Test #3 Insulins, Heparin, PCN, etc. Flashcards
Synthetic Human Insulin is produced either by..
Recombinant DNA synthesis of human insulin, conversion of pig to human insulin
Metformin does not play a role in which type of diabetes?
Type 1 Diabetes
What is the broad classification for heparin?
agents used to treat cardiovascular disorders
What is the specific classification for heparin?
agents affecting blood clotting
What type of syringe do you use to administer heparin?
TB syringe
A heparin injection may not exceed ___
1 mL
When giving SQ, do not round, leave in the __ place.
hundredths
How many strengths does heparin come in?
variety of strengths
Older versions of insulin originate from?
Cow/Pig
Type 1 Diabetes means?
Insulin dependent or juvenile onset (IDDM)
Type 2 Diabetes means?
Non-insulin dependent (NIDDM)
TX for Type 1 Diabetes…
with insulin subq. injection the entire life, failure to make insulin by pancreas.
TX for Type 2 Diabetes…
with oral hypoglycemic agents & insulin injections (ex. metformin & insulin inj)
What does lipodystrophy mean?
tissue damage
Drugs that affect the blood sugar?
steroids, beta blockers, aspirin, alcohol, asthma medications
What is hypoglycemia?
Blood glucose is too low <60 mg/dL
Hypoglycemia is produced from…
- skipped/irregularly scheduled meals
- excessive exercise ( ^ rate of insulin absorbed)
- Insulin administration errors
If a patient is having signs of hypoglycemia, what do you do first? why?
Give glucose (FOOD) first, because you can always bring blood sugar back down
What are the S/S of hypoglycemia?
- sweating
- confusion
- tachycardia
- HA
- excessive hunger
- weakness
- poor muscle control
- emotional instability
- coma & death
TX for hypoglycemia?
Glucose by mouth, but if you can’t & need something faster, you may give Glucagon (IM, IV, SQ), IV dextrose 50% aka D50W
What is glucagon?
this is what you give when glucose is gone (severe)
What are the side effects of insulin?
allergic reactions
lipodystrophy
insulin resistance
What has to be going on in the body in order to give oral hypoglycemics?
has to be producing some insulin
Oral hypoglycemics are used to treat ___ & requires ___ production.
Type 2 diabetes; endogenous insulin resistance
What factors reduce renal function with oral hypoglycemics?
- increase risk of toxic accumulation & lactic acidosis
- monitor creatinine & other renal labs
Anything that reduces renal function can cause an accumulation of ___ in the ___ & can cause ___
metformin; liver; lactic acidosis
Heparin is a blood thinner, so it treats? What is it?
Thromboemboli - little fats in blood vessels
What does heparin inhibit? What does it do to existing clots & new clots?
Inhibits clotting process (formation)
-it does not reverse existing clots, it just keeps from getting more clots
What is heparin’s mechanism of action?
Interferes with clotting mechanism and blocks clotting cascade
How is heparin destroyed?
PO
What routes can you give heparin in?
SQ, IV infusion (No IM injections)
What patients do you not give heparin to?
Coagulation disorders
When giving heparin, you should monitor ___
PTT & other labs
What does PTT stand for? What is it?
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.
PTT is measured in?
Seconds
Normal range of PTT for adults?
25-35 seconds
The normal PTT target to heparin therapy are usually…?
1.5 to 2.0 times the control values
Client should be closely monitored with what drug?
Coumadin (warfarin)
What does coumadin inhibit & how?
blood clotting by interfering w/ the synthesis of Vit K dependent clotting factors
Dosage for Coumadin is ____
individualized
How long does it take for Coumadin to be effective?
2-3 days lag time
What is a PT/international normalized ratio (used w/ coumadin)?
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
What is the normal range for PT in adults?
11 - 12.5 seconds
What is the target for a patient on coumadin?
1.5 to 2.0 times higher than normal values
How does the immune system work?
it responds to foreign agents (antigen), it forms antibodies, it recognizes & destroys antigen, reasons for an allergic reaction is an overaggressive antibody reaction)
What are the two types of immunity?
Active immunity & Passive immunity
What is active immunity?
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)
What is passive immunity?
administration of preformed antibodies, provides instant protection, short duration
Where is zofran stored?
in the GI tract, mostly on dopamine & serontonin receptors
Zofran helps with ___ but does not keep you from ___
Nausea ; vomiting
How does zofran help with nausea?
it blocks the receptor in the CNS
What are some factors that can lead to infection?
- Age (young/elderly)
- ^ exposure to pathogenic organisms
- disruption of normal barriers
- inadequate immunological defenses
- impaired circulation
- poor nutritional status
Sources of infection?
- bacteria
- fungal
- viruses
What are the 3 organisms resistant to antibiotics?
- MRSA/VRSA
- VRE
- ORSA
- C-diff
What does MRSA/VRSA, VRE, ORSA stand for?
- Methicillin or Vancomycin resistant staph aureus
- Vancomycin resistant enterococcus
- Oxacillin resistant staph aureus
Antimicrobial agents are classified based on the following factors…
- Bactericidal or bacteriostatic
- Site of action
- Narrow or Broad spectrum
- Adverse effects
What are the different antimicrobial classes?
- Sulfonamides
- PCN
- Cephalosporins
- Tetracyclines
- Macrolides
- Aminoglycosides
- Fluoroquinolones
- Carbapenem
- Ketolides
What is PCN derived from?
Fungus & Mold
Together with Cephalosporins, PCN is considered a large group called ____
Beta-Lactam Antibotics
What is the action of PCN?
Inhibits synthesis of bacterial cell wall
- most effective on newly forming or actively growing cell walls
- some are rapidly destroyed in stomach
What routes is PCN given in?
PO, IM, IV
