Week 9 Endocrine Emergencies 2022-2023 PDF

EHS 202 Pharmacology for EMS Week 9 - Endocrine Emergencies 10/19/2022 1 ENDOCRINE EMERGENCIES Learning Objectives By the end of this lesson you will be able to: Differentiate type 1 an...

EHS 202 Pharmacology for EMS Week 9 - Endocrine Emergencies 10/19/2022 1 ENDOCRINE EMERGENCIES Learning Objectives By the end of this lesson you will be able to: Differentiate type 1 and type 2 diabetes Explain the roles of glucagon, glycogen, and glucose in hypoglycemia Discuss the following medications for the treatment of hypoglycemia: dextrose (50%, 25%), and glucagon Define diabetic ketoacidosis and describe the complications associated with this condition for diabetic patients 10/19/2022 ENDOCRINE EMERGENCIES 2 Diabetes Diabetes: A common disease, manifested by a dysfunctional pancreas Insulin is required to convert sugars into energy for use by the body Diabetes takes two different forms: Type 1 Type 2 https://prescriptionhope.com/blog-what-is-the-difference-between-type-1-and-type-2-diabetes/ 10/19/2022 ENDOCRINE EMERGENCIES 3 Diabetes Type 1 diabetes Type 2 diabetes do not produce insulin capable of producing Cells of the body are insulin unable to take sugar Insulin is not used into the cell to be used properly by the body for energy (insulin resistance) Sugar is the main fuel of Majority of people have the cells type 2 diabetes Cells are not able to function 10/19/2022 ENDOCRINE EMERGENCIES 4  https://www.prevention.com/health/health-conditions/a21764231/type-2-diabetes-definition/ 10/19/2022 ENDOCRINE EMERGENCIES 5 Insulin Used in type 1 (sometimes in type 2) Stimulates the uptake of glucose by the cells Lowers the level of sugar in the blood Various types of insulins Differ by the time of onset and the duration of action are available. https://www.weightlossresources.co.uk/body_weight/insulin-resistance.htm 10/19/2022 6 Diabetes Diabetic emergencies—complications with blood sugar: Too high (hyperglycemia, potentially resulting in ketoacidosis) Too low (hypoglycemia, resulting in seizure or coma) 10/19/2022 ENDOCRINE EMERGENCIES 7 Hypoglycaemia Is defined as a blood sugar reading lower than ( 12 years – 10 grams IV/IO Repeat every 5 minutes Maximum dose 30 grams or 300 ml 10/19/2022 ENDOCRINE EMERGENCIES 13 Hypoglycemia Management If IV access is not possible, next step is IM glucagon Vomiting is a common side effect Requires close monitoring of the airway Blood glucose should be checked regularly When should we not administer this drug and why? 10/19/2022 ENDOCRINE EMERGENCIES 14 Diabetic Ketoacidosis DKA is most common in patients with type 1 diabetes Caused by a lack of insulin Too little insulin prevents the cells of the body from using glucose Consequently, blood glucose rises Glucose-starved cells start to break down fat, producing acid and chemicals (ketone bodies) 10/19/2022 ENDOCRINE EMERGENCIES 15 https://www.dietdoctor.com/six-principles-of-successful-self-management-of-type-1-diabetes Diabetic Ketoacidosis (DKA) Symptoms Increased thirst Increased urination Tachycardia Vomiting “Fruity” breath Due to the presence of ketone bodies 10/19/2022 ENDOCRINE EMERGENCIES 16  DKA Management DKA management requires correcting dehydration and acidosis with IV fluids and insulin Fluid replacement needs to be done slowly Conditions that quickly develop should be quickly corrected, and situations that slowly develop should be slowly corrected JRCALC – only administer fluids if evidence of circulatory failure or dehydration ADCDA – Symptomatic hyperglycemia (>250 mg/dl or 13.9 mmol/l) 10/19/2022 ENDOCRINE EMERGENCIES 17 Acute Adrenal Insufficiency Adrenal glands are located on top of each of the kidney Responsible for the production and secretion of several important hormones Addison’s disease or adrenal Insufficiency is uncommon & occurs when the body fails to produce enough of certain hormones. Treatment – Hydrocortisone (preferably slow IV, IM is an option if no IV access) Adult > 12 years: 100 mg – no repeat dose 10/19/2022 ENDOCRINE EMERGENCIES 18 Drug Revision for Newt Week Glucose gel Dextrose Glucagon 10/19/2022 ENDOCRINE EMERGENCIES 19 10/19/2022 20 ENDOCRINE EMERGENCIES References Andrew Pollak (2018). Nancy Caroline’s Emergency Care in the Streets, Eighth Edition. Jones & Bartlett Learning. Guy J (2020). Pharmacology for the Prehospital Professional, Second Edition. Jones & Bartlett Learning. Jones & Bartlett Learning (2020). Pharmacology for the Prehospital Professional, Second Edition Instructor's Toolkit. Jones & Bartlett Learning. 10/19/2022 ENDOCRINE EMERGENCIES 21