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14 Cards in this Set
- Front
- Back
Sulfonylurea
Glipizide (glucotrol) |
Glipizide (glucotrol)
Indications Control BS in type 2 DM Actions Stimulate release of insulin from PANCREAS Intermediate action S.E. APLASTIC ANEMIA, wt gain, photosensitivity, hypoglycemia NR. implications: Monitor s/s of hypoglycemia reaction, Pt. Teaching: Take on an empty stomach (30 min before meal), Avoid aspirin and ETOH |
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Biguanide
Metformin (Glucophage) |
Metformin (Glucophage)
Indications: Adjunctive management of type 2 diabetes Actions: Decreases hepatic (liver) production of glucose Intermediate action S.E. LACTIC ACIDOSIS, abd. Bloating, N, V, D NR Implications: Monitor s/s of hypo or hyperglycemia reaction, Stop day of surgery and 48Hp to px lactic acidosis. CONTRAINDICATED IN EXCESS ETOH/KIDNEY DYSFUNCTION, CHF, LIVER/RENAL DISEASE Pt teaching TAKE WITH MEALS S/E of N, D, decreased appetite occurs in the 1-2 weeks. |
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Alpha-Glucosidase Inhibitors
Acarbose (Precose) |
Acarbose (Precose)
Indications: Management type 2 DM w/ diet therapy Inhibits enzyme alpha-glucosidase in GI tract INTESTINES RAPID ACTION!!!!!! S.E. Abd. Pain, diarrhea, flatulence NR Implications: Can be taken w/ other hypoglycemic agents or insulin. Observe s/s of hypoglycemia reaction. Pt. Teaching TAKE WITH 1ST BITE OF FOOD. IF HYPOGLYCEMIA OCCURS: TX WITH GLUCOSE, NOT SUGAR. |
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Thiazolidinedoines
Insulin Sensitizer Rosiglitazone (Avandia) |
Rosiglitazone (Avandia)
Indications: Adjunct to diet and exercise management in type 2 DM Actions: Improves muscle cell sensitivity to insulin by acting as agonist (Decreases insulin resistance) S.E. Liver toxic, edema, weight gain, NR Implications: Can be used with insulin, Observe s/s of hypoglycemia rx. MONITOR LIVER--check enzymes Q 2mo/yr. DON'T USE WITH CHF Pt. Teaching Call dr. s/s of hepatic dysfunction (N, V, Abd. pain, fatigue, anorexia, dark urine, jaundice. Decrease oral contraception effectiveness, cause ovulation in premenopause. |
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Pancreatic Hormone
Lispro, Humalog Very fast acting |
Lispro, Humolog, very fast acting
Indications tx type 1, management type 2 unresponsive to tx with diet oral meds Actions decreases blood sugar by increasing transport into cells and promotes conversion of glucose to glycogen or converts amino acids to protein in muscle. S.E. Hypoglycemia, anaphylaxis NR implications Onset 15 minutes. Peak 30-90 minutes. Duration 6-8 hours. Assess s/s hypo or hyperglycemia Pt teaching Clear insulin All insulins: check expire date, no freeze/heat, store in fridge, but administer room temp. |
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Pancreatic Hormone
NPH, INTERMEDIATE ACTING |
NPH INTERMEDIATE ACTING
Indications Tx type 1, management of type 2 unresponsive to tx w/ diet oral meds. Actions Decreases blood sugar by increasing transport into cells and promotes conversion of glucose to glycogen or converts amino acids to proteins in muscle. S.E. Hypoglycemia, anaphylaxis NR implications Onset 2-4 hours. Peak 4-10 hours. Duration 10-16 hours. Assess s/s of hypo or hyperglycemia Pt. Teaching CLOUDY INSULIN, check for frosting/ crystals (don't use) |
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Pancreatic Hormone
Gargine (Lantis) Long acting Basal/BG |
Gargine (Lantus)
Long Acting Basal/BG Indications: Tx type 1, management type 2 unresponsive to treatment with diet and oral meds Actions: Decreases blolod sugar by increasing transport into cells and promotes conversion of glucose to glycogen or converts amino acids to proteins in muscle. S.E. Hypoglycemia, anaphylaxis NR implications Onset 2-4 hours Peakless. Duragion 20-24 hours Assess s/s hypo or hyperglycemia Pt. teaching Never Mix with other insulins. No IV Clear insulin in tall/thin vials. Always take same time of day within two hour window. |
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Hormones Pancreatics
glucagon |
glucagon
