NU 578 Unit 4 Study Guide | High-Yield Questions
&Answers, Rationales & Advanced Nursing
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Insulin use
ANSWER:
Insulin is used to treat all patients with type 1 and many with type 2
diabetes. consists of two amino acid chains (a acidic and b basic)
linked by two disulfide bridges. it is synthesized in the pancreas by b
ce;;s within islets of langerhans. insulin is released by rise in blood
sugar (eating a. meal).
Anaolic reaction (insulin promotes conservation of energy and
buildup of energy stores)
Insulin metabolic actions
ANSWER:
Insulin promotes glucose into glycogen, amino acids assembled into
proteins, fatty acids into triglycerides.
Insulin deficiency promotes glycogen into glucose, proteins into
amino acids, and fats into glycerol.
Metformin use
ANSWER:
,Biguanide
used for type 2 DM. oral anti diabetic. may be used with other drugs.
can be used for prevention of type 2 diabetes, GDM, PCOS.
Reduces GI absorbance of glucose and hepatic production of
glucose. Does not stimulate insulin release from the pancreas.
Increases HDL, decreases BP, promotes weight loss.
DPP-4 Inhibitors (gliptins)
ANSWER:
go to pancreas and increase insulin release.
Example is Sitaglitpin
Sodium Glucose cotransporter 2 inhibitors (SGLT-2 inhibitors).
(gliflozins)
ANSWER:
Example: empagliflozin
increases urine excretion of glucose, taken PO, reduces
cardiovascular risk of type 2 diabetes.
SE: yeast infections and genital gangrene
Incretin Mimetics ('tides)
ANSWER:
injectables that slow gastric emptying, causes weight loss and help
an overwhelmed pancreas.
Solfonylureas
ANSWER:
stimulate pancreas to release more insulin. range in onset, duration,
and potency and are only used for type 2 diabetes. there are first
generation and second generation. second are more potent and
,doses are lower and drug drug interactions are less common
AE: hypoglycemia
Acarbose
ANSWER:
a glucosidase inhibitor
oral anti diabetic agent that inhibits breakdown of oligosaccharides
into monosaccharides. this delays digestion and prolongs absorption
of carbs and decreases postprandial hyperglycemia!!
ADR: FI upset and flatulence.
take this with first bite of each meal.
Insulin Complications/ Drug Interactions
ANSWER:
hypoglycemia caused by overdose.
hypoglycemic agents (sulfonylureas, glinides, and alcohol),
hyperglycemia agents, b adrenergic blocking agents.
Sitagliptin
ANSWER:
DP4 inhibitor.
stimulates glucose dependent release of insulin and suppresses
postprandial release of glycogen. both actions help keep BG from
climbing to ohhight. used for type 2 dm
AE: URI, headache, inflammation of nasal passages, pancreatitis,
hypersensitivity reactions.
Canagliflozin
, ANSWER:
SGC2 inhibitor
reduces reabsorption of glucose and increases urinary glucose
excretion
AE: UTI, yeast infection, increased urination
DDI: uridine 5 diphospho glucuronosyltransferase inducers can
decrease effects. when used with diuretic can cause dehydration
How does insulin deficiency promote hyperglycemia
ANSWER:
increased glycogenolysis, increase glucomeogemesis, and reduced
glucose utilization. Glycogenolysis generates free glucose by
breaking down glycogen.
Metformin SE
ANSWER:
GI upset and acidosis.
don't use in patients with renal disease or liver disease. d/c before
using iodinated radio contrast media. wait 48 hours after to restart.
Insulin therapy dosing schedules
ANSWER:
Twice daily premixed: twice daily regimen can be used to provide
basal and prandial insulin coverage. if given with breakfast and
dinner, no mealtime coverage
Intensive basal/bolus strategy: type 1 uses this. use of long acting
insulin in addition to short acting. short acting with meals.
