Week 10 Endocrine Flashcards
metformin (Glucophage) class
biguanides
metformin (Glucophage) therapeutic use
first line drug to treat type III diabetes because it does not cause weight gain, can be taken with other oral meds and insulin
metformin (Glucophage) EPA
Reduces the production of glucose by the liver, decreases absorption of glucose from the intestines & increases sensitivity of insulin receptors in tissues
metformin (Glucophage) ADRs
lactic acidosis
nausea, vomiting, diarrhea
metallic taste
metformin (Glucophage) black box warning
risk for potentially fatal lactic acidosis for people with a history because it increases production of lactate
metformin (Glucophage) contraindications and interactions
not given during severe illness, surgery, hospitalization
pregnancy
renal or hepatic impairment
history of lactic acidosis
alcohol use
metformin (Glucophage) interventions and education
take with meals
do not stop without consulting provider
avoid alcohol
cannot be taken within 48 hours of contrast imaging due to kidney injury risk
glipizide (Glucotrol) class
sulfonylureas
glipizide (Glucotrol) therapeutic use
use in combination with diet to lower blood sugar levels in patients with type II diabetes
glipizide (Glucotrol) EPA
stimulates pancreatic beta cells to produce more insulin, increasing secretion of insulin
glipizide (Glucotrol) ADRs
hypoglycemia
glipizide (Glucotrol) contraindications and interactions
allergy to sulfa meds
pregnancy
renal or hepatic dysfuntions
glipizide (Glucotrol) interventions and education
take 30 minutes before meals
do not give during severe illness, surgery, hospitalization, or pregnancy
regular insulin class
short-acting insulin
regular insulin therapeutic use
control blood sugar in pataients with type I diabetes or type II diabetes not controlled by diet, exercise, or oral agents
regular insulin EPA
onset in 30-60 minutes
replaces endogenous insulin and has same effect
regular insulin ADRs
hypoglycemia
regular insulin contraindications and interactions
hypoglycemia
lower dose for renal disease
regular insulin interventions and education
how to store and administer insulin
what to do if hypoglycemic
lispro insulin (Humalog) class
rapid-acting insulin
lispro insulin (Humalog) therapeutic use
given with meals to to correct high blood glucose level
can be used for type I or type II diabetes
lispro insulin (Humalog) EPA
quick onset, 15 minutes
lispro insulin (Humalog) ADRs
hypoglycemia
lispro insulin (Humalog) contraindications and interactions
hypoglycemia
lower dose for renal disease
lispro insulin (Humalog) interventions and education
how to store and administer insulin
what to do if hypoglycemic
glargine insulin (Lantus) class
long-acting insulin
glargine insulin (Lantus) therapeutic use
control blood sugar in type I diabetes or type II not controlled with diet, exercise, or oral medication
glargine insulin (Lantus) EPA
onset after 2 hours, no peak
acts like basal insulin
glargine insulin (Lantus) ADRs
hypoglycemia
glargine insulin (Lantus) contraindications and interactions
hypoglycemia
lower dose for renal disease
glargine insulin (Lantus) interventions and education
how to store and administer insulin
what to do if hypoglycemic
insulin injection sites
injected subQ: abdomen, posterior upper arm, anterior thigh, hips
insulin administration
prime insulin pen with 2 units
dial up correct dose
locate injection site and clean with alcohol
hold and pinch area with non dominant hand, inject at 90 degrees
hold in place for 5 seconds after administration
do not inject into limb that will be exercised, will cause faster absorption
glucagon (GlucaGen) class
hyperglycemics
glucagon (GlucaGen) therapeutic use
treat hypoglycemia from insulin overdose
glucagon (GlucaGen) EPA
raises blood levels of glucose through glycogenesis
glucagon (GlucaGen) ADRs
nausea and vomiting
glucagon (GlucaGen) contraindications and interactions
hypersensitivity
glucagon (GlucaGen) interventions and educationn
turn patient on side if unconscious
provide food once patient regains consciousness and can swallow
educate on signs of hypoglycemia
levothyroxine (Synthroid) class
thyroid replacement
levothyroxine (Synthroid) therapeutic use
lifelong treatment for hypothyroidism
levothyroxine (Synthroid) EPA
synthetic T4 to increase metabolic rate
levothyroxine (Synthroid) ADRs
- signs and symptoms of hyperthyroidism
- thyrotoxicosis
levothyroxine (Synthroid) interventions and education
- monitor T3, T4, TSH levels.
