Health Articles

Safe management of medicines

Healthcare Help
Supporting Health Providers

Welcome to Healthcare Help
‘Caring for the caregivers' Phone: +649 418 2227
Be SAFE giving out medications
Look at this program
It will ask you questions.
WRONG answers help you to learn
CORRECT answers let you move on.

Diabetes Essential Knowledge
Look for Gertrude. She will pop up when you are on the right track. How much do you know about diabetic medications?Click first red dot to find out.
Can you name the common Diabetic Medications? HYPER & HYPO glycaemia. What's the difference? I understand this. ONWARDS.

Click the red words for more information or they may enhance its effect.
Next Question:

Say your answer then click the hyperlink to test yourself

Insulin Dependant Diabetes Mellitis vs Non Insulin Dependant Diabetes Mellitis Question: Can diabetics still make their own insulin?
Answer: Some can some cannot.
Click the green word for more information Can produce some insulin [NIDDM's]
Cannot produce any [IDDM's]
Gliclazide helps the body produce its own natural insulin. It also helps the body recognise and metabolise glucose. Peak Effect: 4 – 6 hours Indications: Diabetes mellitus of the maturity onset type, which cannot be controlled by diet alone. Doses up to 160 mg daily may be taken in a single dose but preferably at the same time each morning. Severe hypoglycaemia can result from over dosage.
Glucophage / Metformin
Metformin or Glucophage is an oral anti-hyperglycaemic medication.
It does not lower blood sugar in non-diabetics. In diabetics it does not cause hypoglycaemia when used alone. Metformin reduces overweight and improves glucose assimilation.
Used to support patients on insulin, especially if they are overweight. Dose: Tablet - 850mg twice a day or 500mg three times a day.
Precautions: When on insulin as well, take regular blood-sugar readings
because combined therapy may cause hypoglycaemia.
Contraindications: Significant renal impairment
Glipizide / Minidiab
Glipizide or Minidiab is used in the treatment of stable, mild to
moderate, non-insulin dependent diabetics (type II diabetes
mellitus or NIDDM)
The usual dose range is 2.5 - 30mg daily but if control is not achieved within this range then it may be increased to a total maximum daily dose of 40mg.
Capable of producing severe hypoglycaemia (overdose). Regular blood sugar monitoring required.
Your answer: Because too much insulin can cause hyperglycaemia No not true: hyPERglycaemia is HIGH blood sugar
measured in millimoles per litre. TOO MUCH insulin would
have the effect of LOWERING the blood sugar.
HYPO and HYPER glycaemia Please click the red & blue bars to learn more.
High sugar in blood Low sugar in blood Millimoles per litre
HYPO and HYPER glycaemia high and low blood sugar Click the bars To learn more.
Millimoles per litre
HYPO and HYPER glycaemia WRONG ANSWERLook very carefully at hyPER & hyPO glycaemia again Insulin is missed Can be caused by too many diabeticpills or by insulin Millimoles per litre
Hyperglycaemia (high blood sugar)
BM reading in upper range – above 20 mmol / litre
Flushed & Dry
Deep & Laboured
Fruity Odour
Diabetic pills work by helping the body make insulin
This will bring the blood sugar back down towards normal Hypoglycaemia (low blood sugar)
BM reading in lowest range – zero to 3 or 4 mmol / litre
Moist & Pale
Excited or Nervous
Rapid & Shallow
Moist / Numb
Diabetic pills work by helping the body make insulin
This will bring the blood sugar back down towards normal
Learn about Insulin Is all Insulin Fast Acting? Well yes some insulin IS fast acting Some is a mixture of FAST and SLOW acting insulin Fast acting & slow acting insulin may be mixed in "Pens" WE NEED TO REALISE:too much insulin causes a rapid drop in blood sugar and may cause unconsciousness Test yourself………Look at the BLUE and the RED lists, below.
HYPOGLYCAEMIA [Low blood sugar] Red list or blue list???
Moist & Pale
Flushed & Dry
Excited or Nervous Drowsy
Rapid & Shallow
Deep & Laboured
Fruity Odour
Moist / Numb
Wrong answer: We all need to KNOW & UNDERSTAND the signs of HIGH blood sugar as opposed to LOW Learn from the chart – and there is more help further on.
YES! HYPOGLYCAEMIA is identified by the
LOW BLOOD SUGAR = LOW BM Moist & Pale
This person requires:
Excited or Nervous
Rapid & Shallow
This person requires
Moist / Numb
HYPOGLYCAEMIA is identified by the
Moist & Pale
This person requires:
Excited or Nervous
Rapid & Shallow
This person requires
Moist / Numb
