Diabetes Pharmacology PDF

Diabetes pharamcology Study online at https://quizlet.com/_g59skc 1. Name the two functions of 1. exocrine the pancreas 2. endocrine 2. What is the exocrine func- secretion of several enzymes into the duode- tion num to assist in the d...

Diabetes pharamcology Study online at https://quizlet.com/_g59skc 1. Name the two functions of 1. exocrine the pancreas 2. endocrine 2. What is the exocrine func- secretion of several enzymes into the duode- tion num to assist in the digestion of nutrients 3. What is the endocrine func- 1. Islets of Langerhans tion (4) 2. Secretion of glucagon/insulin 3. Alpha cells secret glucagon 4. Beta cells secret insulin 4. What 3 things does insulin carbs affect lipids proteins 5. Name 2 roles of insulin 1. assists in glucose transport = activating in- sulin receptors leads to internal cellular mech- anisms that uptake glucose 2. hypoglycemic affect = causes glucose to leave the blood and serum glucose to fall 6. T or F: The brain requires in- False: it does not require insulin for glucose sulin for glucose transport transport. the brain solely requires glucose for its energy needs because it is unable to syn- thesize glucose 7. What is glucagon antagonist to insulin 8. What is the role of glucagon 1. when glucose is low, glucagon secreted 2. maintain adequate blood glucose levels be- tween meals 1 / 13  Diabetes pharamcology Study online at https://quizlet.com/_g59skc 3. hyperglycemic effect 9. T or F: Diabetes mellitus is True a metabolic disorder 10. What is the pathophysiolo- 1. insufficient insulin secretion gy of DM 2. decreased sensitivity of insulin receptors on target cells 11. What is the etiology of DM 1. Combination of genetic + environmental fac- tors 2. Sedentary and stressful life-style, increasing consumption of high calorie foods resulting in obesity, increasing longevity 12. What is the role of the liver regulate the body's fuel supply so that all tis- and pancreas for DM sues of the body have sufficient energy to per- form their functions 13. Describe the normal ranges a) 4-7mmol/L of blood glucose levels: a) during fasting b) 5-10 mmol/L b) 2 hours after meals 14. Where are 2/3 of glucose in the liver and muscle cells as glycogen stored 15. What happens when glu- glycogen is broken down via glycogenolysis cose levels fall between and glucose released into blood stream meals 16. Name 4 physiological ac- 1. promotes the entry of glucose into cells tions of insulin 2. provides for the storage of glucose as glyco- gen 3. inhibits the breakdown of fat and glycogen 2 / 13  Diabetes pharamcology Study online at https://quizlet.com/_g59skc 4. increase protein synthesis and inhibits glu- coneogenesis 17. Name 3 ways you can test 1. Glycosylated hemoglobin (A1C) for diabetes 2. Fasting plasma glucose (FPG) 3. Oral glucose tolerance test (OGTT) 18. What happens during a Serum glucose increases, more glucose be- Glycosylated hemoglobin comes bound to hemoglobin (A1C) test? b) does it require fasting? b) no c) what value does it give? d) what value indicates dia- c) provides average measure of glucose control betes over 8-12 weeks prior to the test d) 6.5% or higher 19. What happens during a Obtained following a fast of at least 8 hours Fasting plasma glucose (FPG) & what value indi- 7.0 mmol/L or higher cates diabetes 20. What happens during a A loading dose of 75 g ofglucose is ingestedo Oral glucose tolerance test plasma glucose level is obtained 2 hours later (OGTT) and what value indi- cates diabetes 11.1 mmol/L or higher indicates diabetes 21. What are 2 types of compli- 1. Macrovascular changes cations of diabetes 2. Microvascular changes 22. What are macrovascular Changes affecting the coronary, carotid, and changes femoral arteries are termed macrovascular and mainly include accelerated atherosclerosis 23. What are microvascular results from thickening of the vessel mem- changes branes in the capillaries and arterioles in re- 3 / 13  Diabetes pharamcology Study online at https://quizlet.com/_g59skc sponse to chronic hyperglycemia onset is later 24. What happens when there Ketosis is a lack of insulin and glu- cose cannot enter cells? 