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Anna Shared "PHARM EXAM #3" - 65 Picmonics

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PHARM EXAM #3

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)
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2 mins
Hyperglycemia
Mechanism
Insulin Resistance
Too Little Insulin/Medication
Infection/Illness
Corticosteroids
Assessment
Elevated Blood Glucose
Polyphagia
Polydipsia
Polyuria
Hypotension
Fatigue/Drowsiness
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1 min
Glucagon (GlucaGen)
Mechanism
Increases Glucose
Indications
Hypoglycemic Emergency
Side Effects
Nausea and Vomiting
Considerations
Reconstitute Powder
Consume Oral Carbohydrates
50% Dextrose IV (If No Effect)
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2 mins
Pancreas
Characteristics
Acinar Cells Release Digestive Enzymes
Ductal Epithelial Cells Release Bicarbonate
Islets of Langerhans
Beta Cells Release Insulin
Alpha Cells Release Glucagon
Delta Cells Release Somatostatin
Somatostatin Inhibits Alpha and Beta Cells
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3 mins
Diabetes Assessment
Assessment Type 1
Juvenile Onset
Absent Insulin Production
Ketosis Prone
Assessment Type 2
Adult Onset
Insulin Resistance
Obesity
Gestational Diabetes
Onset During Pregnancy
Glucose Intolerance
Complications
Retinopathy
Peripheral Vascular Disease
Nephropathy
Neuropathy
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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
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1 min
Hemoglobin A1c Lab Value
4-6%
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1 min
Diabetes Interventions
Early Diagnosis
Insulin
Oral Hypoglycemics
Glucose Monitoring
Routine Exercise
Diabetic Diet
Monitor for Complications
Insulin Therapy
Diabetic Ketoacidosis (DKA)
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2 mins
Hypoglycemia Assessment
Mechanism
Too much insulin
Decreased glucose
Assessment
< 70 mg/dL
Change in LOC
Lethargic
Confusion and Irritability
Tremors
Diaphoresis
Tachycardia
Vision Changes
Weakness
Seizures
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2 mins
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
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3 mins
Metformin (Glucophage)
Mechanism
Decrease Glucose Production
Increase Insulin Sensitivity
Indications
Type 2 Diabetes
Polycystic Ovary Syndrome (PCOS)
Side Effects
GI Distress
Decreased Appetite
Lactic Acidosis
Considerations
IV Contrast
Limit Alcohol Consumption
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2 mins
Glyburide and Glipizide (2nd Generation Sulfonylureas)
Mechanisms
2nd Generation Sulfonylureas
Blocks Potassium Channels in Beta Cells
Stimulate Release of Insulin
Indications
Type 2 Diabetes
Side Effects
Hypoglycemia
Considerations
More Potent
Beta Blockers Reduce Effects
Avoid Alcohol
Avoid Breastfeeding
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2 mins
Hypoglycemia Intervention
Interventions
Mild to Moderate Hypoglycemia
Simple Carbohydrate (Oral Dextrose, Fruit Juice, Candies)
Complex Carbohydrate (Whole Grains, Vegetables)
Severe Hypoglycemia or Unconscious
50% Dextrose
Glucagon
Considerations
Monitor Blood Glucose Q 10-15 Minutes
Give Small Meal After Intervention
Patient Education
Hypoglycemia Prevention
Encourage Self-Monitoring
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3 mins
Adrenal Gland (Basic)
Characteristics
Adrenal Cortex
RAAS Stimulates Aldosterone
CRF (CRH) acts on Anterior Pituitary Gland to Release ACTH
Cortisol Released
Androgens Released
Adrenal Medulla
Epinephrine & Norepinephrine
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2 mins
Adrenal Gland (Advanced)
Characteristics
Adrenal Cortex
Zona Glomerulosa
Aldosterone
Zona Fasciculata
Cortisol
Zona Reticularis
Androgens
Adrenal Medulla
Chromaffin Cells
Epinephrine & Norepinephrine
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2 mins
Addison's Disease Assessment
Assessment
Deficiency of Cortisol and Aldosterone
Irritability
Hyperkalemia
Muscle Weakness
Skin Hyperpigmentation
Hyponatremia
Hypotension
Hypoglycemia
Considerations
Addisonian Crisis
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2 mins
Addison's Disease Intervention
Drug Therapy
Hydrocortisone
2/3 Dose in Morning
1/3 Dose in Late Afternoon
Fludrocortisone
Androgen Replacement Therapy
Considerations
Salt Additives
Increase Dosage During Stress and Infection
Medic Alert Bracelet
Lifelong Hormone Therapy
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2 mins
Cushing's Syndrome Assessment
Assessment
Increased Cortisol Levels
Truncal Obesity
Purple Abdominal Striae
Buffalo Hump
Decreased Bone Density
Moon Face
Thinning Skin
Hyperglycemia
Hypertension
Considerations
Long Term Glucocorticoid Use
Immunosuppression
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2 mins
Prednisone (Glucocorticoids)
Mechanism
Glucocorticoid
Indications
Inflammatory Conditions
Organ Transplant Rejection
Side Effects
Cataracts and Glaucoma
Cushing's Syndrome
Osteoporosis
Immunosuppression
Hyperglycemia
Ulcers
Considerations
Adrenal Insufficiency
Taper Gradually
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2 mins
Diazepam (Valium)
Indications
Anxiety
Seizures and Status Epilepticus
Muscle Spasms
Alcohol Withdrawal
Side Effect/Assessment
Dizziness/Vision Changes
Confusion/Amnesia
Urinary Incontinence
Behavioral Changes
Respiratory Depression
Antidote
Flumazenil (Romazicon)
Nursing Considerations
Fall Precaution
Do Not Stop Abruptly
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2 mins

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