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Pharm 1 Final > Pharm One Final 5 - antidiabetics > Flashcards

Pharm One Final 5 - antidiabetics Flashcards

1
Q

Name three different types of insulin medications

A
  1. Oral Hypoglycemics Type 2
  2. Insulin SubQ
  3. Non Insulin injectables
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2
Q

Normal fasting Blood Sugar?

A

60-100 mg/dl

goal for diabetics less than 150. diabetics adapted to a higher level of Blood Glucose

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3
Q

Symptoms of HYPOGLYCEMIA

Blood sugar less than _____

A

Cold and Clammy (wet) -Give them Candy (Glucose)

  • Headache, light headedness
  • Nervous
  • Tremor
  • Sweating, cold clammy skin
  • Tachycardia
  • Slurred speech, memory lapse, confusion
  • Seizures

BLOOD SUGAR LESS THAN 60

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4
Q

HYPERGLYCEMIA

Blood Sugar greater than ____

A

High and Dry

  • Extreme thirst
  • Polyuria (losing urine)
  • Fruity breath odor
  • Rapid and thready pulse
  • Dry MM, poor skin turgor
  • Deep, rapid, labored breathing - KUSSMAUL BREATHING

Blood Glucose Greater than 250

HIGH and DRY

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5
Q

Three Types of Insulin

List Onset, Peak and Duration

A

MUST KNOW THE PEAK of EACH
Onset, Peak, and Duration

Rapid 30 min, 2.5 - 5 hours, 4-12 hours. Lispro
Intermediate 1-2 hours, 4-12 hours, 14-24 hours. NPH
Long. 1-1.5 hours, 6-8 hours, 24-42 hours

PEAKS: 2.5 - 5 ** 4-12 ** and *** 6-8 hours

Symptoms/Hypoglycemic will happen during the PEAK

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6
Q

When is rapid or short acting Insulin given?

A

30-60 minutes before meals

LISPRO 15 minutes

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7
Q

Name Rapid or Short acting Insulins

A

LISPRO - most common

Human Insulin Aspart

Insulin Glulisine

Human oral inhalation insulin (very fast acting - 15 minutes)

Regular insulin is not quite as fast as rapid

Clear liquid. LI=LIGHTENING =FAST

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8
Q

Name an intermediate acting Insulin

A

NPH - cloudy. contains protamine prolongs action

Onset 1-2 hours

Peak 4-12 hours

Duration 14-24 hours

N=Not Fast=Intermediate

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9
Q

Name a long acting Insulin

A 
Glargine (Amylin Analogues)
Given once a day, usually bedtime, rare hypoglycemia
Onset 1-1.5 hours
Peak 6-8 up to 12 hours
Duration 24-42 hours
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10
Q

Can oral antidiabetic drugs be used for TYPE 1?

A

No, Only Type 2

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11
Q

Under what conditions would you LOWER the dose of an oral antidiabetic drug?

A 
Patient
-Eating less
-N/V
-Stomach virus
-NPO going to surgery
decrease dose or d/c
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12
Q

SULFONYLUREAS - side effects

oral antidiabetic drug

A

SULFONYLUREAS (ie GLIPIZIDE) - side effects
different from other oral antidiabetic drugs
Side effect

Hypoglycemia. Tachycardia.

Similar to too much insulin

Used for TYPE 2 only
SULFS/Cell Phone

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13
Q

SULFONYLUREAS -

Who cannot use them?
What do they interact with?

A

LIVER and KIDNEY disease

ASA (aspirin),  NSAIDS
Anticoags, 
MAOI, (Psych drug)
Sulfonamides, 
NO (nitrous oxide).  ETOH
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14
Q

SULFONYLUREAS

Name common 2nd gen

A

GLIPS

GLIPIZIDE GLYBURIDE, GLIMEPIRIDE
Decreases glucose production by the liver
Increases tissue response to insulin

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15
Q

NONSULFONYLUREAS

Name a common one

A 
BIGUANIDES - *METFORMIN*
Decreases hepatic production of glucose from stored glucagon
Reduces glucose following a meal
Decreases glucose from small intestine
Does not cause hypoglycemia
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16
Q

What is only approved med for prediabetes?

