Diabetes Management and Insulin Types
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Questions and Answers

What is a common side effect of dopamine antagonists?

  • Tachycardia (correct)
  • Muscle cramps
  • Epistaxis
  • Hypotension (correct)

Which of the following is a treatment indication for epinephrine?

  • Dehydration
  • Severe headache
  • Hypertension
  • Cardiovascular collapse (correct)

Which side effect is specifically associated with Ondansetron?

  • Increased appetite
  • Muscle weakness
  • Prolonged QT interval (correct)
  • Severe allergic reaction

What is a key concern when administering opiates for infectious diarrhea?

<p>Dehydration (B)</p> Signup and view all the answers

Which medication class commonly causes extrapyramidal symptoms (EPS)?

<p>Dopamine antagonists (D)</p> Signup and view all the answers

What is a significant risk associated with oral anti-diabetics before surgery?

<p>Lactic acidosis risk (D)</p> Signup and view all the answers

Which type of insulin has the fastest onset?

<p>Rapid Acting Insulin (A)</p> Signup and view all the answers

What is a common side effect of glucocorticoids?

<p>Moon face (C)</p> Signup and view all the answers

What must be monitored in patients taking fludrocortisone?

<p>Potassium levels (A)</p> Signup and view all the answers

What is the primary treatment for hypoparathyroidism?

<p>Calcitrol (B)</p> Signup and view all the answers

What is the typical administration method for long-acting insulin?

<p>Subcutaneously once a day (B)</p> Signup and view all the answers

Which of the following is a side effect of vasopressin?

<p>Watered down urine (B)</p> Signup and view all the answers

What is the main complication of abruptly stopping glucocorticoids?

<p>Adrenal insufficiency (A)</p> Signup and view all the answers

What is the common treatment for hyperparathyroidism?

<p>Partial or full parathyroidectomy (D)</p> Signup and view all the answers

What is a characteristic of short-acting insulin?

<p>Peak action occurs in 1.5-3.5 hours (D)</p> Signup and view all the answers

What is a primary effect of antiulcer drugs?

<p>Decrease vagal nerve activity (C)</p> Signup and view all the answers

Which type of laxative works by pulling water into the colon?

<p>Osmotic laxatives (A)</p> Signup and view all the answers

Which side effect is associated with H2 blockers?

<p>Erectile dysfunction (D)</p> Signup and view all the answers

What is the mechanism of action for PPI medications?

<p>Inhibiting hydrogen/potassium ATPase enzyme (A)</p> Signup and view all the answers

What is a primary use of calcium channel blockers?

<p>To manage stable and variant angina (A)</p> Signup and view all the answers

What condition can occur due to excessive calcium intake from certain antacid medications?

<p>Burnett Syndrome (A)</p> Signup and view all the answers

Which laxative type can lead to decreased muscle tone with prolonged use?

<p>Stimulant laxatives (B)</p> Signup and view all the answers

Which of the following is NOT a side effect of calcium channel blockers?

<p>Increased blood pressure (B)</p> Signup and view all the answers

What is a key symptom of left-sided heart failure?

<p>Shortness of breath (D)</p> Signup and view all the answers

For which purpose are stimulant laxatives most commonly used?

<p>Bowel prep for diagnostics or surgery (B)</p> Signup and view all the answers

What should be avoided when taking Disulfiram (Antabuse)?

<p>Alcohol consumption (C)</p> Signup and view all the answers

What is the main action of Milrinone in heart failure treatment?

<p>Increases cAMP and promotes vasodilation (B)</p> Signup and view all the answers

For how long should Milrinone be administered intravenously to avoid severe cardiac dysrhythmias?

<p>48 to 72 hours (D)</p> Signup and view all the answers

What is the action of anticholinergic medications?

<p>Block cholinergic receptors (B)</p> Signup and view all the answers

What is the antidote for heparin overdose?

<p>Protamine sulfate (C)</p> Signup and view all the answers

Which of the following is a common side effect of all PPIs?

<p>Diarrhea (D)</p> Signup and view all the answers

Which statement best describes a difference between heparin and Low Molecular Weight Heparin (LMWH)?

<p>LMWH can be administered at home with a lower risk of bleeding. (D)</p> Signup and view all the answers

What happens during right-sided heart failure?

<p>Blood backs up in the periphery causing edema. (C)</p> Signup and view all the answers

Which side effect is commonly associated with oral anticoagulants like Warfarin?

<p>Prolonged bleeding (B)</p> Signup and view all the answers

What is a primary action of thrombolytics such as Alteplase?

<p>Dissolve existing blood clots (A)</p> Signup and view all the answers

Which of the following is a significant side effect of statins?

<p>Rhabdomyolysis (B)</p> Signup and view all the answers

Cholesterol absorption inhibitors require combination with which medication for optimal effectiveness?

<p>Statins (B)</p> Signup and view all the answers

What is a major side effect of Niacin therapy?

<p>Flushing (C)</p> Signup and view all the answers

What generation of cephalosporins is known for having broad coverage and better penetration of the cerebrospinal fluid?

<p>Fifth generation (B)</p> Signup and view all the answers

What effect do thrombolytics have on blood pressure?

