Endocrine Drugs Study Notes

Endocrine Drugs Study Notes

Chapter 41: Drugs for Diabetes

Insulin Overview

• Primary Treatment: Insulin is the primary treatment for Type I diabetes.
• Functions:
    - Restores the diabetic's ability to metabolize carbohydrates, fats, and proteins.
    - Enables the storage of glucose in the liver.
    - Facilitates the conversion of glycogen to fat.

Side Effects of Insulin

• Common side effects:
    - Hypoglycemia
    - Blurred vision
    - Lethargy
    - Anaphylaxis
    - Sweating

Drug Interactions

• Notable interactions:
    - Alcohol
    - Steroids
    - Epinephrine

Insulin Characteristics

• Onset, Peak, Duration:
    - Rapid Acting:
      - Novolin (aspart), Humulog (lispro)
      - Clear
      - Onset: 5-15 minutes
      - Peak: 30-60 minutes
    - Short Acting:
      - Humulin Regular (human), Novolin R (human)
      - Clear
      - Onset: 30 minutes
      - Peak: 3 hours
    - Intermediate Acting:
      - Neutral Protamine Hagedorn (NPH)
      - Cloudy
      - Onset: 1-2 hours
      - Peak: 6 hours
    - Long Acting:
      - Lantus (glargine)
      - Onset: 1 hour
      - No true peak

Sliding Scale Use

• Used to determine insulin dose based on blood glucose levels.

Chapter 42: Nursing Interventions for Insulin Therapy

• Pre-Treatment Checks:
    - Check blood sugar before administration.
    - Note when insulin is expected to peak and if the patient has eaten.
• Mixing Insulin:
    - Determine if the insulin can be mixed; follow appropriate steps for mixing.
• Insulin Storage:
    - Store insulin in the refrigerator; lasts 30 days once opened.

Oral Antidiabetic Agents

Sulfonylureas

• Mechanism: Stimulates insulin secretion from beta cells of the pancreas.
• Effectiveness: Works best in early stages of Type II diabetes.
• Side Effects to Report:
    - Hypoglycemia
    - Jaundice
    - Anemia
    - Thrombocytopenia
• Common Drugs: Glipizide (Glucotrol), Glyburide (DiaBeta)

Biguanides

• Mechanism: Does not cause hypoglycemia; increases sensitivity of cells to existing insulin.
• Side Effects:
    - Abdominal cramps
    - Nausea
    - Cramping
    - Diarrhea
• Serious Side Effects to Report: Respiratory distress, hypotension
• Common Drug: Metformin (Glucophage)

Chapter 43: Nursing Interventions for Insulin and Oral Antidiabetic Therapy

• Timing of Medication: Take in the morning to prevent hypoglycemic events during sleep.
• Patient Education: Check for allergies, recognize signs of hyper/hypoglycemic reactions.
• Foot Care: Prevention of infection necessary; patients should monitor urine changes, especially for ketones.
• Lifestyle Considerations: Advise against alcohol consumption; recommend wearing a medical alert bracelet.