25. What happens as a result Lower PH = ketoacidosis of ketosis and what type of diabetes does it effect Type 1 26. Type 1: a) 11-13 yrs or early adulthood a) onset b) occurence b) 5-10% c) etiology c) autoimmune destruction of pancreatic beta cells causing an absolute lack of insulin (genetic, environmental, immunologic) 27. What are typical signs and 1. hyperglycemia symptoms of Type 1 dia- betes 2. 3 P's 3. Glucosuria (glucose in urine) 4. Weight loss 5. Fatigue 6. Bedwetting in children 7. irritability and other mood changes 8. blurred vision 28. What is ketoacidosis? occurs when fat are metabolized in the ab- sence of insulin 29. 4 / 13  Diabetes pharamcology Study online at https://quizlet.com/_g59skc Name 4 ways to character- 1. Hyperglycemia ize ketoacidosis 2. ketosis 3. metabolic acidosis 4. dehydration 30. What are precipitating fac- 1. illness/infection tors to ketoacidosis 2. inadequate insulin dosage 3. insulin omission 4. undiagnosed type 1 5. poor self-management 31. What are presenting symp- 1. Polydipsia toms of ketoacidosis 2. polyuria 3. Dehydration 4. fatigue 5. weight loss 6. Blood glucose above 14mmol/L 32. Name 4 ways to manage ke- 1. IV Fluids toacidosis 2. Electrolyte replacement 3. IV administration of short acting insulin 4. Monitor neuro status, I+O, blood glucose, electrolytes, cardio/resp status 33. True 5 / 13  Diabetes pharamcology Study online at https://quizlet.com/_g59skc T or F: Almost all insulin is human insulin obtained through recombinant DNA technology 34. T or F: Insulin can be used True to correct hyperkalemia (levels over 6.0 mmol/L) 35. Name the 5 types of insulin 1. Rapid acting 2. Short acting 3. Intermediate acting 4. Long acting 5. Mix combinations 36. Name: a) lispro + aspart a) rapid acting (2) b) short acting b) regular 37. Name: a) NPH a) intermediate acting b) long acting (2) b) glargine, detemir 38. Name 2 ways to administer 1. Subcutaneous injection: syringe or pen insulin 2. Insulin Pump 39. Insulin pump: a) abdominally anchored a) where is it? b) what is it? b) programmed to release small SC insulin dose into the abdomen at predetermined inter- vals, with larger boluses administered manually at mealtime if necessary 40. Bolus (rapid-acting) In- a) 10-15 mins sulin: 6 / 13  Diabetes pharamcology Study online at https://quizlet.com/_g59skc a) onset b) given with 1 or more meals a day 0-15 min b) meal? prior 41. Short acting insulin: a) 30 min a) onset b) meals? b) give with 1 or more meals a day 30-45 min prior 42. Basal insulins (intermedi- a) 1-3 hours ate acting) a) onset b) usually given once daily at bedtime b) meals? not given with meals must be mixed before giving 43. Long acting insulin: a) 90 mins a) onset b) meals? b) usually once at bedtime not given with meals 44. Mixed combination insulin: a) varies with type of insulin a) onset b) meals? b) given with 1 or more meals per day inject 15-45 mins prior to start of meal 45. Define hypoglycemia too much insulin and not enough available glu- cose 46. What are: a) exercise a) causes of hypoglycemia skipped meals b) symptoms receives too much insulin b) pale, cool, clammy, diaphoretic blood glucose below 4mmol/L sudden onset 47. What is pseudo-hypo- all the symptoms of hypoglycemia but blood glycemia sugar is in normal range treat for hypoglycemia 7 / 13  Diabetes pharamcology Study online at https://quizlet.com/_g59skc 48. Name the 3 types of morn- 1. waning insulin levels ing hyperglycemia 2. somogyi phenomenon 3. dawn phenomenon 49. What is waning insulin lev- Insulin levels decrease during the night causing els hyperglycemia in the morning 50. What is the somoyi phe- rapid decrease in blood glucose during the nomenon night hormones are stimulated to cause a release of glucose in the blood stream = elevated blood glucose level in the morning 51. What is the dawn phenome- Between 0400 and 0800 the body produces non cortisol and growth hormone = high glucose in blood 52. Name 3 ways to manage hy- 1. Oral = glucose in the form of tablets, sugar, poglycemia and describe life savers, soft drink, juice, honey 2. Subcutaneous = glucagon may produce projectile vomiting 3. IV = dextrose solution D10W or D50W 53. What should the nurse do Closely monitor blood glucose levels before meal and insulin ad- ministration 54. What are signs