A

Metformin - a nonsulfonylurea

17
Q

METFORMIN and IV CONTRAST

A

Renal Impairment Potential with IV CONTRAST

Withhold METFORMIN for 48 hours before and after IV contrast
to prevent ARF or **Lactic acidosis

18
Q

Name Alpha-Glycosidase Inhibitors

PO for Type 2 Diabetes

A

KNOW THE SIDE EFFECTS FOR TEST

ACARBOSE - for those who cannot watch diet. Inhibits the ENZYME that releases glucose from complex carbs.

MIGLITOL - same as above BUT side effect of hypoglycemia with sulfonyurea or insulin

Side Effects - ***GI Disturbance, pain, gas, diarrhea

Ends in ASE (enzyme). Ends in OSE (sugar)
Ends in -ITOL (sugar substitute)

19
Q

THIAXOIDINEDIONES (INSULIN ENHANCING AGENTS)

PO Type 2 Diabetes

Contraindicated for….

A

*****CHF stage 3 and 4 and “GLITAZONE”. Fluid ZONE

promotes FLUID RETENTION
It decreases insulin resistance and improves blood glucose control

Pio-glitazone
Rosi-glitazone

NOT WITH CHF. FLUID RETENTION

20
Q

INCRETIN MIMETICS/Modifiers
PO Type 2 Diabetes
Name 3
Side Effects

A

INCRETIN - “TIDE” the TIDE IS “IN”cretin
Improve BETA CELL Responsiveness

THYROID CANCER and PANCREATITIS

Exenatide
Liraglutide
Dulaglutide (Victoza, Ozempic, Trulicity)

**Thyroid cancer - watch for lumps in the neck
Increased risk of pancreatitis

Type 2 only as Type 1 will never make enough Insulin for this drug. Triggers pancreas to make more insulin

THYROID CANCER - Lump in the neck

21
Q

AMYLIN ANALOGUES

Sub Q Type 2 Diabetes

A

PRAMLINTIDE. Pram-LIN-tide
improves postprandial glucose for those taking insulin without appr control
Sub Q

SLOWS GASTRIC EMPTYING
AMYLIN- pramLINtide

22
Q

Treating MINOR Hypoglycemic Episodes

A

15- 20 grams of fast-acting carbs (ie juice)
If symptoms continue after 15 minutes, repeat.
Want to add PROTEIN to level Glycemic index
CHEESE SANDWICH

23
Q

Preventing Hypoglycemic Episodes

A
  • Follow hypoglycemic diet
  • Reduce simple sugars. -Increase complex carbs

PROTEIN

  • Do not eat a sweet snack without eating protein
  • Bedtime snacks should contain protein.
  • 50-60 % of the protein will become glucose in 3-4 hours
  • Insulin rxn, fast acting carb with protein to stop glucose from dropping later.
24
Q

Why are patients given insulin in the hospital when they are NOT diabetics?

A

Elevated blood sugar contributes to infections and poor wound healing.

Contributing factors to raising glucose levels.

  • steroids
  • Iv solutions with dextrose

Patient may NOT need insulin on discharge, but will need to be monitored.

25
Q

What are 2 major causes for TYPE 2 Diabetes?

A

Heredity and obesity

26
Q

An antidiabetic drug will cause a decrease in _______

A

Blood glucose

27
Q 
Patient receives NPH at 7:30 am, peak will occur at\_\_\_\_\_\_?
8am
10am
5 pm
11pm
A

5 pm.

Peak 4-12 hours

28
Q

Breakfast tray time delivery variable,
do not give which insulin?

NPH
Lispro
Glargine
Regular

A

LISPRO

fast acting 15-30 minute onset

29
Q

Name side effects of Glipizide (Sulfonyurea)

GLIPS

A

Hypoglycemia. Tachycardia. Hunger

30
Q

List four symptoms of HYPOGLYCEMIA

A

HYPOGLYCEMIA

Headache
Nervous
Sweating
Hunger

31
Q

Headaches, nervousness, sweating are symptoms of

HYPO or HYPER GLYCEMIA?

A

HYPO

32
Q

How different Antidiabetic drugs work.

A

Pharm 1 Final (8 decks)

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