Antidiabetic, antianginal

Pancreas produce the hormones______ and _____. The ___ cells produce ____ and the ____ cells produce ___

The pancreas has two glands.. the ____ gland secretes hormones directily into the blood streem, and the ____ gland secretes enzymes into the duodenum via pancreatic ducts

Symptoms of Diabetes mellitus.

criteria for diagnosis of DM:
Symptoms of diabetes +casual plasma glucose level higher than or equal to ___ mg/dl

criteria for diagnosis of DM:
fasting plasma glucose higher than or equal to ___ mg/dl. This is no calorie intake for _ hours

criteria for diagnosis of DM:
2 hour postload glucose level higher than or equal to ____mg/dl durin an oral glucose tolerance test. This is a ___ hour fast before this test

DM 1, there is lack of ____ production or production of ____ insulin. Affected patients need _____ insulin. Complications of DM is ____ ____. and oral antidiabetic drugs are _____ effective

Most common DM is type _. It is caused by insulin ____ or insulin ____. Tissues in the body are resistant to insulin because a _____ number of insulin receptors and the insulin receptors are ___ responsive

major long term complications of DM. Macrovascular (atherosclerotic plaque) coronary artiers, cerebral artiers, peripheral vessels

Hyperglycemia that develops during pregnancy

True or false. Insulin must be given to prevent birth defects

Gestational diabetes usually subsides after deliver

30% percent of patietns may develop type 2 DM with in 10 to 15 years

Screening for DM:
FPG levels higher than or equal to 110 but <126 mg/dl may indicate ______
Impiared glucose tolerace test.

Treatment for DM:
Type 1
___ ____
Type 2
____ _____
___ ___ ____
Insulin when the above no longer provide glycemic contorl

Insulins for DM is a substitute for the endogenous hormone and the ___ are the same as if it were your own

Insulin restores the diabetic patients ability to ____ carbs, fats and protiens, stores ____ in the liver and converts ____ to the fat stores

Insulin was derived from Pigs and Cows. but the most insulin used now is human derived, using recombinant DNA technologies

Rapid acting
oonset 5-15 minutes
short duration

Short- acting
onset 30-60 minutes
the only insulin product that can be given by iV bolus, IV infusion

Intermediat acting
Isophane insulin suspension
Insulin zinc suspension
Both have a ___ appearance slower in onset and more prolonged duration than endogenous insulin

Long acting
white and opaque
Extendned insulin zinc suspension

mixing insulin.. ____ frist

in sliding scale:
No insulin < than
2 units
4 units
6 units
call if blood sugar is >

Oral antidiabetic drugs may not be effective unless the pt makes behavioral and ____ changes

Most common oral drug used is _____ or ____

oral drug thiazoleidinediones enhance sensitivit of _____ receptors. Alpha-glucosidase inhibitors delays ____ of glucose

Abnormally low blood glucose is called_____

Mild cases are treated with diet of ____ and ____ intake of carbs

The brain needs _____. Hypoglycemia if caught early, causes: ? and later can cause hypothermia, seizures, and coma if not trated

Oral forms of glucose is 50% ____ in water, ____ and diazoxide

When the supply of o2 and nutrients in the blood is insufficient to meet the demands of th heart, the heart muscle aches

Thehear requires a large supply of ____ to meet the demands placed on it

Poor blood supply to an organ.
Poor blood supply to the heart muscle, atherosclerosis, CAD
Necrosis or death of cardiac tissue

Types of angina
chronic stable angina, unstable angina, vasospastic angina

Therapeutic objectives is to ____ blood flow to the ishemic heart muscle and ____ myocardial oxygen demand

Nitrates cause ____ due to relaxation of smooth muscles and used to prevent and ____ angina

Vaodilation results in ____ myocardial o2 demands. Causes dilation in both ___ and ____ coronary vessels. Result is ____ to iischemic myocardial tissue. Nitrates alleviate coronary artery spasms

Prevent tolerance by allowing nitrate free periods at ____ for 8 hours before appplying new patch

when taking nitroglycerin, instruct patients not to chew SL forms and stinging will occur means that the drug is still potent

Potency of NTG is lost in about _ moths after the bottle has been open.

NTG should be stored in airtight dark glass bottel with a metal cap. No _____ filler becaue this works against potency

if angina pain occurs.
Stop activity
take SL NTG and wait 5 minutes. repeat 2 more times if no relief. call 911

How to tell if NTG is working

Tenormin, Lopressor, Inderal, Corgard. any thing that endes in LOL

Mechanism of action for B- blockers:
__ receptors on the heart are blocked. ____ the HR, results in decreased myocardial O2 demand and increased o2 delivery to the heart. _____ myocardial contractility helping to conserve energy or decrease demand

B-Blockers block the harmful effects of _______, thus improving survival after MI

B-blockers are used for angina, antihypertensive, cardiac dysrhythmias, cardioprotective effects, migraines and dstage fright

Adverse effects of beta blockers. Bradycardia, hyptension, dizziness, fatigue, mental depression, lethargy drowsiness

Patients taking b blockers should monitor pulse rate daily and report any rate lower than __ beats per minute

B- blockers are for ___ term prevention not immediate relief, and should never be ____ discontinued due to risk of rebound hypertensive crisis

Patients using beta blockers should report weight gain of _ lbs in 1 day or _ lbs in 1 week

Verapamil (calan, isoptin)
Diltiazem (cardizem)
Nifedipine (procardia)
amlodipine (norvasc)

CCB is used for coronary artery vasodialation, reduces the workload of the heart which reduces myocardial need for o2

