-
Function of alpha-glucosidase inhibitor?
- (oral antidiabetic)
- interferes with carb breakdown & absorption
-
How do you treat hypoglycemia if it occurs from an alpha-flucosidase inhibitor combined w/ another oral agent?
treat w/ glucose, not sucrose
-
Actinon of biguanides.
- (oral antidiabetic classes)
- Decreases production & release of glucose from the liver
- lowers lipid levels
- promotes wt loss
-
Action of thiazolidinedione?
- (oral antidiabetic)
- decreases production & release of glucose from the liver
- increases insulin sensitivity in fat & muscle tissue
-
Thiazolidinedione nursing considerations.
- (oral antidiabetic)
- can cause fluid retention and worsening of heart failure
- therapeutic effects take several weeks to develop
-
Action of Incretin Enhancers.
- (oral antidiabetic)
- slows breakdown of insulin (keeps in bld longer)
- slows rate of digestion (which increases satiety)
-
Action of meglitinides (oral antidiabetic).
stimulates insulin release
-
Action of sulfonylureas (oral antidiabetic).
- stimulates insulin release
- decreases insulin resistance
-
Oral antidiabetic that is administered shortly before meals.
meglitinides
-
Onset, peak, duration of Insulin aspart (NovoLog).
- (Rapid)
- 10-20 min
- 1-3 hrs
- 3-5 hrs
-
Onset, peak, duration of Insulin lispro (Humalog)?
- (rapid)
- 5-15 min
- 1-1.5 hrs
- 3-4 hrs
-
Onset, peak, duration of Insulin glulisine (Apidra)?
- (rapid)
- 15-30 min
- 1 hr
- 3-4 hrs
-
Onset, peak, duration of Insulin regular (Humulin R, Novolin R)?
- (Short)
- 30-60 min
- 1-5 hrs
- 6-10 hrs
-
Onset, peak, duration of Insulin suspension (NPH, Humulin N)?
- (Intermediate)
- 1-2 hrs
- 6-14 hrs
- 16-24 hrs
-
Onset, peak, duration of Insulin detemir (Levemir)?
- (long)
- gradual
- 6-8 hrs
- to 24 hrs
-
Onset, peak, duration of Insulin glargine (Lantus)?
- (long)
- 1.1 hrs
- NO PEAK
- to 24 hrs
-
Indication for Ocreotide?
increased GH
-
Indication for Desmopressin?
decreased ADH
-
Indication for somatropin?
decreased GH
-
What is Cushings syndrome?
- caused by long-term use of hydrocortisone
- Hyperglycemia
- Hyperlipidemia
- Hypernatremia
- Hypokalemia
- Edema, HTN
-
Why is metformin held prior to a cardiac cath or other dye study?
- 2 days prior and two days after receiving IV radiographic contrast
- If not, pt can go into RENAL FAILURE
-
What is Metformin?
an antidiabetic agent, most commonly used to manage type II diabetes
-
The two cells that are packed within a lymph node.
- lymphocytes & macrophages
- =recognize anything that is ‘non-self’
-
3 nonspecific body defenses.
-
The 3 cellular barriers.
- Phagocytes- primary cell of innate immunity, activated once physical barriers are breached
- NK cells – Release toxins that kills CA cells or virus-infected cells
- Interferons – Antimicrobial proteins
-
-
The process barriers.
- Complement – Cluster of 20 plasma proteins combine in sequence and order when an infection occurs
- *Fever
- Inflammation
-
Chemical mediators released by mast cells.
- Histamine
- Bradykinin
- Complement
- Leukotrienes
-
Two cellular branches of immune response.
- 1) Humoral - triggered when antigen encounters a B-lymphocyte
- 2) Cell-mediated (T-cell)
-
Two cells involved in cell-mediated immune response.
- Helper T-cells (activate most other immune cells)
- Cytotoxic T cells (travel through body directly killing bacteria, parasites, virus-infection cells and cancer cells)
-
Which protein receptor is on the membrane of the helper T-cell?
CD8
-
Role of Histamine 2?
- Located in stomach
- Stimulates secretion of large amounts of hydrochloric acid in the stomach
-
Role of Histamine 1?
- causes itching, pain, edema, vasodilation, bronchoconstriction (typical allergic
- relations)
- (present in the smooth muscle of vascular system, respiratory & digestive)
-
What are prostaglandins and their fxn?
- Hormones found in every tissue;
- -mediates inflammation by causing vasodilation and increased capillary permeability
- -GI protection through increased bicarbonate and mucous production to protect stomach mucosa from acid
- -Renal protection – helps maintain
- renal blood flow
- -Smoother muscle – helps regulate
- smooth muscle tone
- -Blood clotting – increased platelet
- aggregation to promote clot formation
-
Two classes of drugs most commonly used to treat inflammation?
-
#1 cause of hepatic failure in US.
Excessive use of acetaminophen (Antipyretic & Analgesic, APAP)
-
3 major classes of NSAIDS.
- Salicylates (Cox1 & Cox2 inhibitors)
- Ibuprofen (Cox1 & Cox2 inhibitors)
- Cyclooxytygenase-2 (COX2 inhibitors)
-
How do NSAIDs work?
inhibit sythesis of prostaglandins
-
Two classes most commonly used to treat inflammation?
ASA & NSAIDs
-
Types of agents used as immunosuppressants.
- Calcineurin Inhibitors (cyclosporine)
- Cytotoxic Agents & Antimetabolites (Axathioprine)
- Antibiodies
- Corticosteroids
-
What is cyclosporine used for?
prophylaxis of transplant rejection
-
Contraindications to vaccine administration.
- pts who are:
- immunosuppressed
- pregnant
- have cancer
- HIV (+)
-
Effects of Cox-2 inhibitors.
- platelet aggregation
- GI irritation
-
What risks does Celebrex (COX-2 inhibitor) have that other NSAIDs do not?
risk of MI & stroke
|
|