This video is a quick review of the Endocrine Medications specifically Diabetic Medications their uses, mode of action, and precautions/nursing considerations of these medications
In this video we are going to talk about endocrine pharmacology to be more specific diabetic medication first insulin so insulin there are four different types of enzymes pro regular nph and insulin glycogen insulin lesbo so it is rapid acting insulin onset is less than 15 minutes its peak is between 30 minutes to an hour duration is between three to four hours with
This insulin you have to ensure that the patient’s milk tray is right in front of them when administering this medication even better administer it with melts due to its rapid acting mechanism regular insulin it’s also known as short acting insulin so it’s short acting onset is between 30 minutes to an hour peak is between two hours to three hours its duration is
Between five to seven hours with this insulin the meal tray could be on the floor when administering this medication this medication is also administered iv because it’s clear nph nph is an intermittent acting insulin its onset is between one to two hours peak is between four to 12 hours duration is between 18 to 24 hours nph is a suspension minutes cloudy it’s not
To be administered via iv drip insulin glycogen also known as lantis its onset is an hour there is no peak with insulin glycogen and its duration is 24 hours key things to note when administering insulin is that when insulin is at its peak we normally evaluate the patient for hypoglycemia because when with medication we always check when we do too good we’ll end
Up with the opposite of what we are trading also after opening a new insulin it’s only good between 20 to 30 days after opening so as a nurse make sure you label the insulin and date it and always initial after you open the insulin also remember if you have a question what action by the nurse invalidates the manufactural expiration date is always when you open the
Insulin you could refrigerate it after you open it and for an opened insulin it’s always refrigerated so side effects of insulin are there’s a risk of hyperglycemia the signs and symptoms include tachycardia diaphoresis shakiness weakness and headache and also there’s a possibility of buildup of scar tissue around the abdomen that’s why they encourage patients to
Always rotate sites when administering insulin so key points to remember insulin dose needs to be increased in times of illness for a fully conscious patient with hypoglycemia you can give them 15 grams of readily absorbable glucose which could be four ounces of orange juice or an eight ounce glass of milk for a patient who’s not fully conscious and they are having
A hypoglycemic event we and they are not able to safely swallow safely being the key word we administer iem glycogen never mix insulin glucon which is lentis with any other insulin when mixing insulin always remember clear before cloudy so we’ll inject air into the cloudy take the syringe out inject air into the clear withdraw the clear then go and withdraw the
Cloudy for insulin suspensions we gently rotate it the vial prior to administering if it’s a short acting and it looks discolored remember short acting is always clear we do not use it this pulse of the insulin oral anti-diabetic oral anti-diabetic medication are only used with type 2 patients one sulfoneurease with sulfonylureas we have glyphoside and glyburide
This medications are used for type 2 they are used to bring the sugar down mode of action it increases insulin release from the pancreas side effects include hypoglycemia photosensitivity and gi absent any medication which has sulfur in it there’s always a risk of photosensitivity administration take 30 minutes before the meal chance are not to drink alcohol well on
Therapy and they should wear sunscreen because of the photosensitivity and for pregnant patients we always prefer insulin if they are diabetic but glyburide is safe for pregnancy myelonidae repaglin is an example of it it’s used for that two diabetes to also bring the sugar down mode of action it increases insulin release from the pancreas side effects hypoglycemia
And angina for this medication it’s taken three times with meals 30 minutes before the meal big oneides example metaforming commonly used drugs it’s also used for type 2 diabetes to bring the sugar levels down its mode of action is to decrease glucose production in the liver and also increase glucose uptake by the cells side effects include gi upset b12 deficiency
Lactic acidosis and metallic taste in the mouth so things to remember have the patient take this medication with meals they should avoid alcohol when on therapy they may need b12 supplement if the doctor indicates due to the risk of b12 deficiency metaforming is always discontinued before the procedure that requires npo or contrast dye normally it’s discontinued
A day or two before the procedure we also monitor the patients for signs and symptoms of lactic acidosis which include dizziness diarrhea bradycardia weakness and hypotension and the side note is metaforming can also be used as a weight loss agent in diabetic patients there’s the dions example pioglidazone it’s used it’s to bring blood sugars down motivation it
Decreases insulin resistance by the cell it increases glucose uptake since it’s decreasing its resistance and also increases glucose production side effect is increased fluid retention and increased ldl and hepatotoxicity always remember it’s contradicted for heart failure patients due to either fluid retention and patients should take the medication once a day they
Could take it with or without meals alpha glucose inhibitors example is acobose it’s also used for type 2 diabetics its mode of action is eating so it inhibits glucose absorption in the gi tract side effects include gi upset hepatotoxicity and anemia always remember that it’s contradicted for patients with gi disorders patients should take it three times daily
With meals with a fast bite so it should be taken with meals with each meal the patient takes hypoglycemic agent example is glucagon it’s used for severe hypoglycemia when the patient is unable to take any oral glucose normally the patient will be unconscious or the patient is not safe to swallow mode of action stimulates the breakdown of glycogen into glucose
In the liver side effects include gi upset which are like nausea and vomiting always remember it’s administered subcutaneously i am or via iv route provide the patient with food as soon as they are awake or they are conscious and they are able to swallow safely safely being the key word here and when the glucose is all gone always remember to give them glycogen
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Transcribed from video
Diabetic Medications ( ENDOCRINE PHARMACOLOGY) By Nurse Mosh