Grapefruit juce will affect ____

4 stages of BP measurements
Normal
Pre
stage 1
stage 2

True or false.. the DBP is not longer considered to be more dangerous than the SBP

What should be the first drug therapy for patients with hypertension

Hypertension can be defined by its cause which is unknown cause, known as essential idiopathic, or primary.. 90% of cases

which system slows the heart rate and decreases the speed of conduction through the AV node

This nervous system stimulates the heart to beat faster, speeds conduction through the AV node, and causes the heart muscle to contract harder

Baroreceptors are located int he ____ and________ _____

The left ventricle puts out _ liters of blood per minute

Antihypertensive drugs
Beta blockers
Block vaso_______, decrease heart rate, decrease cardiac muscle contaction increase blood flow to kidney awhich leads to a decrease in renin

Beta blockers reduce heart rate through the B1 blocade

Alpha blockers_ Dilate arteries and veins which reduces peripheral vascular resistance and thus decreases blood pressure

ACE

ACE is often used as first-line ddrugs for HF and hypertension.

ACE inhibits antiotensin 1 to becomming Angiotensin 2 Which causes a potent vasoconstrictor and causes ____ secretion from the adrenals

Aldosterone stimulates ___ and ____ resorptoin

Reabsorption of water and sodium increases ____ ____ and _____ and _____

ACE results in systemic vascular resistance, vasodilation which decreases the ____ ____

Drug of choise in hypertensive pt with HF is ____

What type of hypertension drugs are these?

Captopril (capoten), Enalapril (vasotec) Lisinopril, and quinapril)

Captopril and lisinopril are NOT prodrugs

Drug inactive when administered form. bust bey bio transformed in liver to have an affect

ARB

These drugs let antiotensin I turn into angiotensin II but blocs the receptors that recieve angiotensin II

ARB and ACE Block vasoconstriction and release of aldosterone

Losartan (Cozaar, Hyzaar), Valsartan (diovan), Eprosartan (teveten), Irbesartan (avapro)

This drug causes smooth muscle relaxation by blocking the binding calcium to its receptors, preventing muslce contraction. This causes decreased peripheral smooth muscle tone and decreased systemic vascular resistance, resulting in decreased Bp

Benzothiazepines (diltiazem, Phenylalkamines (verapamil) Dihydropyridines (amlodipine, nicardipine, nifedipine)

Thiazides are most commonly used diuretics for hypertension

Hydralazine (apresoline) Sodium nitroprusside (nipride)

This is caused by a viral infection that invades tissues of upper respiratory tract, cuasing upper respiratory infection URI

Mucosal irritation also causes release of several inflammatory and vasoactive substances, dilating small blood vessels in the nasal sinuses and causing nasal congetsion

Treatment of the common cold is -______ only, not curative

Two histamine receptors:
this mediates smooth muscle contractions and dilation of capillaries
Mediates the acceleration of the heart rate and gastric acid secretion

Antihistamines have several properties, antihistaminic, anticholinergic, sedative

Antihistimes blocks ____ at the H1 receptor

Histimines cause _____, increased GI and respiratory secretions, and capillary permeability

Histamines ___ vessles, Antihistimine _____ dilation

Stimulates salivary, gastric, lacrimal, and bronchial secretions

reduces salivary, gastric, lacrimal and bronchial secretions

____________ is used for nasal allergies, allergic reactions, parkinsons disease, and sleep disorders

Fexofenadine (allegra), Loratadine (claritan),cetirizine (zyrtec)

Oral decongestants are exclusively adrenergics. sudafed

Topical nasal decongestants, use no longer than 5 days. Raises BP. Afrin

Topical nasal steroid decongestants. Beconase, pulmicort, nasacort, flovent, azmacort. if not better after 3 weeks D/C

Site of action for nasal decongestants

respiratory secretions and foreign objects are naturally removed by the ??

Congested, removes excessive secretions. what type of cough

Dry cough is what type of cough

Coughing is harmful after what?

Opiod and nonopiods are used for _____ coughs!

nonopiods and Opiods ____ the cough reflex by direct action on the cough center in the medulla

Antitussives are used to ____ the cough reflex when the cough is nonproductive and/or harmful

Benzonatate (tessalon), Dextromethorphan (vicks 44), Opiods (robitussin, dimatane)

Drucs that reduce the mucous down

guaifenesin (mucinex)

Drugs that accelerate the rate of urine formation. Result is the removal of sodiumand water

what percentage of soidum is reabsorbed in the blood stream in the ascending loop of henle

what percentange is reabsorbed in the convoluted tubules

Acetazolamide (diamox)

Inhibition of carbonic anhydrase reduces H+ ion concentration in renal tubules. As a result there is increased excretion of everything. Reabsorption of water is decreased and urine volume is increased

Bumetanide (bumex) ethacrynic acid (edecrin) furosemide (lasix)
torsemide (demadex

This diuretic acts directly on the ascending limb of the loop of henle to hinbit chloride and soidum reabsorption

This diuretic woks mostly in the proximal tubule, Nonabsorbable, producin an osmotic effect, pulls water into the renal tubules fromthe surrounding tissues. Inhibits tubular resorption of water and solutes, producing a rapid diuresis

Mannitol (osmitrol)

Amiloride (midamor) spironolactone (aldactone) triamerene (dyrenium

work in collecting ducts and distal convuluted tubules, interfere with soidum potassium exchange. binds to aldosterone receptors, blocks reabsorption of sodium and water

hydrochlorothiazide, chlorothiazide, trichlormethiazide,

zaroxolyn

used for most hypertensions

this pulls h20 in the renal tubule