Trulicity- dulaglutide
What is Trulicity for?
DM2
T or F: Labeling a medication or medication container is optional
FALSE. Immediately discard any medication or solution found unlabeled
What is narcan for?
Opioid overdose
Hand hygiene- what two guidelines make up the hand hygiene regulations
Comply with either the current Centers for Disease Control and Prevention (CDC) hand hygiene guidelines (scrub hands for at least 20 seconds)
World Health Organization (WHO) hand hygiene guidelines.
What is the goal BP for the majority of pts?
<130/80
How is Trulicity dosed?
Once a week injection of 0.75 mg/0.5ml inj, can increase to 1.5mg inj after one month
Always wait at least three days before switching doses
Multidose vial expiration
Multi-dose injectable that are used for more than one patient when they are opened, should be discarded within 28 days of opening or according to manufacturer's recommendations, whichever is more stringent.
Narcan comes with 2- 4mg nasal sprays. How long should you wait to see improved breathing before giving another dose?
Breathing does not return to normal or if breathing difficulty resumes, after 2-3 minutes, give an additional dose of NARCAN® Nasal Spray using a new device in the alternate nostril.
What age should a pt receive the shingrix vaccine ?
19 through 64 years with the following chronic conditions 1 dose of PPSV23 (at age 65 years or older, administer 1 dose of PCV13, if not previously received, and another dose of PPSV23 at least 1 year after PCV13 and at least 5 years after PPSV23)
50 and older
pneumococcal conjugate vaccine (PCV13 or Prevnar 13®)
pneumococcal polysaccharide vaccine (PPSV23 or Pneumovax®)
Diagnosis of HTN
Normal BP is defined as <120/<80 mm Hg; elevated BP 120-129/<80 mm Hg; hypertension stage 1 is 130-139 or 80-89 mm Hg, and hypertension stage 2 is ≥140 or ≥90 mm Hg.
Prior to labeling a person with hypertension, it is important to use an average based on ≥2 readings obtained on ≥2 occasions to estimate the individual’s level of BP. Confirm with home BP monitoring as well
Where should you inject trulicity?
Abdomen, thigh, upper arm
How many patient identifiers should be used when administering a medication?
At least two. Patient room number does NOT count.
Who should receive narcan?
Anyone with opioids at home
ONE YEAR AFTER QUITTING Your excess risk of coronary heart disease drops by WHAT PERCENTAGE compared with a smoker.
ONE YEAR AFTER QUITTING Your excess risk of coronary heart disease drops by 50% compared with a smoker.
diet low in sodium, saturated fat, and total fat and increase in fruits, vegetables, and grains may decrease SBP by how much?
apx 11 mm Hg
Side effects of trulicity
ADE: thyroid cancer seen in rats, some nausea, In studies- 8%-29% using Trulicity experienced some nausea, which typically occurred during the first 2-3 days after they took their first dose. Nausea generally subsides after the first 2 weeks. Dont use with pancreatitis
What five things must be verified before administering a drug?
patient, drug, dose, route, time. also important to discuss potential side effects and verify allergies
How do you obtain Narcan?
Although NARCAN® Nasal Spray is a prescription medication, all states have passed laws to increase access of naloxone in the community and in homes where there are opioids present.
In every state, residents can purchase NARCAN® Nasal Spray directly from a pharmacist under a Statewide Naloxone Standing Order or Collaborative Practice Agreement.
About 16 million heart attacks, strokes, and related heart-threatening events* could happen by 2022.
1 in 3 of these life-changing cardiovascular events happened in adults 35-64 years old in 2016.
WHAT PERCENTAGE OF of premature heart disease and strokes are preventable.
80%!
Lifestyle-diet & exercise
Aspirin use when appropriate, Blood pressure control, Cholesterol management, and Smoking cessation.
In patients with diabetes, what specific BP medications are useful in patients with albuminuria?
Diabetes mellitus (DM) and hypertension: Antihypertensive drug treatment should be initiated at a BP ≥130/80 mm Hg with a treatment goal of <130/80 mm Hg.
In adults with DM and hypertension, all first-line classes of antihypertensive agents (i.e., diuretics, ACE inhibitors, ARBs, and CCBs) are useful and effective. ACE inhibitors or ARBs may be considered in the presence of albuminuria.
How does Trulicity work?
Helps your body release its own insulin.
-limits sugar getting into the blood from liver
-helps slow down food leaving the stomach (can lose weight)
-helps pancreas release insulin when blood sugar is high after eating
Medication management: Top Non-Compliant Standards/NPSGs for Hospitals
1) Medication Orders- 49.28%Failure to clarify unclear, illegible and incomplete orders- what’s still on paper?, Consistency in interpreting range orders, Titration orders
2) Storage and Security of Meds- 47.84%
3) Medication Order Review- 14.94%
4) Preparing medications- 14.15 %
5) Labeling in OR/procedures- 8.8%
Name three signs of opioid withdrawal that could occur after administering naloxone?
Opioid withdrawal symptoms may include body aches, diarrhea, increased heart rate, fever, runny nose, sneezing, goose bumps, sweating, yawning, nausea or vomiting, nervousness, restlessness or irritability, shivering or trembling, stomach cramping, weakness, increased blood pressure.
Adults 40-75 years of age with diabetes mellitus and an LDL-C 70-189 mg/dL should be treated with WHAT
moderate-intensity statin therapy per ACC guidelines
First line therapy for HTN
TZ diuretics- Chlorthalidone (12.5-25 mg) is the preferred diuretic because of long half-life and proven reduction of CVD risk.
ACEI or ARB
CCB
Beta-blockers are not first-line therapy except in CAD and HFrEF.