- measure baseline ad periodic VS and weight
levothyroxine (Synthroid) contraindications and interactions
thyrotoxicosis
recent MI
food decreases absorption
signs and symptoms of hyperthyroidism
rapid heart rate, palpitations, chest pain.
nervousness
tremors
decreased appetite
heat intolerance, fever, sweating
weight loss
propylthiouracil (PTU) class
antithyroid: thioamides
propylthiouracil (PTU) therapeutic use
- grave’s disease
- thyrotoxicosis
- suppression of thyroid hormone prior to thyroidectomy
propylthiouracil (PTU) EPA
blocks iodine from integrating into tyrosine, blocks T4 from converting into T3
propylthiouracil (PTU) ADRs
signs and symptoms of hypothyroidism
agranulocytosis
anemia
hepatotoxicity
rash
nausea and vomiting
headache
dizziness
propylthiouracil (PTU) interventions and education
monitor T4, T4, TSH
baseline and regular VS and weight
educate on signs of hypothyroidism - fatigue, weakness, weight gain, cold intolerance
monitor CBC, report fever and sore throat
propylthiouracil (PTU) contraindications and interactions
teratogenic
caution with immunosuppression and infections
liver dysfunction
desmopressin (DDAVP) class
posterior pituitary hormone drug
desmopressin (DDAVP) therapeutic use
diabetes insipidus
desmopressin (DDAVP) EPA
synthetic ADH
desmopressin (DDAVP) ADRs
fluid retention: hyponatremia a nd edema
seizures
desmopressin (DDAVP) interventions and education
H2O intoxication: headache, confusion
decrease water intake
strict I&O
monitor serum sodium
desmopressin (DDAVP) contraindications and interactions
renal failure
nephrogenic diabetes insipidus
electrolyte imbalances
hydrocortisone (Cortef) class
glucocorticoids
hydrocortisone (Cortef) therapeutic use
addison’s disease/ adrenal insufficiency.
autoimmune inflammatory disorders.
asthma.
hydrocortisone (Cortef) EPA
synthetic cortisol
hydrocortisone (Cortef) ADRs
many at high levels
hydrocortisone (Cortef) interventions and education
monitor CBC, electrolytes, glucose, glucocorticoid levels.
may need supplemental dose in time of stress.
medical alert bracelet.
call provider before getting vaccines.
hydrocortisone (Cortef) contraindications and interactions
oral contraceptives
phenytoin and phenobarbital
fludrocortisone class
mineralocorticoids
fludrocortisone therapeutic use
- addison’s disease
adrenal insufficiency - primary hypoaldosteronism
- congenital adrenal hyperplasia
fludrocortisone EPA
synthetic aldosterone
sodium and water retention
fludrocortisone ADRs
fluid and electrolyte imbalances
hypertension, heart failure, hypokalemia
fludrocortisone interventions and education
monitor fluid retention, weight
monitor BP
monitor potassium levels
monitor inadequate dosage: weight loss, poor appetite, fatigue, muscle weakness, hypotension
somatropin class
growth hormone
somatropin therapeutic use
turner’s syndrome
GH deficiency
wasting syndrome - AIDs
somatropin administration
rotate subQ sites
somatropin interventions
monitor urinary calcium due to risk of hypercalciuria
somatropin ADRs
hyperglycemia
