Card Set Information

2012-04-30 21:16:14

diabetes meds
Show Answers:

    • author ""
    • tags ""
    • description ""
    • fileName "Diabetes
    • Meds"
    • freezingBlueDBID -1.0
    • Fasting Blood glucose test
    • A1C?
    • FBS?
    • A1C >_ 6.5%
    • FBS > 126 mg/do
    • NPO for 8 hours before
    • Generally reflects glucose from hepatic production
  1. Casual blood glucose
    Blood glucose?
    • BG > 200 mg/do
    • Non fasting
  2. Postprandial blood glucose
    • After meals
    • Blood is drawn 2 hours after standard meal and reflect the efficiency of insulin-mediated glucose uptake by peripheral tissues
  3. Glycosylated hemoglobin
    • The glucose normally attaches to hemoglobin molecule on rbc
    • The higher the blood glucose levels, the higher the levels of glycosylated hemoglobin (HBA1C)
    • A1C is an average blood glucose level measured over the previous months
  4. Ketonuria
    • Urine levels of ketones can be tested by clients by use of a dipstick or tablets
    • The presence of ketones (ketonuria) indicates body is using fat for energy which may result in ketoacidosis
  5. Sulfonylureas
    Primarly used for?
    Primary action?
    • In type2 DM
    • increased insulin production from the panceas
  6. Meglitinides
    • Increase insulin production for the pancreas
    • Rapidly absorbed and eliminated
    • When taken just before meal (30min), there is a mimicking the normal blood glucose response to eating
  7. OA- Biguanides
    Metformin (glucophage)
  8. Biguanides
    Primary action?
    What does it do?
    Side effects?
    • Primary action- reduce glucose production by the liver
    • Enhances insulin sensitivity, improves glucose transport, does not promote weight gain
    • Side effects- needs to be held 48 hours before and after administration of IV contrast
  9. OA-
    A-Glucosidase inhibitors
    • Precose (acarbose)
    • Glyset (miglitol)
  10. A-Glucosidase inhibitors
    • "Starch blockers"
    • Works by slowing down the absorption of carbohydrates in the small intestine
    • Taken with the first bite of each main meal
    • They are most effective in lowering post prandial blood glucose.
    • Effectiveness of these medications is measured by checking 2 hour postprandial glucose levels
  11. OA- Thiazolidinedioes (TZD)
    • Avandia (rosiglitazone)
    • Actos (pioglitazone)
  12. Thiazolidinediones
    Most effective for who?
    Improve what?
    They don't do what?
    Not recommended for who?
    • "Insulin sensitizers"
    • Most effective for people who have insulin resistance
    • They improve sensitivity, transport, and utilization at target tissues
    • They don't increase insulin production, will not cause hypoglycemia when used alone
    • NOT RECOMMENDED FOR HF patients (can increase/cause fluid retention)
  13. OA- DDP-4 inhibitors
    • Sitagliptin (januvia)
    • Vildagliptin (galvus)
    • Saxagliptin (onglyza)
  14. DDP-4 Inhibitors
    How do they work?
    Work by preventing the break down of a naturally occurring compound in the body which will inhibit insulin secretion. This compound reduces blood glucose levels
  15. Metformin / rosiglitazone
  16. SubQ
    Stimulates incretin hormone
    Reduces glucose release by liver
    Increase satiety -weight loss
    Slows gastric emptying
    Not given with insulin
    For type 2 that have not achieved control with oral agents
    Incretin mimetic (byetta)
  17. Amylin analog
    Pramlintide (symlin)
  18. SubQ -thigh of abdomen only
    Decreases gastric emptying and glucose output from liver
    Increase satiety - weight loss
    Pramlintide (symlin)
  19. Rapid acting insulin
    • Humalog (lispro) & Novolog (aspart)
    • Onset : 15 min
    • peak: 60-90 min
  20. Short acting
    • Regular
    • Humulin R, NovolinR, Relion R
    • Onset: 30-1 hour
    • Peak: 2-3 hours
  21. Intermediate acting insulin
    • NPH
    • Humulin N, Novolin N, Relion N
    • Onset: 2-4 hours
    • Peak: 4-10 hours
    • Cloudy
  22. Long lasting insulin
    • Glargine (lantus) & Detemir (Levemir)
    • No peak action
    • Used once daily
    • SubQ. Either am or pm for patient who requires basal insulin for the control of hyperglycemia
  23. Side affects for sulfonylureas
    • Weight gain
    • Hypoglycemia
  24. Side effects for meglitinides
    • Weight gain
    • Hypoglycemia (less likely than sulfonylureas)
  25. Side affects for avandamet
    Rosiglitazone and metaformin

    • Mi or stroke
    • 48 hours before and after IV conntrast
  26. Drugs that lower glucose
    • Tylenol
    • Alcohol
    • Salicylates
    • Tricyclic antidepressants
  27. Drugs the raise glucose
    • Vaccine
    • Corticosteroids
    • Furosemide (lasix)
    • Nicotine
  28. Alcohol inhibits what?
    • Gluconeogenesis (breakdown of glycogen to glucose) by the liver
    • Can cause severe hypoglycemia
  29. Patients who use what drugs are at increased risk of hypoglycemia
    • Insulin
    • Sulfonylureas
    • Meglitinides
  30. Damage to blood vessels
  31. Autonomic neuropathy can cause
    • Hypoglycemic unawareness
    • Bowel incontinence
    • Urinary retention