DC: Antidiabetic, Rapid Acting Insulin BN: Humulin R, Iletin II Regular, Novolin R, Velosulin BR GN: insulin injection regular

Usual Dose and Route: Indicated Use: Control type 1 diabetes, Control type 2 diabetes when uncontrolled, treat severe diabetic ketoacidosis or diabetic coma, treat hypokalemia in combo with glucose. Action: Activates a process that helps glucose molecules enter the cells of striated muscle and adipose tissue. Adverse Reactions / Side Effects: hypoglycemia, hyperglycemia Nursing Implications: BP pulse weight. Skin assessment. Obtain family hx, diet habits, type and duration of sx. Review labs. Chart brand type and dosage. Assess for hypo and hyperglycemia. Monitor blood glucose. Give 30 to 60 minutes before meal. Patient / Family Teaching: encourage to follow diet and drug regimen, edu on blood glucose and urine testing techniques, teach insulin dose calc, use only type source and brand recommended by dr, store at room temp use within 1 month and 3 months if

refrigerated, store vials not in use in fridge, keep filled syringes vertical or oblique position to avoid plugging of needle, purchase same brand needle and syringe every time, disposal of sharps, admin technique, prep for admin, contact dr when ill dosage may change, s/sx of hyper and hypoglycemia, footcare and hygiene.

DC: Antidiabetic, Rapid Acting Insulin BN: Humalog, Humalog Mix 75/25 GN: insulin lispro Usual Dose and Route: Indicated Use: Control type 1 diabetes, Control type 2 diabetes when uncontrolled, treat severe diabetic ketoacidosis or diabetic coma, treat hypokalemia in combo with glucose. Action: Activates a process that helps glucose molecules enter the cells of striated muscle and adipose tissue. Adverse Reactions / Side Effects: hypoglycemia, hyperglycemia Nursing Implications: BP pulse weight. Skin assessment. Obtain family hx, diet habits, type and duration of sx. Review labs. Chart brand type and dosage. Assess for hypo and hyperglycemia. Monitor blood glucose. Give 15 minutes before meal. Patient / Family Teaching: encourage to follow diet and drug regimen, edu on blood glucose and urine testing techniques, teach insulin dose calc, use only type source and

brand recommended by dr, store at room temp use within 1 month and 3 months if refrigerated, store vials not in use in fridge, keep filled syringes vertical or oblique position to avoid plugging of needle, purchase same brand needle and syringe every time, disposal of sharps, admin technique, prep for admin, contact dr when ill dosage may change, s/sx of hyper and hypoglycemia, footcare and hygiene.

DC: Antidiabetic, Rapid Acting Insulin BN: NovoLog, NovoLog Mix 70/30 GN: insulin aspart Usual Dose and Route: Indicated Use: Control type 1 diabetes, Control type 2 diabetes when uncontrolled, treat severe diabetic ketoacidosis or diabetic coma, treat hypokalemia in combo with glucose. Action: Activates a process that helps glucose molecules enter the cells of striated muscle and adipose tissue. Adverse Reactions / Side Effects: hypoglycemia, hyperglycemia Nursing Implications: BP pulse weight. Skin assessment. Obtain family hx, diet habits, type and duration of sx. Review labs. Chart brand type and dosage. Assess for hypo and hyperglycemia. Monitor blood glucose. Give immediately before meal. Patient / Family Teaching: encourage to follow diet and drug regimen, edu on blood glucose and urine testing techniques, teach insulin dose calc, use only type source and brand recommended by dr, store at room temp use within 1 month and 3 months if

refrigerated, store vials not in use in fridge, keep filled syringes vertical or oblique position to avoid plugging of needle, purchase same brand needle and syringe every time, disposal of sharps, admin technique, prep for admin, contact dr when ill dosage may change, s/sx of hyper and hypoglycemia, footcare and hygiene.

