Question 11

levemir (detemir)

Answer 11

long acting

clear

Question 12

levemir

Answer 12

long acting

clear

Question 13

Lantus

Answer 13

basal, 24 hour acting
clear
Lantus is administered at bedtime

Question 14

rapid acting onset peak duration

Answer 14

onset 10-15 min
peak 1 hr
duration 2-4 hr

Question 15

short acting onset peak duration

Answer 15

onset 1/2-1 hr
peak 2-4 hr
duration 5-7 hr

Question 16

intermediate acting onset peak duration

Answer 16

onset 1-1.5 hr
peak 4-12 hr
duration up to 24 hr

Question 17

long acting onset peak duration

Answer 17

onset 3-4 hr
peak none for lantus; 3-14 for detemir
duration 24-36 hr

Question 18

treatment for hypoglycemia

Answer 18

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

Question 19

if hypoglycemia is left untreated

Answer 19

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

Question 20

Levothyroxine (Levothroid; Synthroid) nursing implications

Answer 20

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.

Question 21

glucocorticoids

Answer 21

aka corticosteroids

anti-inflammatory, maintain glucose levels, decrease immune response,

Question 22

mineralocorticoids

Answer 22

retain sodium (maintain volume status), potassium gets released 
ex aldosterone

Question 23

uses for corticosteroids

Answer 23

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

Question 24

SE of long term corticosteroid use

Answer 24

“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

Question 25

Protonix (pantoprazole) class

Answer 25

proton pump inhibitors

Question 26

Protonix (pantoprazole) MOA

Answer 26

suppress gastric acid secretion by inhibiting H+/K+ ATP pumps.

Question 27

Protonix (pantoprazole) SE

Answer 27

CNS- Dizziness, headache, confusion,

GI- Bloating, diarrhea

Question 28

Protonix (pantoprazole) nursing implications

Answer 28

Do not open, crush, or chew capsules

Question 29

Zofran (ondansetron) class

Answer 29

5-HT3 Receptor Blockers

Question 30

Zofran (ondansetron) MOA

Answer 30

Block receptors in the CTZ

Question 31

Zofran (ondansetron) nursing implications

Answer 31

Mainly used for prevention/treatment of nausea vomiting with chemotherapy. Expensive (not so much any more).
Post-op, cardiac patients, all types of patients

Question 32

Zofran (ondansetron) SE

Answer 32

Headache, dizziness