1050: diabetic meds

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Author:
xiongav
ID:
291197
Filename:
1050: diabetic meds
Updated:
2014-12-16 12:41:30
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NURS
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Description:
insulin R, insulin aspart, glargine, glucagen, glyburide, metformin
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  1. Insulin Regular.

    What is the speed of action?

    What are the uses?
    speed: short

    Uses: decrease BG; stimulates muscles/fat cells to use glucose.

    (need LONG acting insulin, glargine, to keep BG stable; use separate syringe and site)
  2. What are some SFX of insulin R that are the same for insulin aspart and insulin glargine (long acting)?

    What are some AFX with insulin R that are the same for insulin aspart and insulin glargine (long acting)?
    SFX: lipodystrophy, pruritis, wt. gain.

    AFX: HYPOglycemia, anaphylaxis.
  3. Explain some nursing actions for insulin R.

    Can it mix w/ NPH in same syringe?
    Use correct syringe: U50, U100, U500.

    Store open vial at room temp; store closed vial in fridge.

    Give 15-30 minutes before meals.

    Check BG regularly.

    ~Yes, same syringe w/ NPH is okay.
  4. Insulin aspart.

    What is its speed of action?

    What is its use?
    Speed: rapid

    Use: same as Regular but more rapid.

    (need LONG acting insulin, glargine, to keep BG stable; use separate syringe and site)
  5. What are SFX/AFX of insulin aspart (same as insulin R and insulin glargine)?
    SFX: lipodystrophy, pruritis, wt. gain.

    AFX: HYPOglycemia, anaphylaxis.
  6. What are the nursing actions for insulin aspart?
    Give 5-10 minutes before meals.

    May be used in a pump.

    ~Can mix w/ NPH in same syringe.
  7. Insulin glargine.

    What is its speed of action?

    What is its use?
    Long acting.

    Uses: same as regular but slower (lasts 12-24 h)
  8. What are insulin glargine's SFX/AFX that are similar to insulin regular and insulin aspart?
    SFX: lipodystrophy, pruritis, wt. gain.

    AFX: HYPOglycemia, anaphylaxis.
  9. What is insulin glargine's teaching that is similar to insulin regular?

    What are some other actions?
    Storage: open vial in room temperature, closed vial in fridge.

    *Cannot mix in syringe w/ other insulin. 

    Check BG routinely; check A1C q3 months.

    Will need short or rapid insulin for meal coverage & hyperglycemic episodes.
  10. For HYPOglycemia; Glucagen.

    (<70 bg; <40 = severe hypoglycemia)

    What is its action?
    Stimulates hepatic production of glucose to increase BG.
  11. For HYPOglycemia; Glucagen.

    What are some s/sx of HYPOglycemia?
    • tingling
    • chills 
    • cold sweats
    • confusion
    • hunger
    • paleness
  12. What are SFX and AFX of Glucagen (for hypoglycemia)?
    SFX: N/V, hypotension.

    AFX: Respiratory distress.
  13. If Pt is hypoglycemic, how should you treat the Pt (rule)?
    • Use "routine 15": 
    • 1) Take 15 grams..
    • 2) Wait 15 minutes..
    • 3) Retest, call HCP..

    (IV solution: recon. only w/ diluent provided)
  14. For Type II diabetes (PO).

    glyburide; what is its class and action?
    Sulfonylurea.

    Use: decrease BG by increasing insulin secretions in pancreas.
  15. For Type II diabetes (PO).

    glyburide

    What are the contraindications for glyburide?
    • Pregnancy
    • Liver/renal disease
    • Allergy to sulfonylureas
  16. What are some SFX of glyburide?
    (think of route of admin)

    What are some AFX of glyburide?
    • N/V
    • GI upset
    • heartburn
    • pruritus/itch

    • Aplastic anemia
    • HYPOglycemia
    • angioedema
  17. What are some teaching and actions for glyburide?

    (one teaching is similar to metformin, PO 2)
    Give w/ 1st meal of the day.

    Taking w/ alcohol may cause disulfirim-like reaction: cramps, hypoglycemia, MI (same w/ metformin)
  18. What is metformin's uses?

    What organ does it work on?
    • Uses:
    • Decrease liver glucose production.
    • Decrease weight.
    • Increase insulin sensitivity in fat/muscle cells.

    Works on liver.
  19. What is metformin contraindicated for that closely resembles glyburide (PO 1)?
    • liver disease
    • kidney impairment
    • alcohol
  20. What are some SFX of METformin?
    (think of route of admin PO 2)

    What are some AFX of METformin?
    • N/V
    • diarrhea/bloating
    • METallic taste
    • wt loss

    • lactic acidosis
    • HYPOglycemia
  21. METformin.

    What are some teachings involved w/ METformin?
    DO NOT give 48 hours before/after if getting IV iodine contrast.

    • Teach s/sx of acidosis:
    • chills
    • dizziness
    • hypotension
    • muscle pain
    • dyspnea
  22. METformin.

    If prego, surgery, or stress, which should you switch to instead of oral route?
    insulin injection
  23. For HYPOglycemia, Glucagen, what is the routine 15, name some foods that contain 15 grams of CHO.
    Routine 15: give 15g, wait 15 min, restest; call HCP.

    • 1/2 C of fruitjuice
    • 1/2 C of soda
    • 1 C of milk
    • 2-3 candies
    • 3-4 glucose tabs

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