Endocrine Drugs: Glyburide (Diabeta)
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Questions and Answers

What is the main action of glyburide?

  • Reduces hepatic glucose production
  • Stimulates the kidneys to concentrate urine
  • Inhibits the release of thyroid hormone
  • Stimulates the beta cells to release insulin (correct)

    • What is the main indication for Desmopressin (DDAVP)?

  • Diabetes Insipidus (correct)
  • Hypothyroidism
  • Type 2 diabetes
  • Hyperparathyroidism

    • What is the main action of Calcitonin-salmon (Miacalcin)?

  • Stimulates insulin release
  • Inhibits parathyroid hormone secretion
  • Synthetic Thyroid Hormone (correct)
  • Reduces glucose absorption

    • What is the main side effect of Metformin?

    <p>GI upset</p> Signup and view all the answers

    What is the main action of Acarbose (Precose)?

    <p>Delays carbohydrate digestion and absorption</p> Signup and view all the answers

    What is the main indication for Potassium Iodide?

    <p>Thyroid hyperactivity</p> Signup and view all the answers

    What is the main action of Levothyroxine (T4)?

    <p>Replaces thyroid hormone T4 and T3</p> Signup and view all the answers

    What is a common adverse reaction of Desmopressin (DDAVP)?

    <p>Water intoxication</p> Signup and view all the answers

    What is a contraindication for Calcitonin-salmon (Miacalcin)?

    <p>Children under 11 months</p> Signup and view all the answers

    What is a nursing implication for Metformin?

    <p>Monitor for signs of liver disease</p> Signup and view all the answers

    Which cardiac drug mimics Epinephrine and Norepinephrine?

    <p>Metoprolol</p> Signup and view all the answers

    What are the nursing implications for Warfarin Sodium?

    <p>Monitor electrolytes and liver function</p> Signup and view all the answers

    What is the antidote for Warfarin Sodium overdose?

    <p>Vitamin K</p> Signup and view all the answers

    Which drug is an Angiotensin Converting Enzyme Inhibitor (ACE-I)?

    <p>Enalapril Maleate</p> Signup and view all the answers

    What is the action of Simvastatin (Zocor)?

    <p>Interferes with cholesterol synthesis</p> Signup and view all the answers

    Which drug reduces sympathetic excitation in the heart and slows down the heart rate?

    <p>Metoprolol</p> Signup and view all the answers

    What is the primary action of Diltiazem (Cardizem) as a calcium channel blocker?

    <p>Block Ca uptake by myocardial cells</p> Signup and view all the answers

    Which drug is an anticoagulant that interferes with fibrinogen conversion into fibrin?

    <p>Enoxaparin</p> Signup and view all the answers

    In the context provided, which drug is used to prevent clot formation in deep vein thrombosis or pulmonary embolism?

    <p>Enoxaparin</p> Signup and view all the answers

    Which drug class does Andrenalick belong to?

    <p>Cardiac Drug</p> Signup and view all the answers

    Which drug is administered at a 90-degree angle in the lower quadrants of the abdomen?

    <p>Heparin</p> Signup and view all the answers

    What is the antidote for heparin?

    <p>Protamine</p> Signup and view all the answers

    Which drug is a calcium channel blocker that blocks Ca uptake by myocardial cells?

    <p>Amlodipine</p> Signup and view all the answers

    What is the primary action of guaifenesin?

    <p>Reduce viscosity of mucous</p> Signup and view all the answers

    Which drug acts by relaxing the smooth muscle of the bronchi?

    <p>Theophylline</p> Signup and view all the answers

    What is the primary adverse effect of diphenhydramine?

    <p>Drowsiness</p> Signup and view all the answers

    Which medication is classified as a first-generation antihistamine?

    <p>Diphenhydramine</p> Signup and view all the answers

    What is the action of phenylephrine?

    <p>Drain sinus cavity</p> Signup and view all the answers

    Which drug acts by blocking histamine at H1 receptors?

    <p>Loratadine</p> Signup and view all the answers

    What is the primary action of acetylcysteine?

    <p>Reduce viscosity of mucous</p> Signup and view all the answers

    What is the primary mechanism of action of Glyburide in stimulating insulin release?

    <p>By stimulating the beta cells to release insulin</p> Signup and view all the answers

    What is the primary indication for Desmopressin (DDAVP)?

    <p>Diabetes Insipidus</p> Signup and view all the answers

    What is a common adverse reaction of Metformin?

