Patho

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Author:
Rhenea
ID:
148023
Filename:
Patho
Updated:
2012-04-16 21:23:49
Tags:
Diabetic Type II Med Patho
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Description:
Diabetic Medication and Patho
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  1. What is the first line treatment for Type 2 Diabetes?
    • Meal planning for blood glucose control, weight loss and exercise
    • Dietary measures: monitor caloric intake, balance ration of fats/carbohydrates/protein
    • Losing weight and increasing activity may help lower body’s resistance to insulin
    • Exercise also reduces glucose levels by taking glucose from blood and using it for energy
    • Oral hyperglycemic agents are primarily used if these other measures do not work
  2. What is Euglycemic?
    normal blood glucose levels
  3. What are the two treatments available to patients that are cost effective for Type 2 Diabetes? Why?
    • Losing weight and increasing activity may help lower body’s resistance to insulin
    • They don't cost any money to exercise and you gotta eat just make better choices.
    • Stop smoking (that would save you money LOTS of it)
  4. What group of medications is the first line or initial drug given to patients with Type 2 Diabetes name two generic and brand name. Identify “generation”.
    • Second generation: Sulfonylureas - stimulate insulin secretion form the bata cells of pancreas.
    • Amaryl (glimepiride)
    • Glucotrol,(glipizide)
  5. What type of drug is Glucophage (Metformin)?
    What are its onset, peak half-life and duration?
    • Class - Biguanides
    • Onset of action: UNKNOWN
    • Peak: 1–3 hours
    • Half-life: 1 ½ - 5 hours
    • Duration: 6-20 hours
  6. What is the big difference between Repaglinide (Prandin) and Glucophage (Metformin)?
    • Meglitinides - Action similar to sulfonylureas Increase insulin secretion from pancreas *most effective within one hour of taking
    • Biguanides - Decrease production of glucose
    • Increase uptake of glucose by tissues
    • Does NOT increase insulin secretion from pancreas (does not cause hypoglycemia)
  7. Which drugs are the gene regulators and insulin sensitizers?
    • Thiazolidinediones known as insulin sensitizers decrease insulin resistance.
    • They Decrease insulin resistance
    • Are known as “insulin sensitizing drugs”
    • Increase glucose uptake and use in skeletal muscleInhibit glucose and triglyceride production in liver
  8. Which drug class is given to patients that do not get adequate glucose control with Biguanides (Metformin) r Sulfonylurea’s (Diabeta)?
    Alpha-glucosidase inhibitors
  9. What drug class is Precose?
    • Alpha-glucosidase inhibitors - Others
    • Acarbose (Precose), Miglitol (Glyset)
  10. Where does Precose take effect?
    Inhibits the enzyme alpha-glucosidease in the Small Intestine
  11. What are the four major classes of Insulin?
    • Rapid acting - 5-15 min onset
    • Short acting - 30-60 min onset
    • Intermediate acting - 1-2 hours onset
    • Long acting - slowly abosrbed given 1-2x's a day
  12. How is insulin manufactured?
    • Derived from porcine or beef sources
    • Most are human-derived, using recombinant DNA technologies
  13. Name each class then give Onset, peak, half life, and duration.
    • Class Onset | Peak | 1/2Life | Duration
    • Rapid acting - 5-15 min | 1-2Hr | 80min | 3-5Hr.
    • Short acting - 30-60 min | 2-5Hr | ???? | 6-10 Hr
    • Intermediate - 1-2 Hr. | 4-8Hr | ???? | 10-18Hr
    • Long acting - 1 to 6-10 | 0 - 8-20 | ???? | 24+ to 20-24
  14. What is a sliding scale? How is it used?
    • Sliding Scale short-acting (Lispro) or regular insulin doses adjusted according to blood glucose test results
    • Typically used in hospitalized diabetic patients, or in patients on TPN or enteral tube feedings
    • SC insulin is ordered in an amount that increases as the blood glucose increases
    • Example:
    • 2 units for glucose value:141-199mg/dl
    • 4 units for glucose value 200-249 mg/dl
    • 6 units for glucose value 250-299mg/dl
    • 8 units for a glucose value of 300 mg/dl
    • Greater than 300 call the physician
  15. Name five teaching education pointers you would instruct a newly diagnosed patient on prior to discharge?
    • Disease process
    • Diet and exercise recommendations
    • Self-administration of insulin or oral drugs
    • Potential complications

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