Lehne's Pharmacology for Nursing Care, 11th Ed., Burchum & Rosenthal, 2022 | Registered Nurse (RN) School Study Aid
Mixing NPH and Regular Insulin for Injection
- Verify Order
- Roll NPH Insulin
- Alcohol to Multiuse Vials
- Inject Air into NPH Insulin (Cloudy)
- Inject Air into Regular Insulin (Clear)
- Withdraw Regular Insulin Units
- Withdraw NPH Units
- Verify with 2nd Nurse
- Discard if Error
Oral Glucose Tolerance Test (OGTT)
- Used for Diabetes Screening
- Fasting State
- Baseline
- Normal < 100 mg/dL
- 30 and 60 Minutes
- Normal < 200 mg/dL
- 120 Minutes
- Normal < 140 mg/dL
Hyperglycemia
- Insulin Resistance
- Too Little Insulin/Medication
- Infection/Illness
- Corticosteroids
- Elevated Blood Glucose
- Polyphagia
- Polydipsia
- Polyuria
- Hypotension
- Fatigue/Drowsiness
Hypoglycemia Assessment
- Too much insulin
- Decreased glucose
- < 70 mg/dL
- Change in LOC
- Lethargic
- Confusion and Irritability
- Tremors
- Diaphoresis
- Tachycardia
- Vision Changes
- Weakness
- Seizures
Hypoglycemia Intervention
- Mild to Moderate Hypoglycemia
- Simple Carbohydrate (Oral Dextrose, Fruit Juice, Candies)
- Complex Carbohydrate (Whole Grains, Vegetables)
- Severe Hypoglycemia or Unconscious
- 50% Dextrose
- Glucagon
- Monitor Blood Glucose Q 10-15 Minutes
- Give Small Meal After Intervention
- Hypoglycemia Prevention
- Encourage Self-Monitoring
Diabetes Assessment
- Juvenile Onset
- Absent Insulin Production
- Ketosis Prone
- Adult Onset
- Insulin Resistance
- Obesity
- Onset During Pregnancy
- Glucose Intolerance
- Retinopathy
- Peripheral Vascular Disease
- Nephropathy
- Neuropathy
Diabetes Education
- Self-Monitoring (Blood Glucose)
- SubQ Injection Technique
- Lifestyle Changes
- Symptoms of Hyperglycemia and Hypoglycemia
- Sick Day Care
- Foot Care
- Exercise Therapy
- Medication
Diabetes Interventions
- Early Diagnosis
- Insulin
- Oral Hypoglycemics
- Glucose Monitoring
- Routine Exercise
- Diabetic Diet
- Monitor for Complications
- Insulin Therapy
- Diabetic Ketoacidosis (DKA)
Acarbose (Precose) and Miglitol (Glyset) (Alpha Glucosidase Inhibitors)
- Alpha Glucosidase Inhibitors
- Delays Absorption of Carbohydrates
- Type 2 Diabetes
- Flatulence
- Diarrhea
- Anemia
- Cramps
- Monitor LFTs
- Oral Glucose for Hypoglycemia
Chlorpropamide and Tolbutamide (Orinase) (1st Generation Sulfonylureas)
- 1st Generation Sulfonylureas
- Stimulate Release of Insulin
- Type 2 Diabetes
- Hypoglycemia
- Possible Cardiovascular Toxicity
- Weight Gain
- Exacerbated Hypoglycemia with Beta-blockers
- Avoid During Pregnancy and Breast Feeding
- Avoid Alcohol
Exenatide (Byetta)
- Incretin Mimetic
- GLP-1 Synthetic Analog
- Type 2 Diabetes
- Hypoglycemia
- Nausea and Vomiting
- Diarrhea
- Thyroid Cancer
- Pancreatitis
- Renal Failure
- (Give Exenatide) One Hour After Other Medications
- Adjunct Therapy
Glucagon (GlucaGen)
- Increases Glucose
- Hypoglycemic Emergency
- Nausea and Vomiting
- Reconstitute Powder
- Consume Oral Carbohydrates
- 50% Dextrose IV (If No Effect)
Glyburide and Glipizide (2nd Generation Sulfonylureas)
- 2nd Generation Sulfonylureas
- Blocks Potassium Channels in Beta Cells
- Stimulate Release of Insulin
- Type 2 Diabetes
- Hypoglycemia
- More Potent
- Beta Blockers Reduce Effects
- Avoid Alcohol
- Avoid Breastfeeding
Insulin
- Rapid Acting
- Insulin Lispro (Humalog)
- Insulin Aspart (Novolog)
- Insulin Glulisine (Apidra)
- Short Acting
- Regular Insulin (Humulin R)
- Intermediate Acting
- Isophane NPH (Humulin N)
- Long Acting
- Detemir (Levemir)
- Glargine (Lantus)
Metformin (Glucophage)
- Decrease Glucose Production
- Increase Insulin Sensitivity
- Type 2 Diabetes
- Polycystic Ovary Syndrome (PCOS)
- GI Distress
- Decreased Appetite
- Lactic Acidosis
- IV Contrast
- Limit Alcohol Consumption
Pioglitazone (Thiazolidinediones)
- -glitazones Suffix
- Binds PPAR-Gamma
- Decreases Insulin Resistance
- Type 2 Diabetes
- Weight Gain
- Heart Failure
- Myalgia
- Hypoglycemia
- Upper Respiratory Infection
- Increased Risk of Bladder Cancer
- Increased Fracture Risk in Women
- Monitor Liver Enzymes
Pramlintide (Symlin)
- Synthetic Amylin Analog
- Diabetes Type 1 and 2
- Supplement Mealtime Insulin
- Nausea
- Skin Reactions at Injection Site
- Hypoglycemia When Combined with Insulin
- Delayed Absorption of Oral Drugs
Repaglinide and Nateglinide (Meglitinides)
- Meglitinides
- Increased Insulin Release
- Type 2 Diabetes
- Hypoglycemia
- Eat Within 30 Minutes
- Gemfibrozil Increases Risk of Hypoglycemia
- Short Half-Life
Sitagliptin (Januvia) and Saxagliptin (Onglyza) (DPP-4 Inhibitors)
- -gliptin Suffix
- DPP-4 Inhibitor
- Increases Insulin Release
- Type 2 Diabetes
- Pancreatitis
- Upper Respiratory Infection and Inflammation
- Stevens-Johnson Syndrome
- Used as Add-on Agents