NURS 6015 LATEST QUESTIONS AND ANSWERS.
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Pancreas releases what hormones?
insulin, glucagon, somatostatin
Glucagon
A hormone secreted by the pancreatic alpha cells that increases blood glucose
concentration
Type I Diabetes Mellitus
-insulin dependent
- caused by autoimmune destruction of the beta cells of the pancreas leading to little or
no production of insulin
- require regular injections of insulin to permit entry of glucose into cells
Type II Diabetes Mellitus
-Non-insulin dependent
-caused by receptor level resistance to insulin
- partially inherited and partially due to environmental factors like obesity
-meds can help body more effectively use the insulin it produces
What is hypoglycemia?
- Low serum glucose level
S/S:
shakiness, dizziness, fatigue, diaphoresis, fast HR, nervousness/anxiety,
irritability/confusion, hunger
What are the 3 Ps of diabetes?
Polyuria, Polyphagia, Polydipsia
Oral Diabetes Medications
Oral hypoglycemic agents, medications that may be given to type 2 diabetes mellitus
patients to lower blood glucose
- Metformin
- Glipizide
- Pioglitazone
- Sitalgliptin
True or False: Diet and exercise (Lifestyle changes) improve insulin resistance in
Type II DM patients?
True
Biguinides - Metformin
Only used in Type II DM patients
- decreases liver(hepatic) glucose production
- decreased carbohydrate absorption in GI
- increases the sensitivity of insulin receptors
MONITOR KIDNEY FUNCTION (BUN and Cr)
- Do not give to patients with creatine levels of 1.4 or greater due to harmful impacts on
kidneys
, Sulfonylureas (Glipizide, Glyburide)
Widely used to treat type 2 diabetes because they stimulate insulin secretion
from pancreatic β-cells.
S/S
- Weight gain, hypoglycemia, cardiac toxicity, GI symptoms (TAKE WITH FOOD)
Contraindicated
- Pregnant and/or Breastfeeding
- Avoid alcohol (disulfiram-like reaction)
- Many Drug interactions (1st gen)
- If pt is NPO, withhold
Give 30 minutes before food
Thiazolidinediones (TZDs) - Pioglitazone
Decrease insulin resistance by enhancing the sensitivity of insulin receptors
- Can be used alone or in combination with sulfonylureas and metformin.
- Can cause or worsen heart failure and are not recommended in patients with
symptomatic heart failure.
-They also cause peripheral edema and weight gain.
- Referred to as insulin-sensitizing drugs.
S/S
URI, HA, muscle aches, fluid retention, edema, hepatotoxicity, ovulation in pre
menopausal women, can cause or worsen CHF.
Alpha-glucosidase inhibitors (AGIs) (Not used anymore, but on NCLEX)
Inhibit the absorption of carbohydrates from the small intestine. They competitively
inhibit enzymes that convert complex nonabsorbable carbohydrates into simple
absorbable carbohydrates
S/S
- flatulence, bloating, abdominal discomfort, and diarrhea.
- has been linked to rare cases of liver injury.
Contraindications
-Makes GI symptoms worse when used with Metformin
-AGIs should not be given to people with gastrointestinal conditions
DPP-4 inhibitors
Linagliptin, saxagliptin, sitagliptin
Blocks the action of the DPP-4 enzyme, which inactivates incretin hormones. This
allows the body to increase insulin levels after meals, which helps move sugar from
the blood into tissues and stabilize blood sugar levels.
(INcrease insulin, decrease glucagon)
Side effects: mild urinary and respiratory infections
GLP-I receptor agonists
Mimics the actions of the GLP-1 hormone, which is released by the gut after eating.
This helps the pancreas produce more insulin, which keeps blood glucose levels in
check. GLP-1 agonists also slow gastric emptying, reduce glucagon, and decrease food
intake.
Non-insulin injectable antidiabetic agents (Amylin, Incretin)
- slow gastric emptying
- must be dosed before a meal
Buy Quality Materials!
Pancreas releases what hormones?
insulin, glucagon, somatostatin
Glucagon
A hormone secreted by the pancreatic alpha cells that increases blood glucose
concentration
Type I Diabetes Mellitus
-insulin dependent
- caused by autoimmune destruction of the beta cells of the pancreas leading to little or
no production of insulin
- require regular injections of insulin to permit entry of glucose into cells
Type II Diabetes Mellitus
-Non-insulin dependent
-caused by receptor level resistance to insulin
- partially inherited and partially due to environmental factors like obesity
-meds can help body more effectively use the insulin it produces
What is hypoglycemia?
- Low serum glucose level
S/S:
shakiness, dizziness, fatigue, diaphoresis, fast HR, nervousness/anxiety,
irritability/confusion, hunger
What are the 3 Ps of diabetes?
Polyuria, Polyphagia, Polydipsia
Oral Diabetes Medications
Oral hypoglycemic agents, medications that may be given to type 2 diabetes mellitus
patients to lower blood glucose
- Metformin
- Glipizide
- Pioglitazone
- Sitalgliptin
True or False: Diet and exercise (Lifestyle changes) improve insulin resistance in
Type II DM patients?
True
Biguinides - Metformin
Only used in Type II DM patients
- decreases liver(hepatic) glucose production
- decreased carbohydrate absorption in GI
- increases the sensitivity of insulin receptors
MONITOR KIDNEY FUNCTION (BUN and Cr)
- Do not give to patients with creatine levels of 1.4 or greater due to harmful impacts on
kidneys
, Sulfonylureas (Glipizide, Glyburide)
Widely used to treat type 2 diabetes because they stimulate insulin secretion
from pancreatic β-cells.
S/S
- Weight gain, hypoglycemia, cardiac toxicity, GI symptoms (TAKE WITH FOOD)
Contraindicated
- Pregnant and/or Breastfeeding
- Avoid alcohol (disulfiram-like reaction)
- Many Drug interactions (1st gen)
- If pt is NPO, withhold
Give 30 minutes before food
Thiazolidinediones (TZDs) - Pioglitazone
Decrease insulin resistance by enhancing the sensitivity of insulin receptors
- Can be used alone or in combination with sulfonylureas and metformin.
- Can cause or worsen heart failure and are not recommended in patients with
symptomatic heart failure.
-They also cause peripheral edema and weight gain.
- Referred to as insulin-sensitizing drugs.
S/S
URI, HA, muscle aches, fluid retention, edema, hepatotoxicity, ovulation in pre
menopausal women, can cause or worsen CHF.
Alpha-glucosidase inhibitors (AGIs) (Not used anymore, but on NCLEX)
Inhibit the absorption of carbohydrates from the small intestine. They competitively
inhibit enzymes that convert complex nonabsorbable carbohydrates into simple
absorbable carbohydrates
S/S
- flatulence, bloating, abdominal discomfort, and diarrhea.
- has been linked to rare cases of liver injury.
Contraindications
-Makes GI symptoms worse when used with Metformin
-AGIs should not be given to people with gastrointestinal conditions
DPP-4 inhibitors
Linagliptin, saxagliptin, sitagliptin
Blocks the action of the DPP-4 enzyme, which inactivates incretin hormones. This
allows the body to increase insulin levels after meals, which helps move sugar from
the blood into tissues and stabilize blood sugar levels.
(INcrease insulin, decrease glucagon)
Side effects: mild urinary and respiratory infections
GLP-I receptor agonists
Mimics the actions of the GLP-1 hormone, which is released by the gut after eating.
This helps the pancreas produce more insulin, which keeps blood glucose levels in
check. GLP-1 agonists also slow gastric emptying, reduce glucagon, and decrease food
intake.
Non-insulin injectable antidiabetic agents (Amylin, Incretin)
- slow gastric emptying
- must be dosed before a meal
