Pharmacology Exam 10

Adverse effect of metformin to teach patient to report to provider

extreme drowsiness, may indicate lactic acid acidosis.

Adverse effects of long-term use of corticosteroids

Delayed wound healing

increased risk for infections

increased risk for osteoporosis

hyperglycemia

Cushing’s syndrome

Difference in pathophysiology between type 1 and type 2 diabetes

DM type 1 - lack o insulin secretion by the pancreas

DM type 2 - capable of secreting insulin, but amounts are too small, insulin receptors in the target tissues have become unresponsive to the hormone.

effects of prednisone on blood sugar (specially in type 2 diabetic)

increase plasma glucose levels.

hyperglycemia (adverse effect for long term therapy)

How does glipizide work? (method of action)

stimulate beta cells in the pancreas to release insulin.

Lower serum glucose levels by increasing beta cell insulin production

increase receptor sit sensitivity.

Instructions for using Pramlintide (symlin pen)

have the patient inject it just before meal.

insulin storage

current vial of insulin at room temperature for up to 1 month

unopened vials of insulin should be stored in the refrigerator

unopened vials should NOT be frozen !

Lab results show agranulocytosis. What should you monitor the patient for?

monitor the patient for infection.

monitor for infections because the lack of sufficient white blood cells.

measurement patient can use to determine the effectiveness of thyroid medication

Pulse Rate.

Medications used for graves disease

Ionizing radiation

propylthiouracil (PTU)

Radioactive iodide (I-131)

& thyroidectomy (surgical removal of the thyroid gland)

Medications used to treat hyperthyroidism

Propylthiouracil (PTU), Ionizing radiation, radioactive iodide

Newly diagnosed type 1 diabetes - what symptoms too anticipate

Fasting blood glucose greater than 126 on at least 2 separate occasions

polyuria (frequent urination)

Polydipdia (frequent thirst)

Polyphagia (increased hunger)

Glycosuria (high level glucose in urine)

weight loss

fatigue

Onset and peak for Rapid-acting insulin

onset - 15-30 mins

peak - 60 mins

Duration - 3-5 hours

onset and peak for short-acting (regular)

onset- 30-60 mins

peak- 2-3 hours

duration- up to 7 hours

onset and peak of intermediate-acting insulin (NPH)

onset- 2-4 hours

peak- 4-14 hours

duration- 10-16 hours

onset and peak of long-acting insulin

onset- 1-2 hours

peak- no real peak

duration- 24+ hours

Patient teaching for glipizide

risk of hypoglycemia

can interact with alcohol causing flushing, palpations, nausea, and hypoglycemia

n&v, anorexia may be a side effect

lifestyle management

monitoring your serum glucose levels

patient teaching for insulin detemir, prescribed daily

its long-acting insulin

can be injected with the evening meal or before bedtime.

cannot be taken orally, only subcut.

rolls vial in hand do not shake

primary function of the endocrine system

maintain homeostasis by using hormones as chemical messengers

risk for developing type 2 diabetes

patient who are overweight

low HDL-cholesterol and high triglyceride levels

s/s of Addison disease

hypoglycemia, unusual fatigue, orthostatic hypotension, darkening skin pigmentation, joint pain, GI disturbances.

s/s of hyperglycemia

fasting blood glucose greater than 126 mg/dL on 2 separate occasions

polyuria (increased urination)

polydipsia (increased thirst)

polyphagia (increased hunger)

glycosuria (high level glucose in urine)

weight loss

fatigue

kussmaul breathing

fruity breath

s/s of hypoglycemia

confusion

sweating

dizziness

cool/moist skin

s/s of hypothyroidism

fatigue

slurred speech

bradycardia

weight gain

low body temperature

intolerance to cold

slowed body metabolism

s/s of Cushing syndrome

weight gain

fluid retention

moon face

adrenal atrophy

behavioral changes

changes in vision

osteoporosis

hypertension

increased risk of infections

delayed wound healing

acne

peptic ulcers

redistribution of fat

type of insulin used in diabetic ketoacidosis

Regular Insulin

(short-acting)

(discard if it appears cloudy)

type and name of insulin given at bedtime

Long-acting insulin

-insulin glargine (Lantus): given at bedtime

-insulin detemir (Levemir): can be injected in evening meal or before bedtime

types of foods to avoid when taking chlorpropamide

alcohol

high-sugar foods

refined carbohydrates

high-fat meals

foods with hidden sugars (ex. flavored yogurts, sauces, granola bars)

what is glucagon and what does it do when given for hypoglycemia

glucagon is a Glycemic Agent

initiates regulatory processes to promote the breakdown of glycogen to glucose in the liver. moves glucose from cells, primarily in the liver, to the blood; increasing the blood glucose levels.

what is the role of insulin in the body

regulation of blood glucose levels

what to monitor in patient who is taking levothyroxine and cholestyramine

-assess pulse before administrating medication

-assess the patients response

-check labs