Drug Therapy for Diabetes Mellitus - Ch 41

40 vocabulary flashcards covering key terms from the lecture notes on diabetes drug therapy.

Diabetes Mellitus (DM)

A condition characterized by insufficient insulin availability or insulin resistance, resulting in elevated blood glucose.

Insulin

A hormone that facilitates glucose entry into muscle, fat, and liver cells and regulates metabolism of carbohydrates, fats, and proteins.

Type 1 Diabetes

Autoimmune destruction of the pancreas causing insulin deficiency; usually sudden onset; insulin required.

Type 2 Diabetes

Condition with hyperglycemia and insulin resistance; usually adult-onset; onset gradual; insulin not always required.

Hyperglycemia

Abnormally high blood glucose.

Polyphagia

Excessive hunger or eating.

Polydipsia

Excessive thirst.

Polyuria

Excessive urination.

Normal Glucose Level

Fasting blood glucose range of 70-110 mg/dL.

Glucometer

Device used to measure blood glucose levels.

Hypoglycemia

Abnormally low blood glucose, with symptoms such as sweating, shakiness, irritability.

Hypokalemia

Low potassium level (normal range 3.5-5 mEq/L).

Rapid-Acting Insulin

Onset about 15 minutes; peak around 1 hour; duration about 3 hours; used to control postprandial glucose.

Short-Acting Insulin

Onset about 30 minutes; peak around 2 hours; duration about 8 hours; used pre-meal; can be IV.

Intermediate-Acting Insulin

Onset about 2 hours; peak not defined; duration about 24 hours; used for baseline control.

Long-Acting Insulin

Onset about 2 hours; no peak; duration about 24 hours; provides steady basal insulin.

Insulin IV

Regular insulin given IV; the only insulin suitable for IV administration.

Mixed Insulin

Insulin combinations (e.g., 70/30, 75/25, 50/50) containing rapid/short-acting with intermediate-acting components.

Afrezza

Inhaled insulin used for type 1 or type 2 diabetes.

Subcutaneous Injection

Primary route for most insulin administration (injections, pens, pumps).

Sliding Scale Insulin

Dosing method where insulin units are based on current blood glucose readings.

Regular Insulin

Short-acting insulin that can be given IV; used for IV therapy.

A1C

Glycosylated hemoglobin; reflects average blood glucose over ~2-3 months; target typically <7%.

Potassium (K+)

Electrolyte monitored during insulin therapy; normal range 3.5-5 mEq/L due to hypokalemia risk.

Metformin (Glucophage)

Oral agent that reduces hepatic glucose production, lowers intestinal glucose absorption, and increases insulin sensitivity; may cause lactic acidosis; discontinue before certain imaging tests.

Glyburide

Sulfonylurea that increases insulin secretion and may increase insulin receptor numbers.

Glipizide

Sulfonylurea that increases insulin secretion; similar action to glyburide.

Rosiglitazone (Avandia)

Thiazolidinedione that increases insulin sensitivity; adverse effects include hepatotoxicity, edema, and weight gain.

Pioglitazone (Actos)

Thiazolidinedione that increases insulin sensitivity; similar adverse effects such as edema and weight gain.

Sitagliptin (Januvia)

DPP-4 inhibitor that increases hormones responsible for insulin release; taken once daily; may cause URI and sore throat; not for Type 1 DM.

Ozempic

GLP-1 receptor agonist; weekly injectable for Type 2 DM; may aid weight loss; stop 2 weeks before surgery; risk of delayed gastric emptying.

Mounjaro

GLP-1 receptor agonist; weekly injectable for Type 2 DM; dose increases to reach target glucose; stop 1 week before surgery.

Trulicity

GlP-1 receptor agonist; weekly injectable for Type 2 DM; weight loss; stop 1 week before surgery.

Hypoglycemia Treatment (conscious)

Juice or soda, glucose gel; faster acting carbs to raise blood glucose.

Hypoglycemia Treatment (unconscious)

Dextrose 50% IV push or Glucagon given IM or SQ to raise glucose.

Adolescent Considerations (Insulin)

Adolescents may resist adherence to therapy; requires supportive strategies.

Renal Impairment and Insulin

Dosage may need frequent adjustment due to kidney function.

Hepatic Impairment and Insulin

May require lower insulin doses; liver function affects metabolism.

Corticosteroids and Diabetes

Can cause hyperglycemia; may necessitate insulin even in non-diabetics.

Increased Insulin Effects: ACE inhibitors

Drug interactions that can enhance insulin action or risk of hypoglycemia.

Decreased Insulin Effects: Adrenergics

Drugs like albuterol or epinephrine may reduce insulin effectiveness.

Drug Interactions: Estrogen & Oral Contraceptives

Medications that can alter insulin needs or glucose control.

Glucagon and Thyroid Medications

Agents that can interact with insulin therapy, altering glucose control.

Phenytoin and Thiazide Diuretics

Medications that may affect insulin action and glycemic control.

Nursing Diagnoses for DM

Imbalanced diet, Dehydration, Knowledge deficit, Fear/Anxiety, Risk for injury, Hypokalemia.

Nursing Process: Planning/Outcomes

Goals include improved diet and exercise, better glucose management, and patient understanding.

Nursing Process: Interventions

Teach S/S of hyper/hypoglycemia, dosing, glucose monitoring, and injection technique.

Nursing Process: Evaluation

Assess therapeutic effects via glucose and A1C, monitor for adverse effects, ensure patient understanding.