Correct! Hypoglycaemia (low blood sugar) is treated with oral or IV GLUCOSE Had the patient shown the signs of HYPERGLYCAEMIA,in the RED list, they would have needed INSULIN Oh dear do you really think that INSULIN is a good idea for someone with LOW blood sugar? That would lower it even further.
Diabetic Perspective
How do you think it feels to have low blood sugar – a "hypo"?
Think of an answer BEFORE you click on its hyperlink How will your head feel during a"HYPO" Diabetic Perspective
How do you think it feels to have low blood sugar – a "hypo"?
Please just say your answer BEFORE you click. What happens to vision during a "HYPO" Diabetic Perspective
How do you think it feels to have low blood sugar – a "hypo"?
Diabetic Perspective
How do you think it feels to have low blood sugar – a "hypo"?
Pins and needles lips and Diabetic Perspective
How do you think it feels to have low blood sugar – a "hypo"?
How would your knees feel if you really
lacked energy?
Pins and needles lips and Diabetic Perspective
How do you think it feels to have low blood sugar – a "hypo"?
Pins and needles lips and Knees weak and trembling Diabetic Perspective
How do you think it feels to have low blood sugar – a "hypo"?
Pins and needles lips and Knees weak and trembling Excited / nervous Diabetic Perspective
How do you think it feels to have low blood sugar – a "hypo"?
Pins and needles lips and Knees weak and trembling Skin pale and sweaty Excited / nervous Diabetic Perspective
How do you think it feels to have low blood sugar – a "hypo"?
Pins and needles lips and Knees weak and trembling Skin pale and sweaty Excited / nervous Diabetic Perspective
How do you think it feels to have low blood sugar – a "hypo"?
Pins and needles lips and Knees weak and trembling Skin pale and sweaty Excited / nervous Diabetic Perspective
How do you think it feels to have low blood sugar – a "hypo"?
Pins and needles lips and Knees weak and trembling Skin pale and sweaty Excited / nervous Test yourself – call the answer then click Diabetic Perspective
How do you think it feels to have low blood sugar – a "hypo"?
Diabetic Perspective
How do you think it feels to have low blood sugar – a "hypo"?
Diabetic Perspective
How do you think it feels to have low blood sugar – a "hypo"?
Diabetic Perspective
How do you think it feels to have low blood sugar – a "hypo"?
Pins and needles lips and Diabetic Perspective
How do you think it feels to have low blood sugar – a "hypo"?
Pins and needles lips and Diabetic Perspective
How do you think it feels to have low blood sugar – a "hypo"?
Pins and needles lips and Knees weak and trembling Diabetic Perspective
How do you think it feels to have low blood sugar – a "hypo"?
Pins and needles lips and Knees weak and trembling Excited / nervous Diabetic Perspective
How do you think it feels to have low blood sugar – a "hypo"?
Pins and needles lips and Knees weak and trembling Skin pale and sweaty Excited / nervous Diabetic Perspective
How do you think it feels to have low blood sugar – a "hypo"?
Pins and needles lips and Knees weak and trembling Skin pale and sweaty Excited / nervous Diabetic Perspective
How do you think it feels to have low blood sugar – a "hypo"?
Pins and needles lips and Knees weak and trembling Skin pale and sweaty Excited / nervous Diabetic Perspective
How do you think it feels to have low blood sugar – a "hypo"?
Pins and needles lips and Knees weak and trembling Skin pale and sweaty Excited / nervous Diabetic Perspective
How do you think it feels to have low blood sugar – a "hypo"?
Pins and needles lips and Knees weak and trembling Skin pale and sweaty Excited / nervous Diabetic Emergency: Very low blood sugar
Practical suggestions for treatment. Also, notify doctor
and take BM's.
Knees weak and trembling Skin pale and sweaty Excited / nervous Diabetic Emergency: Very low blood sugar
Practical suggestions for low blood sugar treatment.
Also, notify doctor and take BM's.
3 – 4 Vita or glucose tabs 2-3 tea spoons sugar in a Pins and needles lips and ½ glass of cordial or fruit juice Knees weak and trembling Wait 5-10 mins.
Skin pale and sweaty Excited / nervous Diabetic Emergency: Very low blood sugar
Practical suggestions for low blood sugar treatment.
Also, notify doctor and take BM's.
3 – 4 Vita or glucose tabs 2-3 tea spoons sugar in a Pins and needles lips and ½ glass of cordial or fruit juice Knees weak and trembling Skin pale and sweaty If not improved give more Vita / glucose.
Excited / nervous Diabetic Emergency: Very low blood sugar
Practical suggestions for low blood sugar treatment.
Also, notify doctor and take BM's.
3 – 4 Vita or glucose tabs 2-3 tea spoons sugar in a Pins and needles lips and ½ glass of cordial or fruit juice Knees weak and trembling Skin pale and sweaty If not improved give more Vita / glucose.
