Metabolic Pharm Hybrid 16 Bit

Pharmacology Drugs Used In The Treatment Of Metabolic Emergencies 1/07 edit in progress

Insulin Class

Hormone, antihyperglycemic

Actions

Promotes glucose entry into the cell & lowers blood glucose levels

Indications

Diabetic ketoacidosis, hyperglycemia, refractory hyperkalemia

Insulin Contras

Administer only with established hyperglycemia;

Do not administer animal derived insulin to pts who are sensitive to beef or pork

Precautions

Re-evaluate blood glucose level & be prepared to give dextrose 50%

Side Effects

Hypoglycemia, allergic reactions to animal derived insulin

Insulin Drug Pts receiving corticosteroids Interactions may require a higher dose of insulin; β blockers may mask the signs & symptoms of hypoglycemia Dose & Route IV 5 - 10 units regular IVD 0.1 unit/kg/hr SC or IM 5 - 20 units regular

50 Percent Dextrose in Water (D50W) Class

Carbohydrate

Actions

Increases blood glucose levels, brief osmotic diuretic; rapidly metabolized monosaccharide

Indications

Hypoglycemia & coma of unknown origin

50 Percent Dextrose in Water (D50W) Contras None w/ suspected hypoglycemia; Intracranial hemorrhage, ↑ICP hypersensitivity to corn

Precautions

Obtain glucometer reading first, assure patent IV & use large vein if possible; admin. w/ IV flowing, admin. thiamine first if alcoholic

Side Effects

Tissue necrosis, phlebitis; Wernicke’s encephalopathy, Korsakoff’s syndrome

50 Percent Dextrose in Water (D50W) Drug None in the emergency Interactions setting Dose & Route IVP only 25 g May repeat prn D25% for children (0.5 – 1 g/kg) D10% for neonates

Thiamine Class

Vitamin, (B1)

Actions

Required for the conversion of pyruvic acid to acetyl coenzyme A; Facilitates carbohydrate & fat metabolism

Indications

Coma of unknown origin especially if related to alcohol, delirium tremens

Thiamine Contras

None

Precautions

Administer slow IVP

Side Effects

Rapid administration may cause hypotension (from vasodilation), dyspnea or respiratory failure; local pain

Thiamine Drug None in the emergency Interactions setting; may enhance the effects of neuromuscular blocking agents

Dose & Route IVP or IM

100 mg

Glucagon Class

Hormone, antihypoglycemic

Actions

Increases blood glucose by breaking down glycogen to glucose, positive inotrope; (& chronotrope, relaxes smooth muscle)

Indications

Hypoglycemia in a patient in which an IV cannot be started, β blocker overdose

Glucagon Contras

Hypersensitivity; patients with an IV, cannot be mixed with NSS

Precautions

Patients with cardiovascular or renal disease; Pheochromocytoma, administer carbohydrates via another route as soon as possible

Side Effects

N/V, hypotension, dizziness, HA

Glucagon Drug Few in the emergency setting Interactions Dose & Route IM

1 mg

IV

0.25 – 0.5 mg May be repeated in 20 minutes

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