Pharm- Endocrine Test

incretin mimetic drug examples:

-dulaglutide -exenatide -liraglutide ending: -tide

Symptoms of hypoglycemia:

-tremors -sweating -confusion -rapid HR -hunger -headache -nervousness -inability to concentrate

The adrenal gland produces...

cortisol and aldosterone

Non-insulin anti-diabetic drugs are prescribed when ____ and ________ are not enough.

diet and exercise

DM type 2

disorder where a person makes some insulin but does not bind well to its receptors (insulin resistance)

What is the 1st indication of a thyroid storm?

fever

Adrenal gland hypofunction drug example:

fludrocortisone ending: -cortisone

Insulin is what type of chemical?

hormone

levothyroxine can cause...

hyperglycemia

The condition which results from too much insulin for the blood glucose is called...

hypoglycemia

Ms. Larkin complains of weight gain, lack of appetite and dryness of her skin and hair. She also reports recent difficulty with constipation. The doctor suspects thyroid problems. Thyroid tests would probably show the patient is:

hypothyroid

When pts are taking thyroid medications they must be instructed to recognize:

hypothyroid and hyperthyroid signs and symptoms

Insulin is necessary for the metabolism and use of glucose in the body and is produced where?

in the pancreas by beta cells

insulin needs may be _________ when taking birth control, corticosteroids, epinephrine and thiazide diuretics.

increased

How does insulin help lower blood sugar?

it allows movement of sugar into the cells

Adverse reactions of methimazole are...

kidney damage and bradycardia

How long will someone be treated for hypothyroidism?

lifetime

hypoglycemia

low blood sugar, too much insulin in blood

Miss. Eldridge is a 64 year old retired school teacher. She has recently been diagnosed with type 2 diabetes. The most important thing to tell her is that:

medication and diet are both important parts of the treatment plan

An increase in thyroid hormone often produces weight loss in pts because:

metabolic rate is increased

an increase in thyroid hormone often produces weight loss in pts because:

metabolic rate is increased

Biguanide drug example:

metformin

Two antithyroid drugs are:

methimazole and propylthiouracil

Type 2 diabetes develops because of...

obesity and decreased physical activity in people who are genetically predisposed

amylin analog drug example:

pramlintide

Antithyroid preparations are taken when:

production of thyroid hormones must be reduced

How do you mix insulin?

roll between hands clear to cloudy

Which way to give insulin is most common?

subq

What two routes can insulin be given?

subq and IV

almost all insulin used today is ________, in the past it was obtained by pork and beef pancreatic sources due to development of antibodies.

synthetic

ensure the insulin concentration matches the ________.

syringe

glucose

the form of sugar that circulates in the blood and provides the major source of energy for body tissues. When its level is low, we feel hunger.

severe hyperthyroidism causes...

thyroid storm/thyroid crisis -life threatening hypertension -heart failure -seizures -fever (1st indication) CAN LEAD TO DEATH IF UNTREATED

If a type 1 diabetic pt begins taking oral contraceptives, is there a change in the need for insulin?

yes, there is often an increased need for insulin

Which blood test is used to assess the patient's ability to control her blood sugar in recent months?

Hemoglobin A1C

alpha-glucosidase inhibitor drug examples:

-acarbose -miglitol

incretin mimetics are only approved for type _ diabetes

2

Which statement made by a female patient would raise concern that she is experiencing an adverse effect of the prescribed sodium-glucose cotransport inhibitor?

"I have burning when I urinate."

The home care nurse visits a client at home who has been prescribed prednisone 5 mg orally daily. The nurse reinforces teaching for the client about the medication. Which statement made by the client indicates a need for further teaching?

"I can take aspirin or my antihistamine if I need it."

Anti-thyroid medication examples:

-propylthiouracil -methimazole Ending: -thi-

Corticosteroids are commonly given for the following reasons...

-Addison's disease -anti inflammatory

The home care nurse is visiting a client who was recently diagnosed with type 2 diabetes mellitus. The client, prescribed repaglinide and metformin, asks the nurse to explain these medications. The nurse would reinforce which instructions to the client? Select all that apply.

-Diarrhea can occur secondary to metformin. -The repaglinide is not taken if a meal is skipped. -The repaglinide is taken 30 minutes before eating. -Candy or another simple sugar is carried and used to treat mild hypoglycemia episodes.

The most common side effects with insulin stimulants are:

-GI symptoms -photosensitivity -upper respiratory infection

The nurse is monitoring a client receiving levothyroxine sodium to treat hypothyroidism. Which findings indicate the presence of a side effect associated with this medication? Select all that apply.

-Insomnia -Weight loss -Mild heat intolerance

DPP inhibitors drug examples:

-alogliptin -linagliptin -saxagliptin -sitagliptin ending: -glitpin

Drug interactions may occur when patients take thyroid medications and also take which of the following medications?

-anticoagulants -nsaids

sodium glucose cotransport inhibitor drug examples:

-canagliflozin -dapagliflozin -empagliflozin ending: -agliflozin

The adrenal gland produces which of the following substances?

-cortisol -aldosterone

What 3 things should be on an insulin vial?

-drug name -units -exp date

insulin stimulator drug examples:

-glimepiride -glipizide -glyburide -meglitinide -nateglinide -repaglinide ending: -ide

side effects of insulin stimulators (secretagogues):

-heartburn -N/V -diarrhea -abdominal pain -photosensitivity

thyroid hormone antagonist drug examples:

-levothyroxine -liothyronine ending: -thyro-

adrenal gland hyperfunction drug examples:

-mifepristone -mitotane ending: -ne

Mrs. Halifax is a brittle diabetic (one whose blood sugar responds with wide variations in response to insulin), the nurse must watch her carefully for symptoms of hypoglycemia after giving her an insulin injection. What are the signs and symptoms of hypoglycemia?

