Insulin
Forces glucose and potassium into the cell; therefore decreasing levels of glucose and potassium in the blood
insulin
Hallmark symptoms of diabetes
polyuria, polydipsia, polyphagia
During a hypoglycemic episode, how do you know when to administer a med versus give a snack?
Conscious versus unconscious
Young patient
Key symptoms
Polyuria
polydipsia
polyphagia
T1 DM
Lack of ADH
symptoms include
Diurese
increased NA
Diluted urine (Low specific gravity)
Thirsty
Low bp
Diabetes insipidus
treated with demopressin
Watch for water intoxication and cardiac symptoms
Low bp, weight, na, temperature, hair
High- skin pigment, potassium
Addison's disease
Causes agranulocytosis so check for signs and symptoms of infection
Propylthiouracil
Quickest acting insulin with a 15-30 minutes onset and 30 min- 3 hour peak
Lispro, aspart, or glulisine
Autoimmune disorder where the beta cells are destroyed and insulin is no longer produced
Type 1 DM
This medication is for diabetes type 2 and works to increase insulin secretion in the pancreas. It is infamous for causing weight gain and hypoglycemia.
Glyburide
Autoimmune disorder of thyroid gland that can lead to goiter or have an iodine deficiency
Hashimotos disease
Significant amount of ADH
SIADH
Stop fluids
give salt and (IV 3% Saline)
diuretics
Add steroids and increase during times of stress
Diet high in protein, carbs, and sodium
don't stop abruptly
indefinite treatment
Addison's disease treatment
Pregnant women or breastfeeding women with hyperthyroidism should avoid this drug
Methimazole
Most deadly insulin, Must eat within 10-15 minutes of administration
Lispro
Slow onset, precursor of obesity, characterized by hyperglycemia and insulin resistance
T2DM
This medication ends in tide and delays gastric emptying. There is an average of 12lb weight loss with this medication. Common side effects include nausea, pancreatitis.
BBW: CI with history of thyroid cancer
Exanitide
Absence of cortisol (ACTH)
Addison's Disease
Biggest concerning symptom with Desmopressin
Headache
Sudden back pain
Severe n/v
Low bp
LOC
Addison's Crisis
Hydrocortisone IV
Life long, long slow onset
Early morning/ empty stomach daily
Very active
Oh the baby is fine
Levothyroxine
Make sure to educate the patient to eat a snack at bedtime when administering this insulin
NPH
Your patient is sweaty, anxious, hungry, confused, visual disturbances noted, having tremors, and is irritable. What is your priority intervention?
15 g of simple carb
number 1 T2DM
Least likely drug to cause hypoglycemia
Hold this for 24 h before IV dye and 48 h after
indicated for PCOS treatment
Metformin
Characterized by hump back, osteoporosis, stretch marks, acne, central obesity, elevated glucose, increased risk of infection
Cushings disease
Evidence that desmopressin is working and effective
Decreased urine output
Cushion obesity (moon face, buffalo hump)
Hirsuitism
Stretch marks
brittle bones
High glucose, weight, bp
Cushings Syndrome
Tx by
Removal of tumor
Taper off steroids
Effectiveness determined by weight gain, decreased t4 levels
Propylthiouracil or PTU
This insulin has no peak
Long Acting Insulin- Glargine
Sepsis
Stress
Skipping insulin
Steroids
hyperglycemia
This drug inhibits glucose reabsorption in the kidneys. Can also be used to treat CHF because it acts like a diuretic
SGLT2- Inhibitors
Canaglifloooozin
inflammatory response
Stop urination
Sticky and thick urine high sp gravity
hyponatremia
seizures
NA low
High blood pressure
SIADH
Excess growth hormone in childhood versus adulthood
Gigantism versus acromegaly
Elevated TSH and decreased t3, t4
Hypothyroidism
Biggest adverse effects of insulin
Hypoglycemia, lipohypertrophy
Presents with polyuria, polydipsia, polyphagia, nause/vomiting
can progress to
Fatigue, ams, hyperventilation
Priority treatment includes
1. Fluids
2. Insulin
3. Hyperkalemia recognition, but potassium should be given
Diabetic Ketoacidosis
Name the steps for mixing insulin
Clear then cloudy
Overproduction of thyroid hormone, which causes enlargement of the the thyroid, one of the key symptoms is exopthalmus
Graves disease
Given to suppress growth hormone
Octreotide
Watch for symptoms of gallstones
Watch for hyperglycemia
monitor cardiac status
Give IM in a large muscle
Stop treatment before growth plate closes
Somatropin indicated for low growth hormone
life threatening condition due to removal of the thyroid, or sudden stop in meds leads to
hypothermia
drowsiness,
bradycardia
Swelling of the eyes and face that may result from
Myexedema coma