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Lehne's Pharmacology for Nursing Care, 10th Ed., Burchum & Rosenthal, 2019 | Registered Nurse (RN) School Study Aid

Blood Glucose Lab Value

70-100 mg/dL

25 secs

Hemoglobin A1c Lab Value

4-6%

1 min

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

3 mins

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

2 mins

Hyperglycemia

Insulin Resistance

Too Little Insulin/Medication

Infection/Illness

Corticosteroids

Elevated Blood Glucose

Polyphagia

Polydipsia

Polyuria

Hypotension

Fatigue/Drowsiness

1 min

Hypoglycemia Assessment

Too much insulin

Decreased glucose

< 70 mg/dL

Change in LOC

Lethargic

Confusion and Irritability

Tremors

Diaphoresis

Tachycardia

Vision Changes

Weakness

Seizures

2 mins

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

3 mins

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

2 mins

Diabetes Education

Self-Monitoring (Blood Glucose)

SubQ Injection Technique

Lifestyle Changes

Symptoms of Hyperglycemia and Hypoglycemia

Sick Day Care

Foot Care

Exercise Therapy

Medication

1 min

Diabetes Interventions

Early Diagnosis

Insulin

Oral Hypoglycemics

Glucose Monitoring

Routine Exercise

Diabetic Diet

Monitor for Complications

Insulin Therapy

Diabetic Ketoacidosis (DKA)

2 mins

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

2 mins

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

2 mins

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

3 mins

Glucagon (GlucaGen)

Increases Glucose

Hypoglycemic Emergency

Nausea and Vomiting

Reconstitute Powder

Consume Oral Carbohydrates

50% Dextrose IV (If No Effect)

2 mins

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

2 mins

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)

2 mins

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

2 mins

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

2 mins

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

2 mins

Repaglinide and Nateglinide (Meglitinides)

Meglitinides

Increased Insulin Release

Type 2 Diabetes

Hypoglycemia

Eat Within 30 Minutes

Gemfibrozil Increases Risk of Hypoglycemia

Short Half-Life

2 mins

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

2 mins

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