-pale skin -hunger -diaphoresis -feeling shaky

insulin sensitizer drug examples:

-pioglitazone -rosiglitazone ending: -glitazone

Mr. Primrose often does not take his insulin at the correct time, and skips doses when he gets busy. He is at risk for hyperglycemia. What are signs and symptoms of hyperglycemia?

-polyuria -blurred vision -abdominal pain

insulin stimulators are given at least __ minutes before meals.

15

A patient with DM type 2 has been prescribed sitagliptin 100 mg daily. You have 50-mg tablets available. How many tablets should you give this patient?

2 tablets

Mr. Walker, age 47, was recently diagnosed with diabetes. His physician has begun treatment with insulin. Mr. Walker will receive regular insulin. The nurse monitors for the onset of action approximately:

30-60 minutes

A client is taking Humulin NPH insulin daily every morning. The nurse reinforces instructions to the client and would tell the client that which is the most likely time for a hypoglycemic reaction to occur?

6 to 14 hours after administration

How many categories of non-insulin anti-diabetic drugs are there?

8

Give insulin at __ degrees, do not massage, do not aspirate and rotate inj sites.

90

Glimepiride is prescribed for a client with diabetes mellitus. The nurse reinforces instructions for the client and tells the client to avoid which while taking this medication?

Alcohol

You are preparing to give a subcutaneous injection of insulin to a patient. Which of the following procedures is correct?

Assess and rotate the injection sites.

Before administering levothyroxine to a pt check __ and __.

BP and HR

Desmopressin acetate is prescribed for the treatment of diabetes insipidus. The nurse monitors the client after medication administration for which therapeutic response?

Decreased urinary output

Incretin mimetics action:

Injectable drugs that act like gut hormones such as glucagon secreted in response to food in the stomach they work with insulin to prevent glucose levels from becoming too high after meals

You are preparing an injection of Lantus insulin for a diabetic patient, and you notice that the fluid appears cloudy. What action should you prepare to take?

Notify the pharmacy of the cloudy appearance

RAPID ACTING human lispro/Humalog

Onset: 0.25/ 15 minutes Peak: 0.5-1.5/ 30-90 minutes Duration: 5 hours

INTERMEDIATE ACTING 75% insulin lispro protamine suspension/25% insulin lispro/ Humalog mix 75/25

Onset: 0.25/ 15 minutes Peak: 1-2 hours Duration: 24 hours

RAPID ACTING aspart/Novolog

Onset: 0.25/ 15 minutes Peak: 1-3 hours Duration: 3-5 hours

INTERMEDIATE ACTING 70% insulin aspart protamine suspension/ 30% insulin aspart/ Novolog Mix 70/30

Onset: 0.25/ 15 minutes Peak: 1-4 hours Duration: 24 hours

INTERMEDIATE ACTING isophane suspension 30% human insulin injection/ Humulin 70/30

Onset: 0.5/ 30 minutes Peak: 2-12 hours Duration: 24 hours

SHORT ACTING regular human/Humulin R

Onset: 0.5/ 30 minutes Peak: 2-5 hours Duration: 5-7 hours

LONG ACTING INSULIN insulin detemir/Levemir

Onset: 1 hour Peak: 6-8 hours Duration: 5.7-24 hours

INTERMEDIATE ACTING isophane insulin NPH 70% human insulin/ Humulin N

Onset: 1.5/ 1 hour and 30 minutes Peak: 4-12 hours Duration: 16-24 hours +

LONG ACTING INSULIN insulin glargine/Lantus

Onset: 2-4 hours Peak: none Duration: 24 hours

A client with diabetes mellitus visits a healthcare clinic. The client's diabetes mellitus has been previously well controlled with glyburide daily, but recently the fasting blood glucose level has been 180 mg/dL to 200 mg/dL. Which medication, added to the client's regimen, may have contributed to the hyperglycemia?

Prednisone

The homecare nurse visits a client recently diagnosed with diabetes mellitus who is taking Humulin NPH insulin daily. The client asks the nurse how to store the unopened vials of insulin. The nurse would provide which information?

Refrigerate the insulin.

What two hormones are critical for life?

T3 and T4

The primary health care provider (PHCP) prescribes exenatide for a client with type 1 diabetes mellitus who takes insulin. The nurse prepares for which most appropriate intervention?

The medication is withheld and the PHCP is called to question the prescription for the client.

The pt asks the nurse why she has to take both insulin and an oral hypoglycemic agent to control her blood sugars. The best response for the nurse is:

The oral agent and the insulin work differently to help control your blood sugar; it is to help you gain better control

The nurse is reinforcing teaching for a client regarding how to mix regular insulin and NPH insulin in the same syringe. Which action performed by the client indicates the need for further teaching?

Withdraws the NPH insulin first

In counseling Mrs. Wilson, a newly diagnosed diabetic, the nurse discovers that she has been administering regular insulin deep IM just before meals. She seems to have confidence in giving the injection and can draw up her dosage properly. What suggestions would you give her?

You need to be giving your injection subcutaneously, not in your muscle. Let's review that technique.

diabetic ketoacidosis

acidity of the blood caused by the presence of ketone bodies produced when the body is unable to burn sugar; thus, it must burn fat for energy

DM type 1

autoimmune beta cells of the pancreas that store and release insulin are destroyed when a person's own immune system produces antibodies against insulin secreting cells

How does insulin work to lower blood glucose?

binds to insulin receptors

A nurse is caring for a client who is taking methimazole. For which of the following adverse effects of this med should the nurse monitor?

bradycardia

biguanide drug interaction:

contrast dye for diagnostic testing, can lead to kidney failure the drug needs to be stopped 24 hrs before testing and restarted 48 hrs after