Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharmacology > T1&T2DM management > Flashcards

T1&T2DM management Flashcards

1
Q

Pancreatic beta cell deficiency causing hypoinsulinaemia and hyperglucagonaemia

A

T1DM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Insulin resistance causing hypoinsulinaemia

A

T2DM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Role of insulin and glucagon in response to homeostasis

A

Stimuli: Low BSL
Alpha cell in pancreas release glucagon into the bloodstream stimulating the breakdown and release of glycogen in the liver, therefore raises BSL to normal lvl.

Stimuli: High BSL
Beta cell in pancreas release insulin into the bloodstream attaching to insulin receptors of muscles and tissues stimulating the uptake of glucose from the blood therefore lowers BSL.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

form of diabetes diagnosed during pregnancy

A

gestational diabetes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

__________develops in baby and _____________ during post delivery. Gestational diabetes can develop ____________ later in life.

A

hyperinsulinaemia (high BSL of mother can bring extra glucose to baby causing extra weight)
hypoglycaemia
T2DM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Main treatment for T1DM

A

Insulin only!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Main treatment for T2DM

A

Lifestyle management
oral hypoglycaemics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Lifestyle management for chronic conditions - DM

A

exercise
get enough sleep
reduce stress
healthy diet (limit sugar and starch)
have fun

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Oral hypoglycaemics

A

Metformin
SGLT-2 inhibitors
Sulphonylureas
Thiazolidinediones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Metformin pharmacodynamics

A

GI: decrease glucose absorption and increases anaerobic glucose metabolism

Liver: decrease gluconeogenesis, glycogenolysis, fatty acid oxidation

Skeletal muscle: increase insulin-mediated glucose uptake, increase glycogenesis (storing of excess glucose)
upregulates GLUT4 transporter (act as insulin, up-taking excess glucose to muscle and fat tissues)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Metformin benefits

A

NO weight gain
POSITIVE EFFECTS on cholesterol levels
DO NOT CAUSE hypoglycaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Metformin adverse effects

A

GI discomfort (N&V)
increase risk of lactic acidosis
CAUTION with people with renal failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Metformin only works in the presence of ______________

A

insulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Metformin can be used for T1DM to

A

decrease risk of insulin resistance or T2DM (double diabetes)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

SGLT-2 inhibitors pharmacodynamics

A

inhibit SGLT-2 transporter which allows glucose reabsorption in the kidneys. As a result, increases urinary glucose excretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

SGLT-2 inhibitor medication

A

dapagliflozin - only for T2DM

17
Q

SGLT-2 inhibitors benefits

A

lowers BSL and BP
weight loss
good for cholesterol levels
unlikely to cause hypoglycaemia

18
Q

SGLT-2 adverse effects

A

UTIs
candidiasis (fungal infection)
polyuria and polydipsia
hypotension
acute renal injury
risk of ketoacidosis

19
Q

Incretins: GLP1R agonist and DPP4 inhibitors pharmacodynamics

A

GLP1R agonises GLP1 (hormone released by GIT) which stimulates insulin to increase glucose uptake. Decrease stimulation of glucagon which decreases hepatic gluconeogenesis

DPP4 inhibits DPP4 enzyme which destroys GLP1

20
Q

Incretins benefits

A

decrease BSL
no hypoglycaemia
weight loss
reduced appetite
protect beta cells
positive effects on cholesterol levels

21
Q

incretins adverse effects

A

GI upset
NOT FOR PREGNANCY and LACTATION
Liver disfunction
slows gastric emptying
pancreatitis

22
Q

Sulphonylureas pharmacodynamics

A

closes potassium channels in the beta cells stimulating more insulin release

23
Q

sulfonylureas adverse effects

A

GI upset
HYPOGLYCAEMIA
weight gain
allergic reactions to sulfonamide
hepatitis
photosensitivity
blood dyscrasias

24
Q

sulfonylureas nursing considerations

A

TAKE WITH FOOD
ONE daily doses
DONT TAKE WITH NSAIDS (increase risk of HYPO)

25
Q

Thiazolidinediones pharmacodynamics

A

PPAR-Y agonists which creates extra adipose tissue > increasing glucose reauptake
Pancreas: decrease insulin demand
Liver: increase insulin sensitivity, decrease hepatic gluconeogenesis and decrease triglycerides

26
Q

Thiazolidinediones benefits

A

lowers BSL
good for cholesterol levels
no hypoglycaemia

27
Q

Thiazolidinediones adverse effects

A

weight gain
GI upset
oedema
increase risk of HF, osteoporosis (older adults), bladder cancer and liver toxicity

28
Q

Exogenous and endogenous insulin difference

A

Exogenous - external substance injected in the body
Endogenous - internal insulin made by pancreas

29
Q

exogenous insulin pharmacodynamics

A

increase glucose uptake in muscles and adipose tissues
stimulate glycogen synthesis, glycolysis, protein synthesis

inhibit lipolysis, ketogenesis and gluconeogenesis

30
Q

insulin is mainly administered where

A

Subcutaneous only - easiest access to fat layers and better absorption

31
Q

types of insulin

A

rapid acting
short acting
intermediate acting
long acting

32
Q

insulin adverse effects

A

HYPOGLYCAEMIA
weight gain
lipohypertrophy - fat deposits from long-term use of impure insulin
local allergic reactions
systemic allergies

33
Q

nursing management for diabetes

A

encourage self-monitoring of BSLs
healthy balanced diet, exercise, lifestyle adjustment and medication adherence
awareness in long term management of consequences of HYPERGLYCAEMIA - CADs, retinopathy, nephropathy, dementia, PVD, neuropathy and cancer

34
Q

Hypoglycaemia occurs when

A

BSL is less than < 3.5 - 4.0 mmol/L - means your glycogen is depleted

35
Q

hypoglycaemia S&S

A

tremor, shaking, sweating, anxious, hunger, tachycardia, confusion, seizures and LOC

36
Q

causes of hypoglycaemia

A

fasting
increased physical activity
incorrect dose of insulin - usually high
more alcohol no food

37
Q

happens when BSL is low but symptoms are absent (even low as < 2mmol/L

A

hypoglycaemia unawareness

38
Q

exogenous glucagon pharmacodynamics

A

causes breakdown of glycogen in the liver (glycogenolysis) to stimulate the release of glucose in the bloodstream increasing BSL

REQUIRES stored glycogen - risk of depletion if the pt has exercised, fasted or drank alcohol without food

Pharmacology (27 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions