Test #3 Insulins, Heparin, PCN, etc.

Question 1

Synthetic Human Insulin is produced either by..

Answer 1

Recombinant DNA synthesis of human insulin, conversion of pig to human insulin

Question 2

Metformin does not play a role in which type of diabetes?

Answer 2

Type 1 Diabetes

Question 3

What is the broad classification for heparin?

Answer 3

agents used to treat cardiovascular disorders

Question 4

What is the specific classification for heparin?

Answer 4

agents affecting blood clotting

Question 5

What type of syringe do you use to administer heparin?

Answer 5

TB syringe

Question 6

A heparin injection may not exceed ___

Answer 6

1 mL

Question 7

When giving SQ, do not round, leave in the __ place.

Answer 7

hundredths

Question 8

How many strengths does heparin come in?

Answer 8

variety of strengths

Question 9

Older versions of insulin originate from?

Answer 9

Cow/Pig

Question 10

Type 1 Diabetes means?

Answer 10

Insulin dependent or juvenile onset (IDDM)

Question 11

Type 2 Diabetes means?

Answer 11

Non-insulin dependent (NIDDM)

Question 12

TX for Type 1 Diabetes…

Answer 12

with insulin subq. injection the entire life, failure to make insulin by pancreas.

Question 13

TX for Type 2 Diabetes…

Answer 13

with oral hypoglycemic agents & insulin injections (ex. metformin & insulin inj)

Question 14

What does lipodystrophy mean?

Answer 14

tissue damage

Question 15

Drugs that affect the blood sugar?

Answer 15

steroids, beta blockers, aspirin, alcohol, asthma medications

Question 16

What is hypoglycemia?

Answer 16

Blood glucose is too low <60 mg/dL

Question 17

Hypoglycemia is produced from…

Answer 17

• skipped/irregularly scheduled meals
• excessive exercise ( ^ rate of insulin absorbed)
• Insulin administration errors

Question 18

If a patient is having signs of hypoglycemia, what do you do first? why?

Answer 18

Give glucose (FOOD) first, because you can always bring blood sugar back down

Question 19

What are the S/S of hypoglycemia?

Answer 19

• sweating
• confusion
• tachycardia
• HA
• excessive hunger
• weakness
• poor muscle control
• emotional instability
• coma & death

Question 20

TX for hypoglycemia?

Answer 20

Glucose by mouth, but if you can’t & need something faster, you may give Glucagon (IM, IV, SQ), IV dextrose 50% aka D50W

Question 21

What is glucagon?

Answer 21

this is what you give when glucose is gone (severe)

Question 22

What are the side effects of insulin?

Answer 22

allergic reactions
lipodystrophy
insulin resistance

Question 23

What has to be going on in the body in order to give oral hypoglycemics?

Answer 23

has to be producing some insulin

Question 24

Oral hypoglycemics are used to treat ___ & requires ___ production.

Answer 24

Type 2 diabetes; endogenous insulin resistance

Question 25

What factors reduce renal function with oral hypoglycemics?

Answer 25

- increase risk of toxic accumulation & lactic acidosis | - monitor creatinine & other renal labs

Question 26

Anything that reduces renal function can cause an accumulation of ___ in the ___ & can cause ___

Answer 26

metformin; liver; lactic acidosis

Question 27

Heparin is a blood thinner, so it treats? What is it?

Answer 27

Thromboemboli - little fats in blood vessels

Question 28

What does heparin inhibit? What does it do to existing clots & new clots?

Answer 28

Inhibits clotting process (formation) | -it does not reverse existing clots, it just keeps from getting more clots

Question 29

What is heparin's mechanism of action?

Answer 29

Interferes with clotting mechanism and blocks clotting cascade

Question 30

How is heparin destroyed?

Answer 30

PO

Question 31

What routes can you give heparin in?

Answer 31

SQ, IV infusion (No IM injections)

Question 32

What patients do you not give heparin to?

Answer 32

Coagulation disorders

Question 33

When giving heparin, you should monitor ___

Answer 33

PTT & other labs

Question 34

What does PTT stand for? What is it?

Answer 34

Partial thromboplastin time; it is a lab used to evaluate heparin therapy, it shows how long it takes a patient's blood to clot in order to know how much heparin to give.

Question 35

PTT is measured in?

Answer 35

Seconds

Question 36

Normal range of PTT for adults?

Answer 36

25-35 seconds

Question 37

The normal PTT target to heparin therapy are usually…?

Answer 37

1.5 to 2.0 times the control values

Question 38

Client should be closely monitored with what drug?

Answer 38

Coumadin (warfarin)

Question 39

What does coumadin inhibit & how?

Answer 39

blood clotting by interfering w/ the synthesis of Vit K dependent clotting factors

Question 40

Dosage for Coumadin is ____

Answer 40

individualized

Question 41

How long does it take for Coumadin to be effective?

Answer 41

2-3 days lag time

Question 42

What is a PT/international normalized ratio (used w/ coumadin)?

Answer 42

PT (prothamin) a lab used to evaluate a patient's therapy to coumadin, measured in seconds, it is the time it takes for prothamin (clotting factor) to work

Question 43

What is the normal range for PT in adults?

Answer 43

11 - 12.5 seconds

Question 44

What is the target for a patient on coumadin?

Answer 44

1.5 to 2.0 times higher than normal values

Question 45

How does the immune system work?

Answer 45

it responds to foreign agents (antigen), it forms antibodies, it recognizes & destroys antigen, reasons for an allergic reaction is an overaggressive antibody reaction)

Question 46

What are the two types of immunity?

Answer 46

Active immunity & Passive immunity

Question 47

What is active immunity?

Answer 47

administration of an antigen, a weakened/killed vaccine, stimulates (revs up) your immune system to form antibodies against disease, lasts for many years. (ex. HepB Vaccine)

Question 48

What is passive immunity?

Answer 48

administration of preformed antibodies, provides instant protection, short duration

Question 49

Where is zofran stored?

Answer 49

in the GI tract, mostly on dopamine & serontonin receptors

Question 50

Zofran helps with ___ but does not keep you from ___

Answer 50

Nausea ; vomiting

Question 51

How does zofran help with nausea?

Answer 51

it blocks the receptor in the CNS

Question 52

What are some factors that can lead to infection?

Answer 52

- Age (young/elderly) - ^ exposure to pathogenic organisms - disruption of normal barriers - inadequate immunological defenses - impaired circulation - poor nutritional status

Question 53

Sources of infection?

Answer 53

- bacteria - fungal - viruses

Question 54

What are the 3 organisms resistant to antibiotics?

Answer 54

- MRSA/VRSA - VRE - ORSA - C-diff

Question 55

What does MRSA/VRSA, VRE, ORSA stand for?

Answer 55

- Methicillin or Vancomycin resistant staph aureus - Vancomycin resistant enterococcus - Oxacillin resistant staph aureus

Question 56

Antimicrobial agents are classified based on the following factors...

Answer 56

- Bactericidal or bacteriostatic - Site of action - Narrow or Broad spectrum - Adverse effects

Question 57

What are the different antimicrobial classes?

Answer 57

- Sulfonamides - PCN - Cephalosporins - Tetracyclines - Macrolides - Aminoglycosides - Fluoroquinolones - Carbapenem - Ketolides

Question 58

What is PCN derived from?

Answer 58

Fungus & Mold

Question 59

Together with Cephalosporins, PCN is considered a large group called ____

Answer 59

Beta-Lactam Antibotics

Question 60

What is the action of PCN?

Answer 60

Inhibits synthesis of bacterial cell wall - most effective on newly forming or actively growing cell walls - some are rapidly destroyed in stomach

Question 61

What routes is PCN given in?

Answer 61

PO, IM, IV