Pharmacology
What is intermediate acting insulin and what is the peak
NPH (cloudy ) 1-5 hrs
Hyperthyroidism
tachycardia, heat intolerance, thyroid storm, nervousness, diarrhea, weight loss, goiter, diaphoresis, exophthalmos
Hyperthyroidism
T3 elevated, T4 elevated, TSH decreased
how to treat osteoporosis, what do you tell patients to take to prevent it
Vitamin D: fish, eggs, milk, cereal
Calcium: leafy greens, beans, OJ, milk
Exercise, avoid tobacco/alcohol
What is T1 Diabetes and when is it diagnosed
Autoimmune destruction of insulin-producing beta cells in the pancreas, Insulin is not produced → must be replaced with insulin injections, Often diagnosed in childhood or adolescence
Main diabetes diagnostics ( didn't talk abt it but use your critical thinking skills!!) hehe
· HgA1c every 3 months (checks how many glucose stamps are on a red blood cell - red blood cells life span is 90-120 days)
Hypoglycemia
Shakiness, Diaphoresis (sweating), Tachycardia, Fatigue, Confusion / blurred vision, Seizures or unconsciousness (severe)
Hypoglycemia
<70
How can insulins be mixed
Cloudy to clear, clear to cloudy
Risk factors for osteoporosis
Female (Asian/White), >50 years, family history, Low estrogen, sedentary lifestyle, tobacco/alcohol/caffeine use
If a patient has hypoglycemia and is unconscious, what do you give them?
Glucagon injection or IV dextrose
Hyperglycemia
Hot/dry skin (no sweat), N/V, abdominal pain, Rapid, deep respirations (Kussmaul), fruity breath, Possible coma
Hypothyroidism
T3 decreased, T4 decreased, TSH elevated
Cushing's disease tx/manegement
Monitor I&O, BP, infection prevention, support body image, physical activity
Nutrition: High protein/potassium, low calorie/sodium
Rapid acting insulin Onset
30 min to 1.5 hours
Diabetes T2 PO meds
Metformin- #1 choice
Glipizide (-ide)
-glinide
Acarbose
Hypothyroidism
cold intolerance, dry skin, constipation, weight gain, bradycardia, myxedema, pallor
Hyperglycemia
> 250
Addisons disease management
Hydration, hormone replacement, stress management, electrolyte correction
Thyroid storm sx
Thyroid storm - crisis
o Fever ---> CALL DR IMMEDIATLEY
o Tachycardia
o Systolic HTN
o N/V/diarrhea
o Agitation, tremors, anxiety
o Irritability, agitation, seizures
o Coma
Diabetes injectable meds
Incretin mimetic (exenatide/Wegovy)
- Administer SubQ 1 hr. before morning & evening meal
- Report severe abdominal pain
Cushing's disease
moon face, buffalo hump, truncal obesity, hyperglycemia, fragile skin, HTN, infections, personality changes
Cushings disease
Cortisol ↑, ACTH ↑, Glucose ↑, K+ ↓
Obesity tx
· Reduce calorie intake
· Increase resistance training exercise
· Avoid triggers
· Manage stress
· Keep a food diary
What is a sign of HYPOCALCEMIA
Chvostek's sign