Excited / nervous After 10 mins give 1 slice bread or glass milk or two plain biscuits. If close to meal time, have meal.
After Insulin Injection
Keep a careful watch for HYPOglycaemia
If not recognised in time, IV glucose may be required Pins and needles lips and Knees weak and trembling Skin pale and sweaty Untreated, significant hypoglycaemia, after giving insulin, can result in death.
Excited / nervous Let us move on
Are you ready to test your knowledge?
Choose the right sentence….ONLY ONE
CHOICE BELOW IS CORRECT. THE OTHER TWO ARE COMPLETELY WRONG!
Here are some Diabetic pills: Diamicron, Glucophage, Minidiab, and Metformin…… Too many of these pills will make blood sugar rise.
They are used for diabetics who cannot produce insulin.
They should be taken as prescribed.
A missed dose means blood sugar is likely to rise.
Hint: its easy, no trick questions, take your time and look carefully.
Question Two
Hint: Testing if you know what levelsof blood sugar are safe.
It is 7.30 AM. We test our client's blood sugar and get a reading of 2 mmol / litre. Mixtard insulin 36 units is charted.
Should we give the insulin, as charted? The blood sugar (BM) of one of our residents is 5.7 mmol / litre.
This is considered: Jon has a sore stomach. He feels like being sick. You notice a fruity odour on his breath.
He is not hungry but asks for a glass of water.
These are the classic signs of high blood sugar These are the classic signs of low blood sugar These are not classic signs of anything.
Jon is more likely to have a tummy bug.
Question 5
Lets go back to low blood sugar.
How would you treat someone tested with hypoglycaemia?
With insulin as charted.
3 – 4 Vita or glucose tabs or 2-3 tea spoons sugar in a glass. of water immediately and wait 10 minutes. Repeat as required.
They have probably missed a meal, so with food.
Call a doctor and await their orders.
You have completed Module Five Safe Medication Administration View Your Certificate What do you know about the different insulins? Onset: within ½ hour
Maximum Effect: Between 1 & 3 hours
Duration: approximately 8 hours - Injection should be followed,
within 30 minutes, by a meal or snack containing carbohydrates
Contraindications - Actrapid should never be given to patients
with hypoglycaemia. Infections usually increase the patient's insulin
requirement.
Actrapid is a short-acting insulin, often used in combination with intermediate or long acting insulins.
Insulin is administered subcutaneously in the abdominal wall,thigh, the arm or leg.
Onset: within ½ hour
Maximum effect: between 2 & 8 hours
Duration: up to 24 hours – Mixtard is usually given once or twice daily
when a rapid initial effect together with a more prolonged effect is
desired. An injection should be followed by a meal or snack containing
carbohydrates within 30 minutes.
Contraindications - Mixtard should never be given to patients
with hypoglycaemia. Infections usually increase the patient's insulin
requirement.
Insulin is administered subcutaneously in the abdominal wall,thigh, the arm or leg.
Renal or hepatic impairment may reduce insulin requirement.
Onset: within 1½ hours
Maximum effect: between 4 & 10 hours
Duration: 24 hours - Injection should be followed, within 30 minutes, by
a meal or snack containing carbohydrates
Contraindications - Insulin should never be given to patients
with hypoglycaemia.
Lente insulins may also be used in combination with fast acting insulin like Actrapid or with oral hypoglycaemic medication.
Infections usually increase the patient's insulin requirement
Renal or hepatic impairment may reduce insulin requirement.
Healthcare Help Guidelines
It is best if the person needing the insulin can give it to themselves.
Train ALL people who administer insulin.
Assess their knowledge – include practical assessments.
NO ONE ELSE SHOULD GIVE INSULIN! If you are a health provider and have an Registered Nurse at work, this person should administer the Insulin if the client cannot administer it themselves.
This Registered Nurse carries the responsibility for Care Staff who might have been delegated this task.
DO have good INSTRUCTIONS & help lines available.
When giving insulin:
•
Always assess the risk [following the guidelines reduces risk].
If in doubt DO SEEK HELP BEFORE you carry on.
Always seek to increase your own knowledge! This program was written to help nurses and care staff / support workers give out medication
safely.

Source: http://www.hh.net.nz/fck_uploads/file/Understanding%20Diabetes(2).pdf