Insulin Glargine (Lantus)
ANSWER:
&Answers, Rationales & Advanced Nursing
Review | 100 % Guarantee Pass ,Graded A+ ,Well
Revised and Reviewed |Latest Exam and Brand
new Version !!!!
Insulin use
ANSWER:
Insulin is used to treat all patients with type 1 and many with type 2
diabetes. consists of two amino acid chains (a acidic and b basic)
linked by two disulfide bridges. it is synthesized in the pancreas by b
ce;;s within islets of langerhans. insulin is released by rise in blood
sugar (eating a. meal).
Anaolic reaction (insulin promotes conservation of energy and
buildup of energy stores)
Insulin metabolic actions
ANSWER:
Insulin promotes glucose into glycogen, amino acids assembled into
proteins, fatty acids into triglycerides.
Insulin deficiency promotes glycogen into glucose, proteins into
amino acids, and fats into glycerol.
Metformin use
ANSWER:
,Biguanide
used for type 2 DM. oral anti diabetic. may be used with other drugs.
can be used for prevention of type 2 diabetes, GDM, PCOS.
Reduces GI absorbance of glucose and hepatic production of
glucose. Does not stimulate insulin release from the pancreas.
Increases HDL, decreases BP, promotes weight loss.
DPP-4 Inhibitors (gliptins)
ANSWER:
go to pancreas and increase insulin release.
Example is Sitaglitpin
Sodium Glucose cotransporter 2 inhibitors (SGLT-2 inhibitors).
(gliflozins)
ANSWER:
Example: empagliflozin
increases urine excretion of glucose, taken PO, reduces
cardiovascular risk of type 2 diabetes.
SE: yeast infections and genital gangrene
Incretin Mimetics ('tides)
ANSWER:
injectables that slow gastric emptying, causes weight loss and help
an overwhelmed pancreas.
Solfonylureas
ANSWER:
stimulate pancreas to release more insulin. range in onset, duration,
and potency and are only used for type 2 diabetes. there are first
generation and second generation. second are more potent and
,doses are lower and drug drug interactions are less common
AE: hypoglycemia
Acarbose
ANSWER:
a glucosidase inhibitor
oral anti diabetic agent that inhibits breakdown of oligosaccharides
into monosaccharides. this delays digestion and prolongs absorption
of carbs and decreases postprandial hyperglycemia!!
ADR: FI upset and flatulence.
take this with first bite of each meal.
Insulin Complications/ Drug Interactions
ANSWER:
hypoglycemia caused by overdose.
hypoglycemic agents (sulfonylureas, glinides, and alcohol),
hyperglycemia agents, b adrenergic blocking agents.
Sitagliptin
ANSWER:
DP4 inhibitor.
stimulates glucose dependent release of insulin and suppresses
postprandial release of glycogen. both actions help keep BG from
climbing to ohhight. used for type 2 dm
AE: URI, headache, inflammation of nasal passages, pancreatitis,
hypersensitivity reactions.
Canagliflozin
, ANSWER:
SGC2 inhibitor
reduces reabsorption of glucose and increases urinary glucose
excretion
AE: UTI, yeast infection, increased urination
DDI: uridine 5 diphospho glucuronosyltransferase inducers can
decrease effects. when used with diuretic can cause dehydration
How does insulin deficiency promote hyperglycemia
ANSWER:
increased glycogenolysis, increase glucomeogemesis, and reduced
glucose utilization. Glycogenolysis generates free glucose by
breaking down glycogen.
Metformin SE
ANSWER:
GI upset and acidosis.
don't use in patients with renal disease or liver disease. d/c before
using iodinated radio contrast media. wait 48 hours after to restart.
Insulin therapy dosing schedules
ANSWER:
Twice daily premixed: twice daily regimen can be used to provide
basal and prandial insulin coverage. if given with breakfast and
dinner, no mealtime coverage
Intensive basal/bolus strategy: type 1 uses this. use of long acting
insulin in addition to short acting. short acting with meals.
Insulin Glargine (Lantus)
ANSWER:
