Diabetes meds pt.1
What are the contraindications for Biguanide (Metformin)?
-Creatinine > 1.5 mg/mL in males
-diabetic ketoacidosis
-renal failure
-radiographic contrast use
-alcoholism
-hepatic disease
-heart failure
what is the onset, peak, and duration of lispro?
Onset: 15-30 minutes
peak: 0.5-1.5 hours
duration: 3-4 hours
what is the mixing information for regular insulin?
withdraw regular (clear) first, then NPH (cloudy)
what are contraindications for levothyroxine?
-adrenal insufficiency
--recent MI
-thyrotoxicosis
-hypersensitivity to beef
-alcohol intolerance
-hyperthyroidism
-allergy
what is the mechanism of action for PTU?
-blocks synthesis peripherally of T3 and T4
-inhibits organification of iodine
what is the mechanism action of biguanide?
-inhibits hepatic glucose production and increases sensitivity of peripheral tissue to insulin
-decreases liver production of glucose
what is the mixing info for lispro?
75% insulin lispro protamine and 25% insulin lispro : mixture of intermediate and rapid-acting insulin
what is the onset, peak, and duration of NPH?
onset: 1.5-4 hours
peak: 4-12 hours
duration: up to 24 hours (10-18 hours)
what is the mechanism of action of levothyroxine?
-controls protein synthesis
--increases metabolic rate, cardiac output, renal blood flow, O2 consumption, body temp, blood volume, growth, development at cellular level via action on thyroid hormone receptors
common and serious side effects of PTU?
-drowsiness, vertigo, headache
-alopecia
-hyperpigmentation
-hepatitis
-liver failure
-death
-nephritis
-agranulocytosis
-thrombocytopenia
what are the contraindications for glipizide?
-hypersensitivity to sulfonylureas/sulfonamides
-type I diabetes
-diabetic keotacidosis
what is the nursing assessment for lispro?
-fasting BG
-Hgb A1c
-urine ketones
-hypoglycemic/hyperglycemic reaction
what is the mixing information for NPH?
70% NPH and 30% regular: mixture of intermediate and short acting insulin
-aluminum
-calcium
-iron
-magnesium
-sucralfate
-rifampin
-rifabutin
-orlistat
-ferrous sulfate
-anticoagulants
-digoxin
drug drug interactions of PTU
-heparin
-lithium
-potassium/sodium iodide
-radiation
what are the severe signs and symptoms for glipizide?
-hypoglycemia
-hepatotoxicity
-cholestatic jaundice (pruritus, dark urine, yellow sclera)
-leukopenia
-thrombocytopenia
-agranulocytosis
-hemolytic anemia
-serious hypersensitivity
When should insulin lispro be given?
15 minutes before meals
what is the onset, peak, and duration of glargine?
onset: 1.5 hours
peak: no peak identified
duration: >24 hours
what does anxiety, sweating, irritability, chest pain, and palpitation indicate when taking levothyroxine?
overdose of levothyroxine
indications and contraindications for radioactive iodine?
indications:
-graves disease
-goiter
-use after a thyroidectomy
contraindications:
-pregnancy
-lactation
-moderate to severe eye disease
what is the mechanism of action for glipizide?
-causes functioning B cells in pancreas to release insulin, leading to a drop in blood glucose levels
-may improve insulin binding to insulin receptors
what is the onset, peak, and duration of regular insulin?
Onset: 30 minutes
peak: 2.5-5 hours
duration: up to 6 hours
mixing information for glargine?
-roll vials: do not shake
-insert air beforehand
-store room temp for up to 1 month
-SQ at 90 degree angle
-29 gauge needle
-rotate sites
what are the indications for PTU?
-preparation for thyroidectomy
-thyrotoxic crisis
-hyperthyroidism
-thyroid storm
what is the mechanism of action for radioactive iodine?
-produces clinical remission with destruction of thyroid gland
-primarily excreted in urine
-destroys thyroid gland