DM:Pharm-Final

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Author:
amanda430
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306078
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DM:Pharm-Final
Updated:
2015-08-05 11:25:09
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Pharm
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Pharm
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Pharm Final
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  1. Describe the 2 types of DM
    • Type I: no insulin production
    • Type II: decreased insulin productions and/or increased insulin resistance
  2. What are the S&S of DM?
    • Polyuria
    • Polydipsia (increased thirst)
    • Polyphagia (increased hunger)
  3. What is a normal fasting blood sugar / hemoglobin?
    • 70-100 mg/dL
    • < 5%
  4. What is the normal fasting blood sugar/hemoglobin?
    • 100-125 mg/dL
    • 5.7%-6.4%
  5. What is the normal DM fasting blood sugar? Hemoglobin?
    • >125 mg/dL
    • >6.5%
  6. What are the contraindications of insulin?
    • hypoglycemia
    • BS < 60, shaking
    • Tachy cardia
    • pale
    • confused
    • cool
    • clammy
  7. What are the ADE on insulin?
    • hypoglycemia
    • anaphylaxis
  8. In regards to insulin, when do you have 0?
    never, there's always a basal level of insulin
  9. What is the goal BS for people with DM?
    BS 70-100
  10. What is the agent of rapid acting (clear)
    Hemalog (Lispro)
  11. What is the onset of rapid acting insulin (hemalog/lispro)?
    10-15 min
  12. What is the peak of rapid acting (hemalog/lispro)?
    1 hr
  13. What is the duration of rapid acting (hemalog/lispro)?
    3 hr
  14. What is the indication for rapid acting insulin (hemalog/lispro)?
    Rapid reduction of BS
  15. What is the agent of short acting (clear) insulin?
    regular "R"
  16. What is the onset of short acting insulin (clear) 
    (Regular "R")
    .5 hr- 1hr
  17. What is the peak of short acting (clear)
    Regular "R"
    2hr-3hr
  18. What is the duration of short acting (clear)
    Regular "R"
    4hr-6hr
  19. What is the indication of short acting (clear)
    Regular "R"
    Give 20-30 min ac (before meal)
  20. What is the agent of Intermediate Acting (cloudy) insulin
    NPH "Humulin N"
  21. What is the onset of Intermediate acting (cloudy) insulin
    NPH "Humulin N"
    3hr-4hr
  22. What is the peak of Intermediate acting (clouding insulin)
    NPH "Humulin N"
    4hr -12hr
  23. What is the duration of Intermediate acting (cloudy insulin)
    NPH "Humulin N"
    16hr-20hr
  24. What is the indication of Intermediate acting (cloudy insulin)
    NPH "Humulin N"
    Give PC (After Meal)
  25. What is the agent of Long Acting (cloudy)
    Ultralente "UL"
  26. What is the onset of Ulralente "UL" 
    (Long Acting- Cloudy)
    6 hr- 8hr
  27. What is the peak of Ultralente "UL"
    • Long Acting-Cloudy
    • 12-16hr
  28. What is the duration of Ultralente "UL"
    • Long Acting-Cloudy
    • 20hr-30hr
  29. What is the indication of Ultralente "UL"
    • Long Acting-Cloudy
    • Control FPG (Fast plasma Glucose)
  30. What is the agent of Long Acting (clear)
    Glargine (Lantus)
  31. What is the onset of Glargine (Lantus)?
    • 1 hr
    • Long Acting (clear)
  32. What is the peak of Glargin (Lantus)?
    • No Peak
    • Long Acting (clear)
  33. What is the duration of Glargine (Lantus)
    • 24 hr
    • Long Acting (clear)
  34. What is the indication for Glargine (Lantus)?
    • Do NOT mix w/ other insulins
    • Long Acting (clear)
  35. In general, what is the mix of insulin given?
    • 70% NPH
    • 30% Regular
  36. What is the point of rapid and short acting insulin?
    covers meals immediately after injections
  37. What is the point of intermediate insulin?
    covers subsequent meals
  38. What is the point of long acting insulin?
    • relatively constant level of insulin
    • acts as basal insulin
  39. How do you mix insulins?
    • clear > cloudy in syringe
    • meaning you draw up cloudy first, then clear
  40. How often does Type I need to check their insulin? 
    Type II?
    • 2-4x per day
    • 2-3x per week
  41. What are the units needed if the BS is:
    150-199
    200-249
    250-299
    300-349
    350-399
    >400
    • 2 units
    • 4 units
    • 6 units
    • 8 units
    • 10 units
    • CALL MD
  42. What is sulfonylureas?
    an oral hypoglycemics
  43. What is the prototype for sulfonylureas?
    Glipizide
  44. What is the MoA of sulfonylureas (Glipizide)?
    Increased insulin production
  45. What are the ADE for sulfonylureas (Glipizide)?
    • N/Abd fullness
    • Serious: hypoglycemia
  46. What is type of medication is meglitinide
    Oral Hypoglycemic
  47. What are the oral hypoglycemics?
    • Sulfonylureas (Glipizide)
    • Meglitinide (Repaglinide)
    • Thiazolidinediones ( Pioglitazone )
    • Biguanide (Metformin)
    • Glucosidase Inhibitors (Miglitol)
  48. What is the prototype of Meglitinide?
    • Glipizide
    • It's an Oral Hypoglycemics
  49. What is the prototype of Thiazolidinediones?
    • Pioglitazone¬†
    • It's an Oral Hypoglycemic
  50. What is the prototype of biguanide?
    • Metformin
    • It's an Oral Hypoglycemic
  51. What is the prototype for alpha-glucosidase inhibitors?
    • Miglitol
    • It's an Oral Hypoglycemic
  52. What are the ADE of Sulfonylurease/Glipizide?
    • N/abd fullness
    • Serious: Hypoglycemia
  53. What are the ADE of Meglitinide/Repaglinide?
    Hypoglycemia
  54. What are the ADE for Thiazolidinediones/Pioglitazone?
    • increased incidence of angina/MI
    • Black Box: CHF
  55. What are the ADE of of Biguanide/metformin?
    • N/V, Abd discomfort
    • Black Box: Lactic Acidosis
  56. What are the ADE of Alph-Glucosidase Inhibitors/ Miglitol?
    abd discomfort, D, flatulence
  57. What is the MoA of sulfonylureas/flipizide?
    increased insulin production
  58. What is the MoA meglitinide/Repaglinide?
    increase insulin production
  59. What is the MoA of Thiazolidinediones/Pioglitazone?
    Decreased insulin resistance
  60. What is the MoA of Biguanide/Metformin
    • decreased insulin resistance
    • decreased hepatic glucose production
  61. What is the MoA Alpha-Glucosidase Inhibitors/Miglitol?
    Delays GI absorption of glucose
  62. Name the corticosteroid prototype
    Prednisone
  63. What are some of the contraindications/Cautions of Prednisone?
    • Pregnancy
    • Peptic Ulcer Disease
    • Psychosis
    • At risk for/Have an infection
    • increased BP/CHF
    • DM
    • Renal insufficiency
  64. What is the MoA of Prednisone?
    Antiinflammatory
  65. To decrease ADEs for people taking Prednisone what are the courses of action?
    • Local Use
    • Short Course
    • Taper Dose
    • ADT (double dose every other day)
    • Give in am

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