    <p>GI upset</p> Signup and view all the answers

    What is the primary action of Calcitonin-salmon (Miacalcin)?

    <p>Reduces the vascularity of the thyroid gland</p> Signup and view all the answers

    What is a nursing implication for Glyburide?

    <p>Check for allergy to sulfa</p> Signup and view all the answers

    What is the primary action of Levothyroxine (T4)?

    <p>Increases metabolic rate by replacing thyroid hormone</p> Signup and view all the answers

    What is a common adverse reaction of Desmopressin (DDAVP)?

    <p>Water intoxication</p> Signup and view all the answers

    What is the primary indication for Potassium Iodide?

    <p>Mild or severe thyroid hyperactivity in the young</p> Signup and view all the answers

    What is a nursing implication for Calcitonin-salmon (Miacalcin)?

    <p>Monitor for signs of hypocalcemia</p> Signup and view all the answers

    What is the primary action of Acarbose (Precose)?

    <p>Delays carbohydrate digestion and absorption</p> Signup and view all the answers

    What is the indication for Nitroglycerin?

    <p>Angina Pectoris</p> Signup and view all the answers

    What is the action of Amlodipine?

    <p>Block Ca uptake by myocardial cells</p> Signup and view all the answers

    What is a common side effect of Guaifenesin?

    <p>Gastrotoxicity</p> Signup and view all the answers

    What is the action of Acetylcysteine?

    <p>Liquify thick, tenacious secretions</p> Signup and view all the answers

    What is a common side effect of Albuterol?

    <p>Cardiac stimulation</p> Signup and view all the answers

    What is the action of Theophylline?

    <p>Relax the smooth muscle of the bronchi</p> Signup and view all the answers

    What is a common side effect of Diphenhydramine?

    <p>Drowsiness</p> Signup and view all the answers

    What is the action of Phenylephrine?

    <p>Drain sinus cavity</p> Signup and view all the answers

    What is a common side effect of Triamcinolone?

    <p>Rebound congestion</p> Signup and view all the answers

    What is the action of Loratadine?

    <p>Block histamine at H1 receptors</p> Signup and view all the answers

    What is the antidote for heparin overdose?

    <p>Protamine</p> Signup and view all the answers

    What is the primary action of Enalapril Maleate?

    <p>Inhibits ACE from converting angiotensin I into angiotensin II</p> Signup and view all the answers

    What is the action of Digoxin?

    <p>Increases force of contraction in the heart</p> Signup and view all the answers

    What is the primary indication for Metoprolol?

    <p>Supraventricular tachycardia (SVT)</p> Signup and view all the answers

    What is the primary action of Simvastatin?

    <p>Interferes with cholesterol synthesis</p> Signup and view all the answers

    What is the primary indication for Enoxaparin?

    <p>Prevention of DVT or PE</p> Signup and view all the answers

    What is the primary action of Diltiazem?

    <p>Blocks Ca uptake by myocardial cells</p> Signup and view all the answers

    What is the primary indication for Warfarin Sodium?

    <p>Long-term control of anticoagulation</p> Signup and view all the answers

    What is the primary action of Epinephrine?

    <p>Mimics Epinephrine and Norepinephrine</p> Signup and view all the answers

    What is the primary indication for Digoxin?

    <p>Atrial fibrillation</p> Signup and view all the answers

    What is the primary action of Enalapril Maleate in terms of blood pressure?

    <p>Decreases blood pressure</p> Signup and view all the answers

    Study Notes

    Here are the study notes:

    Endocrine Drugs

    • Glyburide (Diabeta)
      • Stimulates beta cells to release insulin
      • Effective, but decreases in effectiveness over time
      • Adverse reactions: hypoglycemia, anorexia, N&V, heartburn, weight gain, weakness, numbness of extremities, heart and blood vessel disease, fetal abnormality, disulfiram (Antabuse) like reaction, hepatotoxicity, photosensitivity
      • Nursing implications: take 30 minutes before breakfast, check for sulfa allergy, recognize hypoglycemia and treatment
    • Desmopressin (DDAVP)
      • Stimulates kidneys to concentrate urine
      • Indications: Diabetes Insipidus, post-operative abdominal distention, dispel gas interfering with X-rays, Enuresis
      • Adverse reactions: hypersensitivity, tremors, vertigo, sweating, belching, N&V, diarrhea, water intoxication, spasms, thrombosis
      • Nursing implications: monitor for signs of hydration/dehydration, record I&O, urine SG, skin turgor, weight, lab tests, and EKG
    • Calcitonin (Miacalcin)
      • Synthetic thyroid hormone for hyperparathyroidism
      • Indications: hypersecretion of parathyroid hormone, osteoporosis
      • Adverse effects: N&V, muscle twitching, tetany, headaches, allergy, injection site irritation, hypocalcemia
      • Nursing implications: allergy testing, reconstitute and use immediately, store in refrigerator, and monitor for hypocalcemia
    • Metformin (Glucophage, Riomet, Fortamet, Glumetza)
      • Reduces hepatic glucose production, increases insulin sensitivity
      • Side effects: decreased weight, improved lipid levels
      • Adverse effects: GI upset, bloating, N&V, cramping, diarrhea, metallic taste, hypoglycemia, and lactic acidosis
      • Caution: liver, kidney disease, and excess alcohol
    • Acarbose (Precose)
      • Delays carbohydrate digestion and absorption
      • Take at first bite of meal
      • Adverse reactions: GI upset, bloating, flatulence, abdominal pain, diarrhea, hypoglycemia
      • Caution: liver and bowel disease
    • Potassium Iodide (Precose, Thyroshield, Thyrosafe, Iostat)
      • Reduces vascularity of the thyroid gland
      • Indications: 7-10 days before surgery, mild or severe thyroid hyperactivity in the young
      • Onset: 24 hours, peak: 10-15 days
      • Adverse reactions: iodism, metallic taste, fever, rash, parotitis, increased salivation, and allergic reaction
      • Nursing implications: check for allergy to seafood and iodine, dilute in milk, water, or fruit juice, and minimize GI toxicity
    • Levothyroxine (T4) (ThyroSAFE, ThyroSHIELD, IOSTAT, SYNTHROID)
      • Increases metabolic rate by replacing thyroid hormone T4 and T3
      • Indication: hypothyroidism replacement therapy
      • Objective: return patient to a euthyroid state
      • Adverse reactions: signs of hyperthyroidism, increased BMR
      • Nursing implications: start with low dose, take at the same time every day, early AM before breakfast, record apical pulse, and monitor for improvement in 10-14 days

    Cardiac Drugs

    • Epinephrine (Andrenalin, Adrenalick, EpiPen)

      • Mimics epinephrine, norepinephrine
      • Increases heart rate, force of contraction
      • Indications: shock (ICU patient)
      • Nursing implications: dilute in 250-500 mL, multi-lumen catheter, large vein, dose mcg/kg/min, titrate B/P parameters, and cardiac monitoring

    • Warfarin Sodium (Coumadin, Jantoven)

      • Prevents synthesis of vitamin K
      • Inhibits clot formation
      • Drug of choice for long-term control
      • Onset: 24 hours, optimal effect: 2-7 days
      • Dose: 2-15 mg/day, based on PT and INR
      • Antidote: vitamin K

    • Enalapril Maleate (Vasotec)

      • Inhibits ACE from converting angiotensin I into angiotensin II
      • Indications: HTN, CHF
      • Adverse reactions: dry cough, hyperkalemia, leukopenia, abnormal taste perception, hypotension, headache, angioedema

    • Simvastatin (Zocor)

      • Interferes with cholesterol synthesis
      • Adverse effects: abdominal pain, flatulence, constipation, muscle pain, headache, dizziness, insomnia, lens opacity, cardiac arrhythmia
      • Daily dose given in the evening

    • Digoxin (Lanoxin)

      • Indication: atrial fibrillation
      • Monitor apical heart rate
      • Patient education: pulse rate
      • Assess B/P before each dose
      • Know med parameters for holding drugs
      • PO: take with full glass of water
      • Monitor: electrolytes, liver and kidney function, intake and output, and space drugs at equal intervals

    • Metoprolol (Lopressor, Toprol XL)

      • Reduces sympathetic excitation in the heart
      • Blocks cardiac cell response to epinephrine
      • Blocks beta receptors
      • Indications: SVT, ventricular arrhythmias
      • Adverse reactions: GI, resp, cardiac, endocrine, reproductive, circulatory, neuro, skin, and mood
      • Nursing implications: monitor for peripheral circulation, BS levels, and signs of CHF

    • Diltiazem (Cardizem)

      • Blocks Ca uptake by myocardial cells
      • Adverse reactions: GI, flu-like symptoms, skin, cardiac, circulatory, and neuro

    • Enoxaparin (Lovenox)

      • Inhibits clot formation
      • Prevents DVT or PE
      • Interferes with fibrinogen conversion into fibrin
      • Drug of choice for initial anticoagulant therapy in acute conditions
      • Intravenous: IVP, IV infusion
      • Titrated objective: APTT or PTT
      • Onset action: 3-5 hours
      • Advantage: less expensive, infrequent coagulation studies, and decreased bleeding
      • Adverse effects: bleeding, hypersensitivity

    • Nitroglycerin (Nitro-Bid, Nitrostat)

      • Indication: angina pectoris
      • Action: opens coronary blood vessels, decreases cardiac workload, decreases cardiac oxygen consumption
      • Adverse effects: 3H's, dizziness, orthostatic hypotension, nausea, vomiting, eczema-like skin eruptions, and rash

    • Amlodipine (Norvasc)

      • Calcium channel blocker
      • Action: blocks Ca uptake by myocardial cells
      • Adverse effects: GI, flu-like symptoms, skin, cardiac, circulatory, and neuro### Respiratory System Drugs

    • Guaifenesin (Mucinex) is an expectorant that reduces the viscosity of mucous, making it easier to expel sputum.

    • It is an indirect acting drug that causes irritation, leading to an increase in bronchial secretions.

    • Side effects of Guaifenesin include hypersensitivity, gastrotoxicity, and drowsiness.

    • Nursing implications for Guaifenesin include positioning the patient in high Fowler's, increasing fluids, humidification, and suction as needed.

    Acetylcysteine (Acetadote, Cetylev)

    • Acetylcysteine is a mucolytic that breaks down thick, tenacious secretions.
    • Side effects of Acetylcysteine include nausea, vomiting, stomatitis, and bronchospasm.
    • Nursing implications for Acetylcysteine include teaching patients how to use an inhaled medication, administering it through inhalation or nebulizer, and mixing the liquid form with cola or fruit juice.

    Albuterol (Accuneb, ProAir, Vospiire ER)

    • Albuterol is a short-acting beta 2 agonist that stimulates beta 2 receptor sites, dilating the bronchi.
    • Side effects of Albuterol include CNS stimulation, cardiac stimulation, gastrotoxicity, and hypoglycemia.
    • Prolonged use of Albuterol can lead to tolerance.

    Theophylline (Elixophyllin)

    • Theophylline is a methylxanthine that relaxes the smooth muscle of the bronchi, increasing the bronchiole lumen size.
    • Side effects of Theophylline include nausea, vomiting, anorexia, hypotension, and CNS stimulation.
    • Caution should be exercised when consuming foods with xanthine (stimulants) such as cola, coffee, chocolate, and charcoal.
    • Drug interactions with Theophylline include increased toxicity with Allopurinol, Erythromycin, and Cimetidine, and decreased effectiveness with Anticonvulsants.

    Diphenhydramine (Benadryl)

    • Diphenhydramine is a first-generation antihistamine that blocks histamine at H1 receptors.
    • Side effects of Diphenhydramine include drying, drowsiness, hypotension, gastrotoxicity, hypersensitivity, photosensitivity, and paradoxical excitement.
    • Nursing implications for Diphenhydramine include taking it with food, administering it through deep IM injection, and stopping it 4 days prior to allergy testing.

    Phenylephrine (Neo-Synephrine)

    • Phenylephrine is a nasal decongestant that drains the sinus cavity.
    • Side effects of Phenylephrine include systemic and CNS stimulation, cardiac stimulation, gastrotoxicity, and rebound congestion.

    Triamcinolone (Nasal Decongestant - Corticosteroid)

    • Triamcinolone is a corticosteroid that decreases the formation of mucous and swelling.
    • Side effects of Triamcinolone include systemic and CNS stimulation, cardiac stimulation, gastrotoxicity, and rebound congestion.

    Loratadine (Claritin)

    • Loratadine is a second-generation antihistamine that blocks histamine at H1 receptors.
    • Side effects of Loratadine include drying, drowsiness, hypotension, gastrotoxicity, and hypersensitivity.

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    Learn about the action, effectiveness, adverse reactions, and nursing implications of Glyburide (Diabeta) as an endocrine drug. Understand its role in stimulating beta cells to release insulin and its potential side effects.

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