NU 578 Unit 4 |
UPDATE|COMPREHENSIVE MOST
TESTED
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
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.
Treatment of thyroid storm - Answer--high doses of potassium iodide or strong iodine solution are given
to suppress thyroid hormone release. methimazole is given to suppress thyroid hormone synthesis. a
beta blocker is given to reduce heart rate. additional measures include desertion, cooling, and giving
steroids and IV fluids.
treatment of graves disease - Answer--treatment is directed at decreasing thyroid hormone productio.
surgical removal of thyroid tissue, radioactive iodine, suppression of thyroid hormone synthesis with
antithyroid drug (methimazole or PTU). blockers and nonradioactive iodine may be used in adjunctive
therapy.
Levothyroxine (t4) - Answer--replacement. DOC for hypothyroidism. can give PO/IV. life long therapy.
absorption reduced by food. take 30-60 minutes before eating. much is converted to t3 in the body.
prolonged half life for about 7 days.
AE: thyrotoxicosis (tachycardia, heat intolerance, angina, tremor, sweating)
DDI: histamine 2 receptor blockers, PPI, carafate, cholestyramine, coletipol, antacids, calcium
supplements, iron, magnesium, warfarin, catecholamines.
UPDATE|COMPREHENSIVE MOST
TESTED
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
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.
Treatment of thyroid storm - Answer--high doses of potassium iodide or strong iodine solution are given
to suppress thyroid hormone release. methimazole is given to suppress thyroid hormone synthesis. a
beta blocker is given to reduce heart rate. additional measures include desertion, cooling, and giving
steroids and IV fluids.
treatment of graves disease - Answer--treatment is directed at decreasing thyroid hormone productio.
surgical removal of thyroid tissue, radioactive iodine, suppression of thyroid hormone synthesis with
antithyroid drug (methimazole or PTU). blockers and nonradioactive iodine may be used in adjunctive
therapy.
Levothyroxine (t4) - Answer--replacement. DOC for hypothyroidism. can give PO/IV. life long therapy.
absorption reduced by food. take 30-60 minutes before eating. much is converted to t3 in the body.
prolonged half life for about 7 days.
AE: thyrotoxicosis (tachycardia, heat intolerance, angina, tremor, sweating)
DDI: histamine 2 receptor blockers, PPI, carafate, cholestyramine, coletipol, antacids, calcium
supplements, iron, magnesium, warfarin, catecholamines.
