Wk 2 Endocrine & Gastrointestinal cards Flashcards by jason kersh

Generic: glipizide
Trade: (Glucotrol)
Indications: stimulates release of insulin
Class: Sulfonylureas

Side effects: nausea, diarrhea, mild hypoglycemia

Caution: pregnancy, lactation, diabetic ketoacidosis

Implications/considerations: 30 minutes before meals

Pt teaching: test blood sugar, retest in 15-20 minutes

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Generic: repaglinide
Trade: (Prandin)
Indications: stimulates release of insulin
Class: Meglitinides

Side effects: hypoglycemia, nausea, diarrhea

Caution: older adults, renal or hepatic dysfunction

Implications/considerations: 30 min. before meals

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Generic: metformin
Trade: (Glucophage)
Indications: decrease synthesis of glucose by liver, increase sensitivity of insulin receptors
Class: Biguanides

Side effects: n/d, anorexia, lactic acidosis, vitamin B12 deficiencies

Implications/considerations: monitor for s/s of lactic acidosis, I&O

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Generic: pioglitazone
Trade: (Actos)
Indications: reduce insulin resistance of tissue/ insulin must be available
Class: Thiazolidinediones (Glitazones)

Side effects: fluid retention, hepatotoxicity, > serum lipid levels

Implications/considerations: monitor for edema, weight gain, lipid levels

Pt teaching: PO QD with or without food

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Generic: acarbose
Trade: (Precose)
Indications: reduce glucose levels
Class: Alpha-Glucosidase Inhibitors

Side effects: GI discomfort, hypoglycemia, liver dysfunction, anemia

Implications/considerations: monitor GI distress, hypoglycemia (treat with 4 g of dextrose), liver enzymes

Pt teaching: TID with meals

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Generic: sitagliptin
Trade: (Januvia)
Indications: decrease glucose levels
Class: Gliptins

Side effects: upper respiratory tract infections, inflamed nasal passages, headache, pancreatitis

Implications/considerations: monitor respiratory symptoms, for headache, for GI effects

Pt teaching: w/ or w/o food

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Generic: pramlintide
Trade: (Symlin)
Indications: reduce glucose levels
Class: Amylin Mimetics

Side effects: hypoglycemia, nausea, injection site reactions

Caution: don’t mix with insulin, gastroparesis (slowing of GI tract)

Implications/considerations: monitor for hypoglycemia

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Generic: glucagon
Trade: (GlucaGen)
Indications: increase glucose levels
Class: Hyperglycemics

Side effects: nausea, vomiting

Implications/considerations: monitor fluid and carb. intake

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Generic: levothyroxine
Trade: (Synthroid)
Indications: treat hypothyroidism
Class: Thyroid Replacements

Side effects: hyperthyroidism

Implications/considerations: monitor thyroid function, assess for s/s of hyperthyroidism

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Generic: propylthiouracil
Trade: (PTU)
Indications: hyperthyroidism
Class: Antithyroid Drugs

Side effects: hypothyroidism, agranulocytosis, rash, headache

Caution: pregnancy, infection, liver failure

Implications/considerations: taper dose

Pt teaching: report fever, sore throat

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Generic: iodine-131
Trade: (Iodotope)
Indications: hyperthyroidism
Class: Antithyroid Drugs

Side effects: hypothyroidism, bone marrow suppression, n/v

Caution: pregnancy, lactation

Implications/considerations: monitor lab values, signs of hypothyroidism

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Generic: somatropin
Trade: (Genotropin)
Indications: treat growth hormone deficiencies
Class: Growth Hormone

Side effects: hyperglycemia, myalgia, hypercalciuria (calcium in urine, flank pain, blood in urine)

Caution: obesity, critical illness, respiratory impairment, DM

Implications/considerations: monitor serum glucose, thyroid function, growth hormone levels, urine calcium, renal stones

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Generic: desmopressin
Trade: (DDAVP)
Indications: treats diabetes insipidus
Class: Antidiuretic Hormone

Side effects: Fluid retention, Hyponatremia, Vasoconstriction (vasopressin, not desmopressin)

Caution: CAD, poor circulation

Implications/considerations: monitor I&O, IV site

Pt teaching: Signs of water intoxication (headache, sleepiness, fluid retention)
Record I&O

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Generic: hydrocortisone
Trade: (Cortef, Solu-Cortef)
Class: Glucocorticoids

Side effects: hypercortisolism, hyperglycemia, hypocortisolism, fatigue, weakness, hypoglycemia

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Generic: fludrocortisone
Trade: (florinef)
Class: Mineralocorticoids

Side effects: fluid & electrolyte imbalance

Pt teaching: report weight gain or swelling, weakness or palpitations

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Generic: ranitidine hydrochloride
Trade: (Zantac)
Class: Histamine2-receptor Antagonists

Side effects: n/v, diarrhea, constipation

Caution: cimetidine > side effects with CNS

Implications/considerations: don’t give antacids w/ in one hour, slow IV admin

Generic: omeprazole
Trade: (Prilosec)
Indications: treat gastric and duodenal ulcers, GERD
Class: Proton Pump Inhibitors

Side effects: bone loss, n/v/d

Caution: St. John’s wort dec. drug levels

Implications/considerations: give before first meal

Pt teaching: drink fluids, exercise, report coffee ground emesis

Generic: Misoprostol
Trade: (Cytotec)
Indications: abort implanted embryo, causes uterine contractions
Class: Prostaglandin E Analog

abort implanted embryo, causes uterine contractions

Generic: sucralfate
Trade: (Carafate)
Indications: Coats ulcers
Class: Mucosal Protectants

Side effects: n/d, constipation, & dyspepsia

Caution: Renal dysfunction, Children

Implications/considerations: Administer on empty stomach, QID don’t give antacids w/in 30-60 mins

Generic: aluminum hydroxide
Trade: (Amphojel)
Indications: PUD & GERD, Neutralize gastric acid
Class: Antacids

Side effects: constipation

Caution: GI obstruction, Renal dysfunction, dehydration, dec. bowel motility

Implications/considerations: monitor bowel function, phos & mag levels

Pt teaching: Inc. fluid, activity level, report ABD pain & diarrhea, report muscle weakness/cramps & coffee-ground emesis

Generic: ondansetron
Trade: (Zofran)
Indications: n/v from chemo, radiation therapy, & post-op recovery
Class: Serotonin Antagonists

Side effects: HA, dizziness, & diarrhea

Implications/considerations: PO or IV

Pt teaching: lie down if dizzy, report diarrhea or signs of hydration, take analgesic for HA

Generic: dimenhydrinate
Trade: (Dramamine)
Indications: motion sickness
Class: Antihistamines

Side effects: sedation, drowsiness, dizziness, anticholinergic effects

Implications/considerations: PO or IM 30 min before activity, CNS depressants inc. sedative effects & tricyclic antidepressants inc. anticholinergic effects

Pt teaching: assist with ambulation, sit or lie down if drowsy, change positions gradually, inc. fluid & fiber intake

Generic: metoclopramide
Trade: (Reglan)
Indications: n/v from chemo, opioids, & radiation therapy, GERD
Class: Prokinetic

Side effects: sedation, dry mouth, diarrhea, extrapyramidal symptoms

Implications/considerations: PO or IV (slowly), 30 mins before meals, CNS depressants inc. sedative effects & opioids & anticholinergics dec. therapeutic effects

Generic: psyllium
Trade: (Metamucil)
Indications: constipation, diverticulosis, IBS, stool regulation for fecal ostomies & diarrhea
Class: Fiber Supplements

Side effects: esophageal or intestinal obstruction

Caution: fecal impaction, n/v, GI obstruction

Implications/considerations: Monitor I&O, take with H2O, should have a soft formed stools in 1-3 days

Generic: docusate sodium Trade: (Colace) Indications: constipation, prevents fecal impaction, straining, & painful elimination of hard stools Class: Stool Softeners

Side effects: diarrhea, abdominal cramps Caution: GI obstruction, fecal impaction, n/v, undiagnosed ABD pain Pt teaching: drink fluids, inc. exercise, & report diarrhea, inc. high-fiber foods

Generic: bisacodyl Trade: (Dulcolax) Indications: constipation & colon evacuation Class: Stimulant Laxatives

Side effects: diarrhea, cramps, burning sensation, laxative abuse Caution: GI obstruction, undiagnosed ABD pain, laxative abuse Implications/considerations: monitor bowel elimination pattern, I&O, diarrhea, dehydration, or rectal discomfort

Generic: diphenoxylate & atropine, loperamide Trade: (Lomotil), (Imodium) Indications: dec. intestinal peristalsis, inc. absorption of water from feces Class: Antidiarrheal

Side effects: sedation, dizziness, anticholinergic effects Caution: GI bleeding, Inc. CNS depression with CNS depressants Implications/considerations: Monitor with ambulation, urinary elimination patterns, & anticholinergic effects

Generic: loperamide Trade: (Imodium) Indications: Class: Antidiarrheal

Side effects: Caution: Implications/considerations: Pt teaching:

TPN Indications: major surgery, severely undernourished, Renal failure, Hepatic failure, Short-term therapy= peripheral vein TPN Long-term therapy= central vein TPN

Side effects: Infection & fluid overload Caution: Implications/considerations: Administer through infusion pump, blood sugar checks, monitor Temp., & weight Pt teaching: