Exam 2 Pharm NUR 330

What is the onset, peak, and duration for rapid acting, and what types of insulin is this?

Onset: 10-30 minutes

Peak: 30 minutes- 3 hours

Duration:

3-6 hours

lispro, aspart, glulisine

What is the onset, peak, and duration for short acting?

Onset: 30-60 minutes

Peak: 1-5 hours

Duration: 6-10 hours

What types of insulin is short acting?

Regular

What is the ONLY insulin you can give IV

regular

What is the onset, peak, and duration for intermediate insulin and what insulin does this include?

Onset: 1-2 hours

Peak: 6-14 hours

Duration: 16-24 hours

NPH (cloudy)

What is the onset, peak, and duration for long acting insulin and what insulin does this include?

Onset: 1-2 hours

Peak: NONE

Duration: 12-24 hours

glargine & detemir

Metformin

Biguanide; enhance insulin sensitivity @ tissues, improve glucose transport into cells

HOLD FOR 24-48 HOURS BEFORE IV CONTRAST AND 48 HOURS AFTER

Side effects: GI, N/V, weight loss

GLP-1 Agonists

example is Exenatide, or Byetta

enhances glucose dependent insulin secretion & exhibit antihyperglycemic actions

side effects: weight loss, N/V, diarrhea, pancreatitis

Sitagliptin

Dipeptidyl peptidase-4 (DDP-4) inhibitor

increase insulin release, decrease glucagon secretion

Side effects: upper respiratory infection, allergic reactions, joint pain

Steroids

end in -sone

It is important to taper off steroids- meaning not stopping them completely.

These patients are at a higher risk of hyperglycemia, or higher blood glucose.

These patients are at a higher infection risk due to the high blood glucose.

If you take steroids too long, they are at risk of Cushing's disease, which is when the patient has excess cortisol. But if you don't taper and cut them off, they are at risk of Addison's disease, or not enough cortisol.

Beta blockers

end in -lol for example, propranolol used to decrease heart rate

side effects: 3 B's; bronchospasms, bradycardia, hypotension (low BP)

oxybutynin

used for urge incontinence

pioglitazone & rosiglitazone

increase body's sensitivy to insulin

Levothyroxine

used for hypothroidism

Need lifelong therapy

take 30 minutes before food

What antibiotic is used for C.diff?

vancomycin

glipizide

stimulates the pancreas to release a greater amount of insulin

Side effects: weight gain, dizziness, skin reactions

glyburide

helps the pancreas to release more insulin

Side effects: GI issues, dizziness, headache, weight gain

Radioactive Iodine

used for hyperthyroidism to help destroy the unhealthy tissue.

Need to teach patient to flush toilet twice; do not cook for children; good hand hygiene; best for them to be in their own room

essentially avoid as much exposure to others as possible!

What is the normal blood glucose range?

70-100

What is the normal A1C

4-5.6

What is the A1C for prediabetics?

5.7-6.4

What is the fasting glucose for prediabetics?

100-125

What is the A1C for Type II diabetics?

>6.5

What is the blood glucose level for DKA (diabetic ketoacidosis)

blood glucose >300

What is the blood glucose level for HHS (hyperosmolar hyperglycemic syndrome)?

blood glucose >600

What is the range for BUN?

10-20

What is the normal range for Cr?

0.7-1.4 or 0.6-1.2

What is the normal range for GFR?

>120