Summary
BNF chapter summary - Endocrine system
- Course
- Institution
- Book
Summary of BNF chapter of the Endocrine system
[Show more]
Connected book
Book Title:
Author(s):
- Edition:
- ISBN:
- Edition:
More summaries for
-
Antibiotic summary - BNF chapter
-
BNF chapter summary - Cardiovascular system
-
BNF chapter summary - CNS
Seller
Follow
manar_sabbagh123
Content preview
Chapter 6: EndocrinologyDiabetes- the use of ACEI, low dose aspirin and lipid regulating drug are beneficial to reduce the
risk of CV disease.
Optimal glycaemic control- measure the fraction HbA1c, gives control over the last three months,
aim for 6.5-7.6% (normal 4-6%)
Inject insulin into upper arms, thighs, buttocks or abdomen; factors which increase insulin
requirements: infection, stress, trauma, puberty, pregnancy;
If acute onset diabetes then suitable starting doses of insulin:
Soluble insulin TDS
Medium acting at bedtime
If less severely ill then mixture 30% soluble and 70% isophane; 8 units BD
Short acting insulin: lispro and aspart
Intermediate: isophane, zinc suspension,
Long: crystalline insulin zinc suspension
Requirements for insulin decrease in renal/hepatic impairment, endocrine disorders (Addisons,
hypopituitary), celiac disease;
Monitoring: ‘normoglycaemia’ not always achieved in 24 hours without damaging hypos therefore
advise 4-10mmol/l; it may sometimes be above this for brief periods but never below.
Hypoglycaemia: need to educate patient;
An increase in the number of episodes decreases the warning symptoms to patient
therefore need to keep to minimum
Tight diabetic control will decrease the conc of glucose needed to trigger hypos
Beta-blockers mask the symptoms
If converting beef to human insulin need to decrease dose by 10% and monitor closely.
Driving:
Drivers on insulin/oral hypoglycaemics need to notify DVLA
Drivers of group II vehicles (HGV/public service vehicles) need to also inform DVLA if diet
controlled diabetes
Drivers with insulin: need to check blood glucose before driving and on long journeys at 2 hour
intervals (if on oral hypoglycaemics and at risk of hypos then also need to monitor); IDDM need to
have sugar in vehicle, and avoid driving if late for a meal; Recommendatios for hypos see pg 340
Diabetes and surgery: see sliding scale insulin guidelines pg 340-1
NICE guidelines insulin glargine: p342
Oral hypoglycaemics- prescribe only if patient fails to respond adequately to at least 3 months
restriction of energy and CHO intake and increase in physical activity; should augment diet and
exercise;
Sulphonylureas- augment insulin secretion so only effective if residual beta cell activity; long term
have extrapancreatic action; consider for patients NOT overweight; avoid in porphyria
Metformin- decrease gluconeogenesis, increase peripheral utilisation of glucose; effective only if
residual function of beta cells (acts in presence of endogenous insulin); hypoglycaemia rarely
occur with metformin; may provoke lactic acidosis (esp in renal impairment); during anaesthesia
need to stop 48 prior to surgery.
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller manar_sabbagh123. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $9.79. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
60281 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now