<p>They may cause low blood pressure. (A)</p> Signup and view all the answers

Which of the following is NOT a side effect associated with statins?

<p>Hair loss (A)</p> Signup and view all the answers

Elevated hepatic enzymes are a common concern for patients taking which type of medication?

<p>Statins (C)</p> Signup and view all the answers

Which action is a property of cholesterol absorption inhibitors?

<p>Inhibit dietary cholesterol absorption (B)</p> Signup and view all the answers

What is a common effect of lithium treatment that requires monitoring?

<p>Toxicity at levels greater than 1.5 (D)</p> Signup and view all the answers

What should be avoided for at least six hours before bedtime as part of insomnia patient education?

<p>Heavy meals (B)</p> Signup and view all the answers

What is a potential adverse effect of inhaled anesthetics?

<p>Respiratory depression (D)</p> Signup and view all the answers

Which appetite suppressant is associated with stimulant effects on the brain?

<p>Phentermine (D)</p> Signup and view all the answers

Which type of sedatives should be avoided in older adults due to excessive CNS depression?

<p>Barbiturates (C)</p> Signup and view all the answers

What is the primary effect of general anesthesia?

<p>Loss of consciousness (C)</p> Signup and view all the answers

How soon does consciousness typically return after the discontinuation of inhaled anesthetics?

<p>Minutes to an hour (C)</p> Signup and view all the answers

What is a recommended practice for the use of short to intermediate acting benzodiazepines in older adults?

<p>Use 4 times per week or less (C)</p> Signup and view all the answers

Flashcards

Calcium channel blockers

Drugs that block calcium channels, preventing calcium entry into heart muscle cells, reducing heart rate and blood pressure.

Right-sided heart failure

A condition where the right ventricle of the heart struggles to pump blood efficiently, leading to fluid buildup in the body's periphery.

Left-sided heart failure

A condition where the left ventricle of the heart struggles to pump blood efficiently, leading to fluid buildup in the lungs.

Milrinone

A phosphodiesterase inhibitor used to treat heart failure by increasing heart muscle contraction and widening blood vessels.

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Protamine sulfate

An antidote for heparin overdose; it reverses the anticoagulant effects of heparin.

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Heparin

An anticoagulant drug, used short term, that needs close monitoring and has a high risk of bleeding.

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Low Molecular Weight Heparin (LMWH)

An anticoagulant drug that is safer and can be administered at home.

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Phosphodiesterase inhibitors

Class of drugs helping to improve heart function by increasing cAMP and promoting contractility, widening vessels.Milrinone is one example.

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Oral Anti-Diabetics for DM2

Used to treat type 2 diabetes only. Withhold before IV contrast or surgery to reduce the risk of lactic acidosis or renal failure.

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Rapid-Acting Insulin

Insulin types like Lispro, Aspart, and Glulisine act quickly (within 15 minutes of injection), peak in 30-90min, and last between 1-3 hours. Often used before meals.

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Short-Acting Insulin

Examples like Regular Insulin, having an onset of 30 minutes, a peak of 1.5-3.5 hours, and a 4-12 hour duration. Can be given SQ or IV.

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Intermediate-Acting Insulin

Insulin like NPH has onset of 1-2 hours, peak 4-12 hours and duration 14-24 hours.

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Long-Acting Insulin

Glargine (Lantus) and Detemir generally have a prolonged duration of action (24 hours) and a minimal peak. Administered once daily, usually before bedtime.

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Steroid Side Effects

Steroids can increase blood glucose (steroid-induced diabetes), cause fat redistribution (moon face, buffalo hump), and may impair growth in children. Tapering is crucial.

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Hypoparathyroidism Treatment

Calcitrol, a Vitamin D analogue, is the primary treatment. It increases calcium absorption and release from bone.

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Hyperparathyroidism Treatment

Parathyroidectomy (surgical removal) is the most common approach for hyperparathyroidism.

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Vasopressin Use

Vasopressin is used to treat diabetes insipidus, a condition characterized by ADH deficiency.

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Vasopressin Side Effects

Vasopressin can lead to increased urine output(watered down) and possible fluid imbalance.

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Dopamine antagonists' use

Used to treat postoperative nausea/vomiting and chemo/radiation sickness, by blocking dopamine receptors in CTZ (chemoreceptor trigger zone).

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Ondansetron side effects

Serotonin antagonist with potential side effects like prolonged QT interval, hypotension, and headache.

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Opiates' GI effect

Opiates slow GI motility (movement of the intestines), and decrease intestinal activity by slowing peristalsis.

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Opiate use in diarrhea

Opiates reduce GI motility, and are used in some cases of diarrhea, but use can lead to dehydration.

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Atropine glaucoma

Atropine is contraindicated in glaucoma because it is an anticholinergic.

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Lithium's effect on serum sodium

Lithium can deplete sodium levels in the blood.

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Therapeutic range of lithium

Levels of lithium should be kept within a narrow range to avoid toxicity, and levels exceeding 1.5 may cause toxicity.

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Inhaled anesthetics

Gases used to induce general anesthetics, such as Halothane and Sevoflurane.