DC: Antidiabetic, Immediate-Acting Insulin BN: Humulin N, Novolin N, NPH Iletin II GN: isophane (NPH) Usual Dose and Route: Indicated Use: Control type 1 diabetes, Control type 2 diabetes when uncontrolled, treat severe diabetic ketoacidosis or diabetic coma, treat hypokalemia in combo with glucose. Action: Activates a process that helps glucose molecules enter the cells of striated muscle and adipose tissue. Adverse Reactions / Side Effects: hypoglycemia, hyperglycemia Nursing Implications: BP pulse weight. Skin assessment. Obtain family hx, diet habits, type and duration of sx. Review labs. Chart brand type and dosage. Assess for hypo and hyperglycemia. Monitor blood glucose. Patient / Family Teaching: encourage to follow diet and drug regimen, edu on blood glucose and urine testing techniques, teach insulin dose calc, use only type source and brand recommended by dr, store at room temp use within 1 month and 3 months if

refrigerated, store vials not in use in fridge, keep filled syringes vertical or oblique position to avoid plugging of needle, purchase same brand needle and syringe every time, disposal of sharps, admin technique, prep for admin, contact dr when ill dosage may change, s/sx of hyper and hypoglycemia, footcare and hygiene.

DC: Antidiabetic, Immediate-Acting Insulin BN: Humulin L, Lente Iletin II GN: insulin zinc (Lente) Usual Dose and Route: Indicated Use: Control type 1 diabetes, Control type 2 diabetes when uncontrolled, treat severe diabetic ketoacidosis or diabetic coma, treat hypokalemia in combo with glucose. Action: Activates a process that helps glucose molecules enter the cells of striated muscle and adipose tissue. Adverse Reactions / Side Effects: hypoglycemia, hyperglycemia Nursing Implications: BP pulse weight. Skin assessment. Obtain family hx, diet habits, type and duration of sx. Review labs. Chart brand type and dosage. Assess for hypo and hyperglycemia. Monitor blood glucose. Give 30 to 60 minutes before meal. Patient / Family Teaching: encourage to follow diet and drug regimen, edu on blood glucose and urine testing techniques, teach insulin dose calc, use only type source and brand recommended by dr, store at room temp use within 1 month and 3 months if

refrigerated, store vials not in use in fridge, keep filled syringes vertical or oblique position to avoid plugging of needle, purchase same brand needle and syringe every time, disposal of sharps, admin technique, prep for admin, contact dr when ill dosage may change, s/sx of hyper and hypoglycemia, footcare and hygiene.

DC: Antidiabetic, Long-Acting Insulin BN: Humulin U GN: insulin glargine (Lantus) Usual Dose and Route: Indicated Use: Control type 1 diabetes, Control type 2 diabetes when uncontrolled, treat severe diabetic ketoacidosis or diabetic coma, treat hypokalemia in combo with glucose. Action: Activates a process that helps glucose molecules enter the cells of striated muscle and adipose tissue. Adverse Reactions / Side Effects: hypoglycemia, hyperglycemia Nursing Implications: BP pulse weight. Skin assessment. Obtain family hx, diet habits, type and duration of sx. Review labs. Chart brand type and dosage. Assess for hypo and hyperglycemia. Monitor blood glucose. Give 30 to 60 minutes before meal. Patient / Family Teaching: encourage to follow diet and drug regimen, edu on blood glucose and urine testing techniques, teach insulin dose calc, use only type source and brand recommended by dr, store at room temp use within 1 month and 3 months if

refrigerated, store vials not in use in fridge, keep filled syringes vertical or oblique position to avoid plugging of needle, purchase same brand needle and syringe every time, disposal of sharps, admin technique, prep for admin, contact dr when ill dosage may change, s/sx of hyper and hypoglycemia, footcare and hygiene.

