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Pharm endocrine

Terms in this set (62)

Insulin can't be given PO because
it would be destroyed
Corticosteriods (glucocorticoids or steroids) are
Hormones produced by the adrenal gland
Maintain homeostasis
Have profound effects both therapeutic and adverse
Act as an anti-inflammatory
Steroid indications
Take PO meds with food to decrease GI upset
Increase dose during periods of stress (surgery)
Anticipate ulcer formation and start antacids or H2 antagonists
taper dose
do not abruptly DC
Monitor blood sugars if diabetic
notify MD for adjustment of diabetic meds while taking steroids
Monitor for acute infection
treat quickly
Increase activity
reduce bone demineralization
3S's of adrenal cortex
Sugar, sex, salt
Corticosteroids: what are they used for
Immunosuppressive, transplant pts, asthma, dont stop abruptly, takes time to take effect
Glucocorticoid Effects
Immunosuppressant-Caution in patients who are infected or at risk

Decrease the viscosity of the gastric mucosa-Caution, can contribute to the development of peptic ulcers

Decreases growth-Caution in children

Increases appetite with subsequent weight gain
-Caution may Alter body image

Mood swings-Caution in folks who are in long term therapy

Raises blood sugar-Caution May necessitate insulin therapy, particularly in ICU
Steroids: Take PO meds with food
to decrease GI upset
Increase dose during periods of stress (surgery)
Anticipate ulcer formation and start antacids or H2 antagonists
taper dose-do not abruptly DC
Monitor blood sugars if diabetic
notify MD for adjustment of diabetic meds while taking steroids
Monitor for acute infection
treat quickly
Increase activity
reduce bone demineralization
Steroids: Take daily doses before 9AM
to match body's circadian rhythms
Diabetes Mellitus is either
Insufficient secretion of insulin from beta cells
Or
Primarily involves the body's inability to metabolize carbohydrates due to deficiency or diminished effectiveness of insulin
Type 1: Insulin-Dependent
Abrupt failure of the pancreas (autoimmune disease)
Beta cells disabled
Absolute insulin dependency
(10-12%)
Type 2: Non-Insulin Dependent
Resistance to insulin action in target tissues
Abnormal insulin secretion
Inappropriate hepatic gluconeogensis (liver function)
(85-90%)
Liver producing lots of sugar, so goes up & up
Secondary diabetes : Gestational & Stress Related
Use of adrenal corticosteroids, oral contraceptives, and other drugs that antagonize the effects of insulin
Not related to pancrease
Blood Sugar Ranges
Normal is 90's-120's
According to the American Diabetes Association a person is diabetic if:
Fasting blood glucose >126 mg/dl
Random blood glucose > 200 mg/dl
Serum glucose levels determine amount of medication
Most sensitive test is glycated or glycosylated hemoglobin (Hgb A1c)
Hyperglycemia s/s
Polyuria
Polydipsia
Polyphagia
Weight loss
Fatigue
Weakness
Vision changes
Frequent skin infections
Dry, itchy skin
Vaginal discomfort
Hypoglycemia s/s
Confusion
Irritability
Hunger
Nausea
Cold & clammy skin
Tremors
Numbness
Tingling of lips/tongue
Seizures
Coma
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