Term
| What are 3 nondrug measures patients can take to decrease cholestrol? |
|
Definition
-Quit smoking
-Low cholestrol diet (TLC)
-Exercise |
|
|
Term
| What is MOA of "statin" drugs like Lipitor (atorvastatin)? |
|
Definition
| Inhibits biosynthesis of cholestrol-HMG inhibitor |
|
|
Term
| What effect on the lipid (LDL, TG, HDL) can we expect from statins? |
|
Definition
| Lowers LDL*** and TG, slightly increases HDL |
|
|
Term
| Major Adverse Effects of Statins |
|
Definition
| Hepatotoxicity, Myalgia, Pregnancy Category X |
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|
Term
| Bile Acid Resins (BARs) like cholestyramine utiliza what MOA? |
|
Definition
Binds to bile acids in GI, prevent reabsorption, increase LDL clearance
(lower VLDL levels) |
|
|
Term
| What effect on the lipid panel can be expected from BARs? |
|
Definition
| Lowers LDL, may increase TG's |
|
|
Term
| What adverse effects of BARs should patients be educated on? |
|
Definition
Primarily GI: constipation, bloating, nausea, indigestion.
-Decreases absorption of Fat soluble vitamins (A,D,E,K)
-Many drug interactions: binds to Thiazide diuretics (HCTZ), digoxin, warfarin, some antibiotics |
|
|
Term
| What is the MOA of Zetia (Ezetimibe)? |
|
Definition
| Inhibits intestinal absorption of cholesterol |
|
|
Term
| Why might Zetia be useful when used with a statin medication? |
|
Definition
| Lowers LDL by exogenous and endogenous cholesterol production |
|
|
Term
| What are the adverse effects of Niaspan (intermediate-release naicin) and how can patients prevent these effects? |
|
Definition
| Flushing & itching; take aspirin 20 minutes before Niacin, avoid hot beverages, take w/ food at bedtime |
|
|
Term
| What labs should be monitored to ensure diabetes meds are working properly (how do we know the disease is under control)? |
|
Definition
| Blood glucose and hemoglobin A1C |
|
|
Term
| What insulins may be administered sub-Q and which can be given IM or IV? |
|
Definition
| Regular insulin can be given IM or IV; all types can be given sub-Q |
|
|
Term
| How are modified insulins like NPH and lente different from regular insulin? |
|
Definition
NPH- protamine added
lente- zinc added
* delays absorption, longer acting |
|
|
Term
| What should pt's taking (insulin glargine)be educated about regarding the drug effect and adverse effects? |
|
Definition
Duration is 24 hrs, do not confuse with other clear insulins
**it can not be mixed |
|
|
Term
| How should pt's taking rapid acting insulins like Humalog (insulin lispro) be educated regarding the drug effect and adverse effects? |
|
Definition
Has a quick onset (15-30 min) but a short duration (3-6 hrs).
Hypoglycemia is the major A.E. |
|
|
Term
| What are the signs of hypoglycemia patients should monitor for? |
|
Definition
| Sweating, tremor, confusion, tachycardia, ------>coma & death |
|
|
Term
What is the MOA of sulfonylurea meds?
(oral-T2 DM) adverse effects? |
|
Definition
Stimulates release of insulin from the pancreas, but is ineffective if patients can not produce insulin.
A.E.- Hypoglycemia, weight gain, Derm. reactions (sulfa) |
|
|
Term
| MOA and adverse effects of metformin (1st line for most T2) |
|
Definition
Decreases production of glucose in liver;enhances glucose uptake and utilization by muscle. DOC for overweight pt's and pre-diabetes.
A.E.- GI: decreased appetite, nausea, diarrhea; avoid use in renal dysfunction due to risk of Lactic acidosis. |
|
|
Term
| How do glitazones like Actos (pioglitazone) or Avandia (rosiglitazone) affect insulin and/or glucose utilization? |
|
Definition
| Decrease insulin resistance; increases ability of target cells to respond to insulin. |
|
|
Term
| T/F: Symlin (pramlintide) and Byetta (exanatide) can be used for T1 and T2 diabetes patients. |
|
Definition
False:
Symlin- Type 1 & 2
Byetta- Type 2 only! |
|
|
Term
| Symptoms of Hypothyroidism? |
|
Definition
| Weight gain, brittle hair, dry skin, depression, cold intolerance, goiter |
|
|
Term
| Symptoms of Hyperthyroidism (Graves disease)? |
|
Definition
| Weight loss, increased appetite, buldging eyes, tachycardia, arrythmias, angina,anxiety, increased body temperature |
|
|
Term
| What labs should be monitored when patients are receiving Levothyroxine for thyroid replacement? How often? |
|
Definition
Labs- TSH, T4
Frequency- 6-8 weeks after starting tx |
|
|
Term
| What labs should be monitored when patients are receiving Levothyroxine for thyroid replacement? How often? |
|
Definition
Labs- TSH, T4
Frequency- 6-8 weeks after starting tx |
|
|
Term
| What are the side effects of levothyroxine if the medication is given in excess? |
|
Definition
| Nervousness, tachycardia, irritability, insomnia, angina, sweating |
|
|
Term
| What are potential drug/ food interactions for levothyroxine? |
|
Definition
Warfarin; Cholestyramine, colestipol, calcium, antacids, iron supplements; carbemezapine, phenytoin, rifampin
**binding issues |
|
|
Term
| What are the available treatments for hyperthyroidism? |
|
Definition
| Surgery, radioactive iodine, thioamides |
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