DC: Antidiabetic, Sulfonylureas BN: DiaBeta, Micronase, Glynase GN: glyburide Usual Dose and Route:1.25-20 mg daily PO Indicated Use: Type 2 diabetes adjunct to diet and exercise. Action: Stimulates B cells of pancreas to release sufficient amount of insulin. Adverse Reactions / Side Effects: N, epigastric discomfort, heartburn, and hypoglycemia Nursing Implications: Weight BP pulse RR. Skin assessment. Go over diet habits, family hx. Review labs and dx. Chart name and dose of diabetic drug. Monitor q 2-4 hr for hypoglycemia. Monitor glucose. Patient / Family Teaching: Take as directed on container. Follow diet and drug regimen, this is NOT insulin, do not stop or dec dose. Take at same time each day. Eat meals at same times. Avoid alcohol dieting commercial weight loss products and strenuous exercise unless approved. Test blood glucose and urine for ketones as directed. Maintain good foot and skin care. Routine eye and dental exams. Wear medic

alert. Notify dr of hyperglycemia, hypoglycemia, elevated blood glucose, positive urine for ketones and glucose, pregnancy. Teach glucose monitoring.

DC: Antidiabetic, Nonsulfonylureas, Biguanides BN: Fortamet, Glucophage, Riomet GN: metformin Usual Dose and Route: 500-3000 mg/day PO XR 500-2000 mg/day Indicated Use: Type 2 diabetes with a sulfonylurea or insulin to improve glycemic control. Action: Sensitizes liver to circulating insulin levels and reduces hepatic glucose production. Adverse Reactions / Side Effects: NVD, flatulence, asthma Nursing Implications: Weight BP pulse RR. Skin assessment. Go over diet habits, family hx. Review labs and dx. Chart name and dose of diabetic drug. Monitor q 2-4 hr for hypoglycemia. Monitor glucose. Patient / Family Teaching: Take as directed on container. Follow diet and drug regimen, this is NOT insulin, do not stop or dec dose. Take at same time each day. Eat meals at same times. Avoid alcohol dieting commercial weight loss products and strenuous exercise unless approved. Test blood glucose and urine for ketones as

directed. Maintain good foot and skin care. Routine eye and dental exams. Wear medic alert. Notify dr of hyperglycemia, hypoglycemia, elevated blood glucose, positive urine for ketones and glucose, pregnancy. Call dr immediately if respiratory distress, muscular aches, unusual somnolence, unexplained malaise, or non specific abd distress occurs.

DC: Posterior Pituitary Hormones BN: GN: vasopressin Usual Dose and Route: Diabetes insipidus: 5-10 units IM, Sq q 3-4 hr parenteral solution may be used intranasally Indicated Use: Diabetes insipidus, prevention and treatment of post op abd distension, to dispel gas interfering with abd x-ray exam. Action: regulates reabsorption of water by kidneys. Adverse Reactions / Side Effects: tremor, sweating, vertigo, NV, abd cramps, HA Nursing Implications: Vitals, auscultate abd and measure with distention, observe for excessive dosage. Patient / Family Teaching: adhere to tx program. Teach admin technique of drug. Wear medic alert. Have liquids at all times. Monitor I&O. report changes. Carry extra doses. Avoid alcohol. Rotate injection sites. Contact dr if increase or dec in urine output, abd cramps, blanching of skin, nausea, signs of inflammation or infection at injection site, confusion, HA, drowsiness

DC: Glucocorticoids BN: Prelone GN: prednisone Usual Dose and Route: indiv. Dose initial b/t 5-60 mg PO Indicated Use: Adrenocorticoidal insufficiency, allergic reactions, collagen diseases, dermatologic conditions, rheumatic disorders, shock, etc Action: Enters target cells to bind to receptors which initiates many complex reactions. Adverse Reactions / Side Effects: Nursing Implications: Vitals, assess according to disease being tx, vitals 4-8 hrs. weigh daily or weekly. Evaluate response. Assess for adverse reactions especially electrolyte imbalance. Assess mental status. Check glucose weekly. PO dose before 9 am. Patient / Family Teaching: Alternate day: take before 9 am once every other day. Do not stop drug. If problem worsens especially on day drug is not taken contact dr. Long Term: take as directed. Inform all medical providers of drug. Do not take OTCs. Do not receive live virus vaccines. Avoid infection. Contact dr if persistant infection occurs. If drug cannot be taken PO or diarrhea occurs call Dr before next dose or go to ER. Weight

weekly if significant gain noted call dr. follow diet. Labs and eye exams as ordered. Intra-articular: do not overuse injected joint, follow rest and exercise orders.

