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List the 6 classifications of oral diabetics
- 1. sulfonylurea
- 2. meglitinides
- 3. thiazolodiodine
- 4. biguanides
- 5. DDP4
- 6. Alpha-glucosidase inhibitor
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What is the function that both sulfonylureas & meglitinides have in common?
They stimulate the productions of insulins from pancreatic cells
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What is the function that both biguanides & thiazolidinedione have in common?
They are "insulin sensitizer" - enhance the sensitivity of insulin receptors in the tissues. They decrease glucose productions from the liver
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What is the MOA of alpha-glugosidase inhibitor?
- They inhibit the enzyme in the small intestine
- Thereby, they decrease the breakdown of glucose & delay the absorption of glucose
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Which classification of oral diabetic would not cause hypoglycemia?
Biguanides. Generic: metmorfin
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What is the MOA of DDP4?
Increases Incretin. & Incretin's functions are:
Increases insulin, decreases glucagon
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What are the 2 oral diabetics that must be taken with foods? Why?
- Biguanides & alpha glucosidase inhibitor.
- Because they both have a common function of delaying absorption of glucose
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Name the prototype of each classification of oral diabetic
1. Sulfonylurea
2. Meglitinide
3. Biguanide
4. Thiazolidinediones
5. Alpha-glucosidase inhibitor
6. DDP4
- 1. glipzide
- 2. repaglinide
- 3. metmorfin
- 5. rosiglitazone
- 6. acarbose
- 7. stagliptin
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Antithyroid compounds are to treat _________ (specific dz)
What are the 3 generics under this classification?
Hyperthyroidism (Grave's dz)
- 1. radioactive iodine 131
- 2. propylthiouracil (PTU)
- 3. methimazole
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What is the MOA of radioactive iodine 131? What is this drug for?
It damages/destroys thyroid tissue.
This is for hyperthyroidism
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What is the common MOA of methimazole & propythiouracil? What are these drugs for?
They inhibit the synthesis of T4-T3.
They are for hyperthyroidism
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What are the 2 classifications for parathyroid dz?
Hypercalcemic drugs & hypocalcemic drugs
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What is the MOA of antihypercalcemic drugs.
What is its generic name?
- It moves CA from blood to bone.
- (It inhibits CA resorption)
Generic: Calcitonin
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What type of insulin is usually used for sliding scales?
If administering insulin aspart, what action must be taken place right after to prevent hypoglycemia? & what classification is insulin aspart?
1. Short acting
2. Make sure meal tray is gonna come soon & they'll eat ASAP before peak action (1-2 hrs)
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What type of insulin can be given IV or IV bolus?
What type cannot be mixed w/ other type of insulins?
1. Short acting.
2. Long acting
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What insulin has peak action of 1-2 hrs & duration of 3-6 hrs?
What is the onset for short acting?
1. Rapid acting
2. Onset for short acting (30-60 min)
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What is the onset for lantus? What's the peak & duration?
What is the generic name for Lantus?
1-2 hr. No peak. Duration is 24+ hrs
glargine
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What oral diabietic (name of classification)that if mix with iodine-containing radiologic contrast, can cause acute renal failures?
What are the precautions of this drug w/ surgery?
* biguanides
*Should be discontinued 48 hrs pre procedure & 48 hrs post procedure
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Which oral diabetic(s) can cause hypoglycemia?
sulfonylureas & meglitinides
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what is hte prototype for DDP4?
sitagliptin
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What is the generic name for the new type of oral diabetic drug (that can be given as an injection for both type 1 & 2 diabetes) that is a synthetic analog of human amylin?
pramlintide acetate (Symlin)
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What is the biggest concern when giving pramlintide?
Whom should we not give this drug to??
SEVERE HYPOGLYCEMIA!
GERD PTs
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Synthroid is used for hypo or hyperthyroidism?
What is the generic name?
HYPOTHYROIDISM
LEVOTHYROXINNE
*remember: levo = synthro = hypo
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Pt. asks if she has to take levothyroxine for life. What is your answer.
Yes, it is a lifelong therapy, must not stop RX w/o HCP instruction
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What drugs are used for Hyperthyrodisim? (give generic names)
Propylthioracil (PTU) & methimazole (Tapazole)
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What function test should be monitored when giving pt.hyperthyroidism drugs?
What are some patient teaching to mention to pts receiving hyperthyroidism drugs?
1. TSH.
2. Weigh weekly, caution driving, report: sore throat, fatigue, fever, malaise (agranulocytosis)
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What does Radioactive Iodine 131 do?
What is the down side of this treatment?
Destroys thyroid tissue, limiting TH secretion
Pt. might be on synthroid for lifetime since she will be developing hypothyroidism
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What drugs are used for Pagets disease, hypercalcemia or osteoporosis?
*these diseases all have one thing in common: too little calciums in the bones!
Calcitonin = stop bone resorption
Calcitonin takes calcium from blood to bone
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ALL THESE HYPER/HYPOTHYROIDISM & PARATHYROIDISM DRUGS ARE ALL CONTRAINDICATED IN PREGNANCY
ALL THESE HYPER/HYPOTHYROIDISM & PARATHYROIDISM DRUGS ARE ALL CONTRAINDICATED IN PREGNANCY
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What parathyroid drugs are active vitamin D compounds?
Antihypercalcemic drugs (calcitonin) or
Antihypocalcemic drugs (calcitriol)
CALCITRIOL
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Calcitonin & alendronate (c: biophosphates) = for hypercalcemia (too much calciums in the blood & too little in the bone)
- Calcitonin: inhibits bone resorption
- Alendronate = inhibits osteoclast activity --> inhibits resorption.
Alendronate is for long term management
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What serious adverse effect should be reported to MD when taking alendronate?
- GI irritation
- A problem of movement muscle in esophagus
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T or F
1. Freeze insulin not-in-use
2. Never expose insulin to direct heat or light
3. Refrigerate insulin not-in-use
- 1. F. Never freeze insulin
- 2. T
- 3. T
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What are the symptoms of hypoglycemia?
- Cool clammy skin
- Shaky
- Fatigue
- Dizziness
- Restless
- Hungry
- Irritable
- Difficulty concentrating
- Palpitations
- Nausea
- Delirium (severely low)
- Seizures (severeley low)
- Death
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What are the criteria for diagnosis of diabetes? (3)
THESE TESTS MUST BE CONFIRMED ON SECOND DAY TESTING
- 1. S&S of DM + random BS > 200mg/dL
- OR
- 2. Fasting glucose >126mg/dL
- OR
- 3. 2hr plasma glucose (post-prandial)>200mg/dL on a glucose tolerance test
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