of over- Nervousness dosage (hypoglycemia) Confusion Excessive Sweating Rapid Pulse 8 / 13  Diabetes pharamcology Study online at https://quizlet.com/_g59skc Tremors 55. What are signs of under- Increased thirst/urine output dosage Decrease appetite Excessive fatigue 56. T or F: When in doubt True about whether symptoms indicate hypoglycemia or hyperglycemia, treat for hy- poglycemia 57. Why is it important to rotate Prevent lipodystrophy (Fat cell accumulation) injection sites 58. T or F: Keep insulin vials True that are currently in use at room temperature; when not needed, refrigerate in- sulin to keep it stable 59. Type 2: a) insulin resistance = enough insulin but cells a) cause? do not recognize insulin b) onset? b) 35+ years but can be any age 60. What are symptoms of type gradual onset 2 3 P's, blurred vision, fatigue, glucosuria, weight gain, recurrent infections 61. What is gestational dia- Glucose intolerance with an onset or first betes recognition during preganancy 62. What are risk factors of a) family history, gestatinoal diabetes and how do you manage it history of stillbirth/spontaneous abortion/large 9 / 13  Diabetes pharamcology Study online at https://quizlet.com/_g59skc gestational age baby, obesity, advanced maternal age, five of more pregnancies b) diet and exercise, oral antidiabetic drugs that are teratogenic 63. Name 7 oran antihyper- 1. Alpha-glucosidase inhibitors glycemics 2. Biguanides 3. Incretin enhancers 4. Glinides 5. Sulfonylureas 6. Thiazolidinediones 7. Sodium glucose cotransporter inhibitor 2 64. Alpha-glucosidase In- a) acarbose hibitors: a) Name? b) interferes with carb breakdown and absorp- b) MOA tion acts locally in GI = little systemic affects 65. Alpha-glucosidase In- a) flatulence hibitors: diarrhea a) adverse effects abdominal distention b) meals? hypoglycemia when w/ another drug b) take with first bite of meals 66. Biguanides: a) Metformin a) Name b) MOA b) Decrease production and release of glucose 10 / 13  Diabetes pharamcology Study online at https://quizlet.com/_g59skc = increases cellular uptake of glucose -lowers lipid levels and promotes weight loss 67. Biguanides: a) flatulence a) adverse effects diarrhea b) meals? nausea anorexia abdominal pain bitter/metallic tase lactic acid b) take with meals 68. Incretin enhancers: a) liptin or tide a) name (suffixes) b) MOA b) mimics the effects of incretin: slows break- down of insulin = in blood longer slows rate of digestion = increase satiety 69. Incretin Enhancers a) headache a) adverse effects upper resp/urinary infections b) route skin rashes Steven's Johnson Syndrome Weight loss diarrhea vomiting nausea b) given subcutaneous 70. Glinides: a) glinide a) name (suffix) b) MOA b) stimulates insulin release 71. Glinides: a) flu-like symptoms a) adverse effects upper resp infection b) meals? back pain b) shortly before meals 11 / 13  Diabetes pharamcology Study online at https://quizlet.com/_g59skc 72. Sulfonylureas: a) ride a) name? (suffixes) b) MOA b) stimulates insulin release, decreases insulin resistance 73. Sulfonylureas: a) nausea a) adverse effects heartburn b) meals? dizziness headache drowsiness rash cross-sensitivity with sulpha drugs + thiazide diuretics b) shortly before meals 74. Thiazolidinedioneses: a) tazone a) name? (suffixes) b) MOA b) decrease production/release of glucose from liver; increase insulin sensitivity in fat/muscle tissue 75. Thiazolidinedioneses: a) upper resp infection a) adverse effects myalgia headache weight gain fluid retention/worsening HF 76. Sodium Glucose Cotrans- a) flozin porter inhibitor 2: a) name (suffixes) b) prevents kidneys from reabsorbing glucose b) MOA into the blood; kidneys lower blood glucose lev- els; glucose removed via urine 77. Sodium Glucose Cotrans- a) female genital mycotic infections porter inhibitor 2 UTI a) adverse effects naspharyngitis b) meal? b) in the morning, with out w/o food 12 / 13  Diabetes pharamcology Study online at https://quizlet.com/_g59skc 78. What is a hyperosmolar hy- insufficent circulating insulin perglycemic state 79. HHS: a) gradual, sometimes mistaken for stroke a) onset b) symptoms b) flushed, dry, warm c) blood glucose levels c) above 33.3 mmol/L 80. Name 2 ways to treat HHS 13 / 13