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BC3 Diabetes
BC3- diabetes
| Question | Answer |
|---|---|
| injection sites | Rapid- Abdomen, Medium- Arms, Slowly- Legs, Very slowly- buttocks, Lantus absorbs about the same, any site |
| Inhaled Insulin | Exubera, Onset 10-20 min, peak 30-90 min, durration, 6 hrs. |
| Rapid acting insulin | Glulisine, Humalog, Novolog, Onset 15 min, peak 60-90 min, durration 3-4 hours |
| Short acting insulin | Regular Humulin R, Novolin R, Regular lletin, Onset 1/2 to 1 hour, peak 2-3 hour, durration 4-6 hours |
| Intermediate acting insulin | NPH (Humulin N, Novolin N) lente (Humulin L, Novolin L) Onset 2 hours, Peak 6-8 hours, durration, 12 to 16 hours |
| Long acting insulin | ultralente (Humulin U) detemir (Levemir) Onset 2 hrs, Peak 16-20 hrs., durration 24+ hrs. |
| Long acting insulin | glargine (Lantus) onset 1-2 hrs., peak no pronounced peak, durration 24 +hrs. |
| combination therapy | 70/30 Humulin, 70/30 Novolin, 50/50 Humulin NPH/regular |
| combination therapy | 75/25 (Humalog mix) NPH/lispro |
| storage of insulin | refrigerate maintain potency, unopened vials , stored in refrig. good until expiration date. Un-refrigerated insulin, discard in one month (opened or not) |
| what to do for Hyperglycemia | test b/g if over 200 mg/dL for several tests or for 2 days, call Dr. |
| Symptoms of hyperglycemia | extreme thirst, frequent urination, dry skin, hunger, blurred vision, drowsiness, decreased healing |
| causes of hyperglycemia | too much food, too little insulin or diabetes medicine, illness or stress, onset gradual, may progress to diabetic coma |
| to help hypoglycemia | drink 1/2 glass juice or soft drink (not diet), 1 glass milk or soft candy (not chocolate),test b/g, eat light snack peanut butter or meat sandwich and 1/2 glass milk |
| symptoms of hypoglycemia | shaking, fast heartbeat, sweating, dizziness, anxious, hunger, impaired vision, weakness/ fatigue, headache, irritable |
| hypoglycemia cause | too little food, too much insulin or diabetes medicine or extra activity, onset sudden, may progress to insulin shock |
| actions of Symlin | slowing of gastric emptying, increased satiety, leading to weight loss due to decreased caloric intake, decrease in glucagon release post prandially, never mix with insulin, for both type 1 & 2 |
| Byetta actions | increased signaling of the pancreatic B cells to synthesize& release insulin but only in the presence of an elevated glucose level, Slowing of gastric emptying, Increased satiety, leading to weight loss die to decreased caloric intake |
| Lantus | Long acting insulin (Clear) |
| Humulin U, Levemir | Lomg acting insulin (Clear) |
| Humulin N, Novolin N | intermediate acting insulin (cloudy) |
| Humulin L, Novolin L | intermediate acting insulin (cloudy) |
| Humulin R | short acting insulin (clear) |
| Novolin R | short acting insulin (clear) |
| Regular lletin | short acting insulin (clear) |
| Humalog | rapid acting insulin (clear) |
| Novolog | rapid acting (clear) |
| Glulisine | rapid acting (clear) |
| Exubera | inhalation powder, type 1& 2, Short acting for meal time, reaches peak quickly, glucose lowering within 10 to 20 min, peak 2 hrs. after inhalation, durration 6 hrs., give 10 min. before meal, not for asthma, smokers, COPD, newly quit smokers |
| Glucotrol, Glucotrol XL | second generation sulfonylureas |
| Amaryl | PO, second generation sulfonylureas |
| Micronase, DiBeta, Glynase | PO, second generation sulfonylureas |
| Glyset | A-Glucosidase inhibitor PO |
| Precose | a-Glucosidase inhibitor PO |
| Avandia | Thiazolidinediones PO |
| Actos | Thiazolidinediones PO |
| Starlix | Meglitinides PO |
| Prandin | (blank) |
| Duetact | combination of Pioglitazone & Glimepiride combination PO |
| Glucovance | combination of metformin & Glyburide PO |
| Avandaryl | Combination of Rosiglitazone/ Glimepride PO |
| Avandamet | combination of metformin & rosiglitazone PO |
| Metaglip | Combination of metformin and glipizide PO |
| Actoplusmet | combination of Pioglitazone & metformin Po |
| PO, meglitinides, action | stimulate a rapid- short lived release of insulin from the pancreas |
| meglitinides, side effects | weight gain, hypoglycemia |
| Meglitinides | repaglinide (Prandin), nateglinide (starlix) |
| second generation sulfonylureas PO, action | stimulate release of insulin form pancreatic islets, decrease glycogenolysis and gluconeogenesis, enhance cellular sensitivity to insulin |