DC: Anterior Pituitary Hormones and Hormone Inhibitors BN: ACTH GN: adrenocorticotropic hormone Usual Dose and Route: 20 units IM, Sq QID Indicated Use: Dx adrenocortical function, nonsupportive thyroiditis, hypercalcemia, MS Action: Stimulates the adrenal cortex to produce and secrete adrenocortical hormones. Adverse Reactions / Side Effects: Nursing Implications: Review dx and labs. Weight and skin assessment. Monitor weight and edema. Monitor glucose. Monitor for occult bleeding. Patient / Family Teaching: Report adverse reactions, avoid contact with infection, report infection immediately, monitor glucose, notify dr of weight gain, edema, muscle weakness, HA, visual disturbances, and behavior changes

DC: Glucocorticoids BN: Decadron GN: dexamethasone Usual Dose and Route: Dose individualized Indicated Use: Cerebral edema, anti inflammatory, reg BP, metabolize carbs and proteins and fat, stress protection, CNS Action: Enters target cells to bind to receptors which initiates many complex reactions. Adverse Reactions / Side Effects: Nursing Implications: Vitals, assess according to disease being tx, vitals 4-8 hrs. weigh daily or weekly. Evaluate response. Assess for adverse reactions especially electrolyte imbalance. Assess mental status. Check glucose weekly. PO dose before 9 am. Patient / Family Teaching: Alternate day: take before 9 am once every other day. Do not stop drug. If problem worsens especially on day drug is not taken contact dr. Long Term: take as directed. Inform all medical providers of drug. Do not take OTCs. Do not receive live virus vaccines. Avoid infection. Contact dr if persistant infection occurs. If drug cannot be taken PO or diarrhea occurs call Dr before next dose or go to ER. Weight

weekly if significant gain noted call dr. follow diet. Labs and eye exams as ordered. Intra-articular: do not overuse injected joint, follow rest and exercise orders.

DC: Glucocorticoids BN: Cortef, Solu-Cortef, A-hydroCort GN: hydrocortisone Usual Dose and Route: Dose individualized Indicated Use: anti inflammatory, reg BP, metabolize carbs and proteins and fat, stress protection, CNS Action: Enters target cells to bind to receptors which initiates many complex reactions. Adverse Reactions / Side Effects: Nursing Implications: Vitals, assess according to disease being tx, vitals 4-8 hrs. weigh daily or weekly. Evaluate response. Assess for adverse reactions especially electrolyte imbalance. Assess mental status. Check glucose weekly. PO dose before 9 am. Patient / Family Teaching: Alternate day: take before 9 am once every other day. Do not stop drug. If problem worsens especially on day drug is not taken contact dr. Long Term: take as directed. Inform all medical providers of drug. Do not take OTCs. Do not receive live virus vaccines. Avoid infection. Contact dr if persistant infection occurs. If drug cannot be taken PO or diarrhea occurs call Dr before next dose or go to ER. Weight

weekly if significant gain noted call dr. follow diet. Labs and eye exams as ordered. Intra-articular: do not overuse injected joint, follow rest and exercise orders.

DC: Thyroid Hormones BN: Levothroid, Levoxyl, Synthroid, Unithroid GN: levothyroxine Usual Dose and Route: 100-125 mcg/day Indicated Use: hypothyroidism, thyroid stimulating hormone suppression, thyrotoxicosis, thyroid dx testing Action: Mimic action of thyroid hormone. Adverse Reactions / Side Effects: palpitations, tachycardia, HA, nervousness, insomnia, diarrhea, vomiting, weight loss, fatigue, sweating, flushing Nursing Implications: May take a few weeks before effects are apparent, vitals monitored, hyperthyroidism assessed. May indicate excessive dose. Monitor for therapeutic effects. Take before breakfast. Patient / Family Teaching: used for life. Take as directed. Take in early am before breakfast. Notify dr of HA palpitations, diarrhea, excessive sweating, heat intolerance, chest pain, increased pulse, unusual physical change or event. May require periodic

dose adjustments. Needs to be evaluated at 2 weeks, then 6-12 months, weight weekly and report gain or loss. Do not change brands.