SIADH + DM pt 1 Flashcards
What causes SIADH?
The body produces too much ADH.
What happens to sodium levels in SIADH?
Sodium levels drop due to water retention.
What type of saline is used for severe acute SIADH?
Hypertonic Saline (3% NS).
How is chronic SIADH treated?
Vasopressin antagonists (ADH blockers) like Tolvaptan and Conivaptan.
What are the adverse effects of Vasopressin antagonists?
Thirst, dry mouth, polyuria, weakness, constipation, hyperglycemia, osmotic demyelination.
How quickly should hyponatremia be corrected?
Slowly, <12 mEq/L per 24 hours.
What are the two types of Diabetes Mellitus?
Type 1 (T1DM) and Type 2 (T2DM).
What is the cause of T1DM?
Destruction of pancreatic beta cells leading to no insulin production.
What are common symptoms of T1DM?
Polyuria, polydipsia, polyphagia, weight loss, ketosis.
What is the main treatment for T1DM?
Insulin and diet.
What is the primary cause of T2DM?
Insulin resistance and impaired insulin secretion.
What are common characteristics of T2DM?
Gradual onset, often obese, may be asymptomatic, ketosis uncommon.
How can T2DM be cured?
Weight loss, exercise, and dietary control.
What is the goal Hgb A1c level for diabetes management?
Less than 7.0% (e.g., 6.9 or lower).
What is the target fasting glucose level?
70 – 130 mg/dL.
What is the target postmeal glucose level?
Less than 180 mg/dL.
How is hypertension in diabetics managed?
ACE inhibitors or ARBs.
How is dyslipidemia in diabetics managed?
Statins.
What are the types of insulin therapy?
Rapid-acting, short-acting, intermediate-acting, long-acting, and ultra-long-acting.
Name some rapid-acting insulins.
Insulin lispro (Humalog), Insulin aspart (NovoLog), Insulin glulisine (Apidra), Inhaled human insulin (Afrezza).
Name a short-acting insulin.
Regular insulin (Humulin R, Novolin R).
Name an intermediate-acting insulin.
NPH insulin (Humulin N, Novolin N).
Name some long-acting insulins.
Insulin detemir (Levemir).
Name some ultra-long-acting insulins.
Insulin glargine (Lantus), Insulin degludec (Tresiba).
How is insulin detemir (Levemir) dosed?
Once or twice daily (QD or BID).
What is the only cloudy insulin?
NPH insulin.
What is the only insulin that can be mixed with NPH?
Short-acting insulin (Regular) or rapid-acting insulin.
In what order should mixed insulin be drawn up?
Clear (short-acting) before cloudy (NPH).
How is rapid-acting insulin administered?
Before or with meals.
What is the onset of rapid-acting insulin?
15 – 30 minutes.
What is the peak time for rapid-acting insulin?
0.5 – 3 hours.
What is the duration of rapid-acting insulin?
3 – 5 hours.
What is the onset of short-acting insulin?
30 – 60 minutes.
What is the peak time for short-acting insulin?
1 – 5 hours.
What is the duration of short-acting insulin?
6 – 10 hours.
What is the onset of intermediate-acting insulin (NPH)?
1 – 2 hours.
What is the peak time for intermediate-acting insulin (NPH)?
4 – 14 hours.
What is the duration of intermediate-acting insulin (NPH)?
14 – 24 hours.
What is the onset of long-acting insulin (Detemir)?
1 – 4 hours.
What is the peak time for long-acting insulin (Detemir)?
None.
What is the duration of long-acting insulin (Detemir)?
24 hours.
What is the onset of ultra-long-acting insulin (Glargine, Degludec)?
1 – 4 hours.
What is the duration of ultra-long-acting insulin (Glargine, Degludec)?
24 hours.
What are common premixed insulin combinations?
70% NPH + 30% Regular, 75% Intermediate + 25% Lispro.
