Endocrine Pharmacology

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  1. What is the action of oral hypoglycemic agent?
    • increase insulin
    • carb metabolism
  2. Rapid Acting Insulin
    • Lispro (Humalog)
    • Insulin Aspart (Novolog)
    • Insulin Glulisine (Apidra)
  3. Rapid-acting Insulin:  onset, peak, and duration
    • onset:  < 15 min
    • peak:  0.5 to 1hr
    • duration:  3 to 4hr
  4. Short-acting Insulin
    • Regular insulin (Humulin R)
    • Regular insulin (Novolin R)
  5. Short-acting insulin:  onset, peak, and duration
    • onset:  0.5 to 1hr
    • peak:  2 to 3hr
    • duration:  5 to 7hr
  6. Intermediate-acting Insulin
    • NPH insuling (Humulin N)
    • Insulin determir (Levemir)
  7. Intermediate-acting:  onset, peak, and duration
    • onset:  1 to 2hr
    • peak:  4 to 12 hr
    • duration:  18 to 24hr
  8. Long-acting Insulin:  onset, peak, and duration
    • onset:  1hr
    • peak:  none
    • duration:  10.4 to 24hr
  9. What is the pharmacological action of insulin?
    • decrease glucose levels
    • convert glucose into glycogen
    • moves K+ into cell along c glucose
  10. What 4 medications/foods have additive hypoglycemic effects when used concurrently c insulin?
    • sulfonylureas
    • meglitinides
    • beta blockers
    • alcohol
  11. What 2 agents could raise blood glucose levels by counteracting the effects of insulin?
    • thiazide diuretics
    • glucocorticoids
  12. What hypertensive medication masks hypoglycemia?
    beta blockers
  13. Oral Hypoglycemics
    • Sulfonylureas
    • Meglitinides
    • Biguanides
    • Thiazolidinediones (Glitazones)
    • Alpha glucosidase inhibitors
    • Gliptins
  14. sulfonylureas - insulin release from pancreas
    • tolbutamide (Orinase)
    • glipizide (Glucotrol)
    • chlorpropamide (Diabinese)
    • glyburide (DiaBeta, Micronase)
    • glimepiride (Amaryl)
  15. meglitinides - insulin release from pancreas
    • repaglinide (Prandin)
    • nateglinide (Starlix)
  16. Biguanides- reduce production of glucose; increase glucose uptake
    metformin HCL (Glucophage)
  17. Thiazolidinediones (Glitazones)-decrease insulin resistance; increase glucose uptake and decrease glucose production
    • rosiglitazone (Avandia)
    • pioglitazone (Actos)
  18. Alpha gluosidase inhibitors - slows carb absorption and digestion
    • acarbose (Precose)
    • miglitol (Glyset)
  19. Gliptins - lowers fasting and postprandial blood glucose levels
    Sitagliptin (Januvia)
  20. hpoglycemia
    GI effects
    Vit B12 and folic acid deficiency
    Lactic acidosis
    • glipizide (Glucotrol)
    • repaglinide (Prandin)
  21. fld retention
    elevations in LDL
    rosiglitazone (Avandia)
  22. intestinal effects (abd distention and cramping, hyperactive bowel sounds, diarrhea, excessive gas)
    risk for anemia
    acarbose (precose)
  23. Which oral hypoglycemic is generally well tolerated?
    sitagliptin (Januvia)
  24. contraindications of oral hypoglycemics
    • avoid in pregnancy and lactation
    • renal failure, hepatic dysfunc, heart failure
    • contraindicated in DKA
    • Metformin HCL contraindicated in pts c  severe infection, shock, and hypoxia
    • acarbose (Precose) contraindicated in pts c GI disorders (Inflammatory, ulceration, or obstruction
  25. alcohol use disulfiram-like rxn
    alcohol, NSAIDs, sulfonamide antibiotics, ranitidien (Zantac), and cimetidine (Tagament) give hypoglycemic effect
    BB mask hypoglycemia
    glipizide (Glucotrol)
  26. use c gemfibrozil (Lopid) lead to increased risk of hypoglycemia
    • repaglinide (Prandin)
    • rosiglitazone (Avandia)
  27. use c alcohol increase risk of lactic acidosis
    use c iodine-containing contrast can result in renal failure
    metformin HCL (Glucophage)
  28. use c sulfonylurea or insulin increase risk of hypoglycemia
    use c metformin causes GI effects & risk of hypoglycemia
    acarbose (Precose)
  29. best taken 30 min prior to meal
    glipizide (Glucotrol)
  30. eat w/in 30 min of taking dose
    repaglinide (Prandin)
  31. take immediate release tabs 2 times/day c breakfast & dinner
    take sustained release tab 1 time/day c dinner
    metformin HCL (Glucophage)
  32. take once or twice a day c or s food
    rosiglitazone (Avandia)
  33. take c first bit of food 3 times/day
    do not take if 2 doses if miss a dose
    acarbose (Precose)
  34. take once a day c or s food
    sitagliptin (Januvia)
  35. pramlintide (Symlin)
    • reduce postprandial glucose levels
    • use c Type 1 or 2
    • use c insulin or oral hypoglycemic
  36. increase risk for hypoglycemia
    use c opiods or meds that delay food absorptions such as acarbose (Precose)
    pramlintide (Symlin)
  37. promotes release of insulin
    decrease secretion of glucagon
    slow gastric emptying
    fasting & postprandial blood glucose levels lowered
    exenatide (Byetta)
  38. glucose control for Type 2
    may be used c oral hypoglycemic (metfomin (Glucophage) or sulfonylurea)
    exenatide (Byetta)
  39. Complications:
    GI effects
    exenatide (Byetta)
  40. use cautiously in pts c cardio disease
    admin SC, IM, or IV
    provide food as soon as consciousness is regained
  41. oral contraceptives and antibiotics absorption are delayed
    exenatide (Byetta)
  42. use c sulfonylurea increase risk of hypoglycemia
    exenatide (Byetta)
  43. in prefilled injectors
    admin SC in thigh, abd, upper arms
    keep pen in fridge
    discard after 30 days
    exenatide (Byetta)
  44. give w/in 60 min b/f morning & evening meal
    exenatide (Byetta)
  45. never give after meal
    exenatide (Byetta)
  46. emergency management of hypoglycemia (insulin OD)
    decrease in GI motility in pts undergoing radiological procedures of stomach & intestines
Card Set:
Endocrine Pharmacology
2013-12-02 04:48:49
Endocrine Pharm
Index Cards for NCLEX Preparation
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