Download NUR 3145 (Pharm) Exam 3: Antidiabetic Drugs and Hormones and more Exams Nursing in PDF only on Docsity!
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What is desmopressin for? - correct answers it is a synthetic analog of ADH so it keeps water in you What do you use desmopressin to treat? - correct answers Diabetes insipidus because they have too little ADH What is SIADH? - correct answers Too much ADH secretion (you will have sodium loss). How do you treat SIADH? - correct answers Treat with fluid restriction and diuretics: Conivaptan and Tolvaptan, they promote renal water excretion and increase serum sodium levels What is somatotropin? - correct answers identical to our body's growth hormone What is the adverse effect of somatotropin? - correct answers hyperglycemia What is a nursing responsibility for somatotropin? - correct answers assess baseline height and weight and monitor
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What is the cousin of somatotropin? - correct answers Mescasermin (A/E: hypoglycemia) Why would you give somatotropin? - correct answers Growth failure in children due to GH deficiency or AIDS wasting What is octreotide? - correct answers growth hormone antagonist (mimics the action of growth hormone antagonist) What is octreotide used for? - correct answers GI bleed (also used to treat diarrhea because it prolongs intestinal transit time) What is the adverse effect of octreotide? - correct answers hypo or hyperglycemia What are the cousins of octreotide? - correct answers Lanreotide, Pegvisomant, Bromocriptine What patients do you caution for when using octreotide? - correct answers Patients with gallbladder disease What are sulfonylureas for? - correct answers antidiabetics
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When are biguanides contraindicated? - correct answers 2 days before and 2 days after receiving IV contrast dye (may cause lactic acidosis and renal failure) When do you not use biguanides in males and females? - correct answers Males: serum creatinine greater than or equal to 1.5 mg/dL Females: serum creatinine greater than or equal to 1.4 mg/dL What are meglitinides? - correct answers antidiabetic drug How do meglitinides work? - correct answers By stimulating the release of insulin from the pancreatic cells (similar to sulfonylureas) When should you not give meglitinides? - correct answers If a meal is skipped (take before a meal) What are thiazolidinediones for? - correct answers antidiabetic drug How do thiazolidinediones work? - correct answers They work by decreasing insulin resistance and inhibiting hepatic gluconeogenesis
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Rosiglitazone is a thiazolidinedione that may worsen ________ - correct answers Heart failure (due to increased fluid retention) (has a BBW) What are alpha glucosidase inhibitors for? - correct answers antidiabetic drug How do alpha glucosidase inhibitors work? - correct answers by blocking enzymes in the small intestine responsible for breaking down complex carbs into monosaccharides, which delays digestion of glucose The two alpha glucosidase inhibitors are acarbose and migitol. When should you administer these drugs? - correct answers With the first bite of each main meal, do not give if patient does not have adequate oral dietary intake What is glucagon for? - correct answers Emergency treatment of severe hypoglycemia in diabetic patient What are incretin enhancers for? - correct answers antidiabetic drug
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What are the signs/symptoms of cushing's syndrome? - correct answers personality changes, hyperglycemia, moon face, CNS irritability, increased susceptibility to infection, sodium and fluid retention (edema), thin extremities, gynecomastia in males, fat deposits on face and back of shoulders, GI distress (increased acid), amenorrhea and hirsutism in females, thin skin, purple striae, bruises and petechiae, and osteoporosis. How do you treat cushing's syndrome? - correct answers - Ketoconazole (drug of choice - blocks the synthesis of glucocorticoids which signals pituitary to release more ACTH) -Mitotane (antineoplastic drug) -Metyrapone (used for diagnosis) Signs/symptoms of hypoglycemia - correct answers Shakiness, dizziness, nervousness, sweating a lot, hunger, headache, pale face, clumsiness, confusion, trouble paying attention, tingling around the mouth, and passing out. What groups of antidiabetic drugs are known for causing hypoglycemia? - correct answers Sulfonylureas and Meglitinides What is the only insulin you can give IV? - correct answers Regular
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When should you give regular insulin? - correct answers 30-60 min before a meal (it is short-acting) What should you give if you have an overdose of regular insulin? - correct answers Dextrose or glucagon What are the fast-acting insulins? - correct answers Aspart, Lispro, Glulisine When should you give fast-acting insulin? - correct answers 5-10 mins before a meal because it acts so rapidly What are the intermediate insulins? - correct answers NPH and Humulin N When do you give intermediate insulin? - correct answers Usually given 30 minutes before the first meal of the day, sometimes may take a second/smaller dose before the evening meal or bedtime. (basal level of insulin coverage) Is NPH clear or cloudy? - correct answers Cloudy (cannot mix with glargine) (clear before cloudy)
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Nursing 101 for Levothyroxine - correct answers administer on an empty stomach with a full glass of water 30-60 minutes before breakfast (we give in the morning because it interacts with so many other drugs) A/E of Levothyroxine - correct answers tachycardia and insomnia (also CNS excitability, diarrhea, vomiting, weight loss and anxiety) Don't give levothyroxine if HR > ____ - correct answers 100 beats/min Cushing's syndrome is an adverse effect of what? - correct answers Hydrocortisone A/E of hydrocortisone - correct answers sodium and fluid retention CNS effects of hydrocortisone - correct answers insomnia, anxiety, and depression Serious adverse effect of hydrocortisone - correct answers hypertension nursing 101 for hydrocortisone - correct answers Do not stop abruptly!! Take with food, milk, or a meal to prevent GI upset.
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Cousins to hydrocortisone - correct answers Prednisone and Dexamethasone Adverse effects of corticosteroids - correct answers Suppression of immune and inflammatory responses, peptic ulcers, osteoporosis, behavioral changes, eye changes, metabolic changes, hyperglycemic effect, hyperlipidemia, myopathy For acute conditions in which corticosteroids need to be given, how do you give it? - correct answers Large doses, then gradually tapered until discontinued Ketones are present in which condition? - correct answers DKA (not hyperosmolar hyperglycemic state) Propylthiouracil (PTU) is given for hyperthyroidism and is pregnancy category D but when would you give it to a pregnant woman? - correct answers Thyroid storm (preferred over Methimazole because less of the drug crosses the placenta) Fludrocortisone is a mineralcorticoid (drug for hypoaldosteronism). What should you monitor for this drug? - correct answers BP, Potassium levels, I&O, and weight
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What are ARBs (angiotensin II receptor blockers) for? - correct answers To treat HTN and HF (causes vasodilation, reduces PR, and decreases BP) Unlike ACEIs, ARBs do not cause _____ - correct answers cough (and angioedema is less common) What drug is an ARB? - correct answers Losartan A/E of Losartan - correct answers angioedema Drug interaction of Losartan? - correct answers hyperkalemia with potassium supplements or with potassium-sparing diuretics (don't give with spironolactones) What do calcium channel blockers do? - correct answers vasodilation, lower myocardial oxygen demand, less workload of heart, reduces force of myocadial contraction, decreases HR Drugs that are calcium channel blockers - correct answers Nifedipine and Verapamil
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A/E of nifedipine - correct answers peripheral edema (caution in CHF) Nursing 101 for verapamil - correct answers listen to lungs The dihydropyridines (calcium channel blockers) are selective for ________ _______ _______ and are used to treat _______ and ______ ______. - correct answers vascular smooth muscle; hypertension and angina pectoris The nondihydropyridines (calcium channel blockers) act on both ______ ______ ______ and the _______. - correct answers Vascular smooth muscle and the myocardium Is atenolol cardioselective or noncardioselective? - correct answers cardio-selective Atenolol blocks what? - correct answers beta 1 adrenergic receptors in the heart Atenolol is used for - correct answers HF and HTN Nursing 101 for atenolol - correct answers have to taper it off
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Beta adrenergic antagonists are nonselective and hit both _____ and _____ - correct answers beta 1 and beta 2 (may worsen asthma and COPD) A/E of beta adrenergic antagonists - correct answers bronchoconstriction, hypoglycemia, and rebound cardiac excitation may occur if beta blockers are withdrawn abruptly so ween off slowly When would it be beneficial to use a cardio-selective beta blocker? - correct answers If the patient has asthma or COPD What is digoxin given to treat? - correct answers Heart Failure Drug interaction with digoxin - correct answers Hypokalemia and risk of dysrhythmias with diuretics Low potassium increases chance of digoxin toxicity What should you do before administering digoxin? - correct answers Take apical pulse for 1 minute and if it is below 60, hold it Positive inotropic effect of digoxin - correct answers increased myocardial contractility
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Negative chronotropic effect of digoxin - correct answers decreased heart rate What does nitrolgycerin do? - correct answers relaxes both arterial and venous smooth muscle (CHF, MI, HTN) and treats angina symptoms Nitroglycerin drug interactions - correct answers life-threatening hypotension and CV collapse with Sildenafil Most commonly seen side effect of nitroglycerin - correct answers headache What is the drug of choice for hypertensive emergencies? - correct answers Nitroprusside A/E of nitroprusside - correct answers Thiocyanate toxicity from extended therapy When is nitroprusside contraindicated - correct answers If patient has serious renal impairment
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Chlorothiazide, Metolazone, Chlorthalidone, and Indapamide are cousins to _________ - correct answers Hydrochlorothiazide Spironolactone is a ______ - correct answers diuretic (potassium sparing), antihypertensive, and aldosterone agent What does your body retain with Spironolactone? - correct answers potassium Spironolactone can cause hyperkalemia with ______ _____, ______, or ______. - correct answers potassium supplements, ACEIs, and ARBs Mannitol is an _____ ______ - correct answers osmotic diuretic (drug for renal failure) A/E of Mannitol - correct answers CHF (listen for fluid in the lungs) With patients on Mannitol, what are nursing 101s? - correct answers Measure I&O, weight patient before therapy and daily thereafter A/E of vasodilators - correct answers reflex tachycardia (compensatory increase in HR due to sudden decrease in BP)
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What are the vasodilator drugs? - correct answers Hydralazine and Nitroprusside Sodium Hydralazine is an _____________ - correct answers antihypertensive A/E of hydralazine - correct answers lupus-like syndrome You should not abruptly stop hydralazine because of - correct answers rebound hypertension When do you use nitroprusside sodium? - correct answers Emergency hypertension situations Statins are drugs for _____ - correct answers hyperlipidemia What can statins reduce? - correct answers LDL cholesterol, triglyceride levels, and VLDL levels Statins can raise what? - correct answers HDL levels Big A/E of statins - correct answers Rhabfomyolysis (leg pain)