Indications Acute management of severe hypoglycemia when administration of glucose is not feasible. Actions: stimulates hepatic production of glucose from glycogen stores (glycogenolysis) Relaxes teh musculature of the GI tract (stomach, duodenum, small bowel, and colon), temporarily inhibiting movement. Has positive inotropic and chronotropic effects. S.E. N/V anaphylaxis, transient increase in heart rate and blood pressure Nr. Implications Assess signs of hypoglycemia. Assess for nausea and vomiting. Assess neurologic status. Pt. Teaching Instruct family on correct technique to prepare, draw up, and administer injection. Teach patient and family s/s of hypoglycemia. Instruct pt to take oral glucose as soon as symptoms of hypoglycemia occur--glucagon is reserved for episodes when pt is unable to swallow |
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Endocrine
Corticosteroids Systemic Hormone replacement Steroids (Solu-Medrol, Prednisone, Decadron) |
Steroids (Solu-Medrol, Prednisone, Decadron)
Indications: Used in wide variety of chronic diseases Actions: Suppress inflammation and normal immune response. Side Effects: PEPTIC ULCER, decreased wound healing, depression, HTN, osteoporosis, THROMBOEMBOLISM NR Implications Monitor I/O, wt daily, peripheral edema, rales/crackles, dyspnea Pt. teaching: NEVER stop oral med independently--> adrenal insufficiency (anorexia, N, weak, fatigue, dyspnea, hypotension, hypoglycemia). Report infection immediately. |
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Thyroid Preparation/Hormone Replacement
Levothyroxine (Synthroid) |
Levothyroxine (Synthroid)
Indications: Hypothyroidism Actions: Increases metabolic rate, promote gluconeogensis, protein synthesis, cell growth, contain t3, t4 activity NR. Implications If too large dose: Monitor for CORONARY INSUFFICIENCY (chest pain, dyspnea, tachycardia). Assess if take anticoagulant or dig--bleed/dig toxic Pt teaching: TAKE LIFELONG-SAME TIME EVERY DAY 1 H BEFORE OR TWO HOURS AFTER MEAL WHEN MOST ACTIVE, do not switch to generic. Avoid excess foods inhibit TH-turnips |
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Anti-diuretic Hormone (ADH) Pituitary
Pitressin (Vasopressin) |
Pitressin (Vasopressin)
Indications: Diabetes insipidus Actions: Signals kidneys to retain H2O, returns it to vascular circulation. Inhibits urine production. High doses act as peripheral vasoconstrictor S.E. MI, dizzy, abd. cramp, heartburn, pounding sensation in head NR implications: Monitor ECG throughout therapy pt teaching: Drink 1-2 glasses of H20 with med to minimize s/e (blanching of skin, abd. cramps, N) normally go away in few min. |
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Calcium Replacement
Calcium Gluconate |
Tx and px of hypocalcemia
actions-Essential for nervous, muscular, skeletal, bone formationand blood coagulation S.E. CARDIAC ARREST AND phlebitis (IV only) arrhythmias, constipation NR Implications Monitor BP, pulse, ECG throughout IV therapy. Can cause vasodilation (results in hypotension, bradycardia, arrhythmias, and cardiac arrest) Pt. teaching Avoid taking w/in 1-2 hours of other meds. Avoid large amounts of oxalic acid (spinach, rhubarb, phytic acid (brans, cereals, or phosphorus dairy products). |
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Sodium Iodine
Radioactive Iodine (RAI) |
Indications: Adjunct with antithyroid drugs prior to surgery. Tx thyroid crisis
Actions: thyroid gland absorbs iodine, RAI destroys/damages cells so they produce less thyroid hormone. S.E. D, Hypothyroidism NR Implications: CONTRAINDICATED IN PREGNANT WOMEN. CAN CAUSE HYPOTHYROIDISM. Assess for s/s metallic taste, stomatitis, skin lesions, severe GI upset. Pt teaching GIVE ONE ORAL DOSE EXCRETED IN TWO DAYS. PRECAUTIONS: FLUSH TOILET 2-3xs, INCLUDE FLUID INTAKE, USE SEPARATE UTENSILS, TOWELS, WASHCLOTH. RINSE SINK |
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Parathyroid Hormone
Calcitonin/Salmon |
Calcitonin/Salmon
Indications; adjunctive therapy of hypercalcemia Actions: Decreases serum calcium by direct effect on bone, kidney, and GI tract. Promotes renal excretion of Calcium S.E. Anaphylaxis, N, V, inject site rx, facial flushing NR Implications Assess s/s hypersensitivity, on 1st few doses: watch for hypocalcemic tetany (nervous, irritable, muscle twitch, tenaic spasms, convulsions) Call dr. if hyperglycemia reoccurs (deep bone/flank pain, renal calculi, anorexia, N/V, thirst, lethargy. |