NURS 165 Study Guide - Final Guide: Corticosteroid, Tachycardia, Dipeptidyl Peptidase-4
Diabetes Meds
*Side note: )slets aren’t cells. They’re clusters of cells, & each has -4 thousand.
Normal pancreas has a bout 1,000.
• Review Type 1 and Type 2
o Type 2 can go years undiagnosed – changes are gradual
▪ Pancreas can try and compensate for insulin resistance w/
more insulin → wears out beta cells
o They’re trying islet cell transplantation
▪ Healthy islets in diabetics → can really help!
• Pharmacologic Therapy
o Insulin
▪ Rapid, short, intermediate, long acting (pump is usually short)
o Amylin analog
▪ Used as an adjunct
• Non-pharmacologic (Type 2)
o Behavior modification
o Obesity associated
o Physical activity brings more GLUT 4s to muscle cell surface
▪ This is called translocation!! Very important
o Manage co-morbidities
▪ Hypertension, dyslipidemia, ya know
• Pharmacologic
o Oral anti-diabetic agents
▪ Ex. to inc. insulin
o Injectables
▪ Insulin, analogues, etc.
• Mechanism of Action
o Injectables
▪ Insulin: initiates glucose uptake in cells
▪ Amylin analogs: slows gastric emptying; suppresses glucagon;
promotes satiety
▪ Incretin GLP-1 Mimetics
• Stimulates glucose-dependent insulin secretion
• May be safer than insulin – don’t promote hypoglycemia
• Also slow gastric emptying & suppress appetite
o Oral agents
▪ Biguanides: increase insulin receptor sensitivity; decrease liver
gluconeogenesis
▪ Sulfonylureas: stimulate insulin release (secretagoge)
▪ Meglitinides: same as sulfonylureas
▪ Alpha glucosidase inhibitors: inhibit GI brush border enzymes
▪ TZDs: inc. insulin sensitivity
find more resources at oneclass.com
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Document Summary
They"re clusters of cells, & each has (cid:885)-4 thousand. Very important: manage co-morbidities, hypertension, dyslipidemia, ya know, pharmacologic, oral anti-diabetic agents, ex. to inc. insulin, injectables. Insulin, analogues, etc: mechanism of action, injectables. Insulin: initiates glucose uptake in cells: amylin analogs: slows gastric emptying; suppresses glucagon; promotes satiety. Stimulates glucose-dependent insulin release: sglt2 inhibitors: decrease glucose reabsorption, when sodium gets reabsorbed. Insulin: indication: either type of diabetes; acute hyperglycemia, moa: binds to its receptor stimulates translocation, ex. Know this chart: administration, all given sq, rapid/short can also be iv, don"t ever give im!! Absorption can be too quick: can"t mix most intermediate/long with rapid/short, only nph of int. /long can be mixed w rapid or short. Insulin drip: correction dose for bg > 150, 1-4 units per 50 mg/dl to correct, based on insulin sensitivity, sliding scale, gives action based on bg, problematic, because not individualized.