| second generation sulfonylureas side effects | weight gain, hypoglycemia |
| a-glucosidase inhibitors action | delay absorption of glucose from GI tract, slow carbohydrate digestion |
| a-glusodidase inhibitors side effects | gas, abdominal pain, diarrhea, nausea |
| a-glucosidase inhibitors | at start of meals, a carbose (Precose) miglitol (Glyset) |
| thiazolidinediones action | increase glucose uptake in muscle. Lower endogenous glucose production |
| thiazolidinediones, side effects | weight gain, edema, fluid retention, CHF |
| thiazolidinediones | take once or twice per day PO pioglitazone (Actos), rosiglitazone (Avandia) |
| Glucovance | PO combination therapy of metformin and glyburide |
| Avandamet | PO combination of rosiglitazone and metformin |
| Metaglip | PO combination of metformin and glipizide |
| PO combination therapies side effects | Nausea, diarrhea, abdominal pain, lactic acidosis, weight gain, hypoglycemia |
| biguanide action | augments glucose uptake by tissues especially muscles. lowers rate of hepatic glucose production |
| biguanide sied effects | nausea, diarrhea, lactic acidosis |
| biguanide | metformin (Glucophage, Glucophage XR and Fortamet) take with meals |
| Duetact | Combination of Pioglitazone and Glimpiride PO |
| Actoplusmet | combination of metformin and pioglitazone PO |
| Avandaryl | combination of Rosiglitazone and Glimepride PO |
| When mixing insulins | Draw up clear first, Never mix Humulin RU500, Lantus, Levemir or premixed insulins with any other insulins |
| assessing patient treated with GLA (glucose lowering agent) cognitive | patient responsible? able to understand why insulin or OA is used. understands asepsis, combining insulins, OA actions and SE. able to remember to take 1/day, take meds at right time relation to meals.administer OK?, attitudes and emotion about diagnosis |
| assessment follow up for GLA treated patient | effectiveness of therapy, symptoms of hyperglycemia?, BG record show good control?, glycosylated hemoglobin consistant w/glucose records.Atrophy/hypotrophy present at injection site?, had hypoglycemic episodes, how are they handled< how often, what time ? |
| assessment for patient treated with GLA | compplaints of nightmares?, night sweatrrs, early AM headaches, any skin rash, GI uppset since taking OA? |
| discard insulin after 1 month | any insulin in a vial, Humalog, apidra pen/cartrige, Novolog flex pen/pen fill |
| discard after 14 days | Humulin N.Pen, Novilin, pen fill/ innolet,Novolog 70/30 flex pen/ penfill |
| discard after 10 days | Humulog 75/25, 50/50 Pen, Humulin 70/30 pen, NOvolin 70/30 penfill/innolet |
| discard after 42 days | any Levemir |
| Symlin action | slows rate of release from stonach to small intestine, supresses secretion of glucagon, slows production of glucose |
| Symlin, what is it? | Meant to repplace naturally occuring amylin, a synthetic analog of the hormone amylin. Amylin enhances how insulin works. |
| Symlin SE and precautions | not to be mixed with insulin in same syringe, insulin level to be reduced, causes fullnes, nausea, vomiting (rare), not for those with gastric bypass, or Low BSugar, or children. |
| second generation sulfonylureas | glipizide (Glucotrol, Glucotrol XL), glyburide (Micronase, DiaBeta, Glynase), glimepiride (Amaryl), Take with meals, SE hypoglycemia |
| first and second generation sulfonylureas action | stimulate release of insulin from pancreatic islets, decrease glycogenolysis and gluconeogenesis, enhance celluylar sensitivity to insulin |
| sulfonylureas side effects | weight gainand hypoglycemia |
| first generation sulfonylureas | PO for diabetes, not common, replaced with second generation. 1st generation are tulbutamide (orinase), acetohexmamide (dymelor), tolazamide (Tolinase) and chlorpropamide (Diabinese) |
| Byetta action | Mimics action of glucagon like peptide 1 (released in the gut), 1st drug in this class of incretin mimetics because they mimic function of incretin hormones, stimulates bodys insulin secretion |
| Byetta information and SE | Only for type 2 diabetes injectable. approved for people who take metformin, a sulfonylurea, or both, take less than 1 hour before AM & PM meals. Not for children, severe kidney disease or gastroparesis |
Created by:
goryan
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