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Adverse effects of inhaled anesthetics

Potential side effects include respiratory depression and malignant hyperthermia.

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Anorexiants

Appetite suppressants that stimulate the brain to reduce hunger.

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Benzodiazepines and older adults

Short-intermediate acting benzos are okay, but use cautiously due to the increased risk of side effects.

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General anesthesia

Causes unconsciousness, pain relief, and CNS depression for surgery.

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Local anesthesia

Provides pain relief in a limited area without loss of consciousness

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Warfarin Side Effects

Prolonged bleeding, petechiae, ecchymosis, tarry stools, hematemesis, hemorrhage, dermatitis, nausea, and GI upset are possible side effects, potentially fatal.

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Thrombolytics Action

Dissolve existing blood clots to improve blood flow and possibly prevent blood clots.

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Alteplase (tPA)

A thrombolytic that activates plasmin, decreasing fibrinogen and clotting factors to increase bleeding risk.

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Thrombolytics Usage

Thrombolytics treat conditions like pulmonary embolism, acute heart attack, ischemic stroke, and deep vein thrombosis.

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Statin MOA

Statins inhibit HMG-CoA reductase, decreasing cholesterol production and increasing HDL.

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Statin Side Effects

Possible GI issues, cataracts, high blood sugar, liver problems, and muscle breakdown (rhabdomyolysis).

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Cholesterol Absorption Inhibitor MOA

Inhibit cholesterol absorption in the intestines, lowering LDL and triglycerides.

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Cholesterol Absorption Inhibitors (Ezetimibe)

Ezetimibe inhibits dietary cholesterol absorption, typically used with statins.

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Niacin (B3) Therapy

Reduces VLDL and LDL but has significant side-effects (so not commonly used except when triglycerides are high and other methods fail.)

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Cephalosporins Action

Cephalosporins inhibit bacterial cell wall synthesis with varying degrees of gram-positive/gram-negative coverage, based on generation.

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GERD Cause

Esophageal inflammation or erosion from refluxed gastric acid due to an incompetent lower esophageal sphincter.

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GERD Treatment

Used to treat GERD, including antiulcer drugs, H2 blockers, and PPIs.

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Antiulcer Drugs

Reduce the vagal nerve activity or block acetylcholine receptors, lessening acid secretions, although most have minimal effects on ulcers.

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Antacids MOA

Neutralize stomach acid (HCl) and decrease pepsin activity.

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H2 Blocker MOA

Block H2 receptors in stomach cells, reducing acid production, aiding ulcer healing by reducing acid cause.

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PPI MOA

Reduce stomach acid by inhibiting the hydrogen/potassium ATPase enzyme in parietal cells.

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Osmotic Laxative

Increase water in the colon, increasing stool bulk and stimulating bowel movements.

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Stimulant Laxative

Increase bowel movements by irritating nerve endings in the intestinal lining.

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Bulk-Forming Laxative

Absorb water, increasing stool bulk and stimulating bowel movements.

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Antabuse MOA

Blocks the enzyme needed for alcohol metabolism, preventing alcohol's breakdown in the body

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Study Notes

Patient Education for Oral Anti-Diabetics

  • Guidelines for Type 2 Diabetes patients over 40 or diagnosed within the last 5 years
  • Considerations include normal weight or overweight individuals with fasting blood glucose at or below 200 mg/dL and those requiring less than 40 units of insulin per day
  • Normal renal and hepatic function is essential
  • Withhold for IV contrast or surgery; increases risk of lactic acidosis and risk of renal failure

Types of Insulin

  • Rapid Acting (onset around 15 minutes): Insulin lispro (Humalog), Insulin aspart (NovoLog), Insulin glulisine (oral inhalation insulin)

  • Peak: Lispro and Aspart = 40 minutes; Glulisine and inhalation = 55 minutes

  • Duration: Between 1-3 hours

  • Administration: Before meals

  • Short Acting (onset 30 minutes): Regular Insulin(short)

  • Peak: 1-2 hours

  • Duration: 4-12 hours

  • Administration: SubQ or IV

  • Intermediate Acting (onset 1-2 hours): NPH Insulin Isophane

  • Peak: 4-12 hours

  • Duration: 12-24 hours

  • Administration: SubQ

  • Long Acting (onset 1-1.5 hours, does not peak): Insulin glargine (Lantus) and Insulin detemir

  • Peak: Does not peak

  • Duration: 24 hours

  • Administration: Once daily before bedtime

Side Effects and Patient Education for Steroids

  • Glucocorticoids:
    • Increased blood glucose (steroid-induced DM)
    • Moon face/buffalo hump from fat deposition
    • Growth retardation
    • MUST taper off slowly to avoid adrenal insufficiency
  • Mineralocorticoids (Fludrocortisone):
    • Monitor potassium (K+) levels
    • Monitor for fluid imbalance, fluid overload, hypertension, hypokalemia, and GI distress

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Description

This quiz covers essential patient education on oral anti-diabetics for Type 2 diabetes, including guidelines for patients over 40 and insulin types. Learn about the characteristics, administration, and risks associated with various insulin types to optimize diabetes management.

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