Pharmacology case study discussion

Pharmacology case study discussion essay assignment

Pharmacology case study discussion essay assignment

This week we are discussing Gami, who presents to the clinic for primary care. She is a 48-year -old female, whose history includes Type 2 DM, memory deficits.  She is treating the Type 2 DM with cassia cinnamon is also prescribed Aricept and Coumadin.

Additional subjective data would include dates of diagnosis of current disease processes, pain scale, any adverse events, full surgical history, medical history including why she is being prescribed Coumadin, social history, familial history of disease, mental issues, ethnic considerations, nutritional information, and economic factors that may affect compliance.  Objective data should include a full head to toe exam, blood work including A1C, vital signs, BMI, thorough wound check and foot care as well as a memory examination, dosages of all medications.  It is important to gather as much relevant information as possible during the initial history and visit in order to be able to constructively evaluate the current treatment and what plan of care may be necessary with these factors included (HealthyPeople.gov, 2018).

Request “Write My Nursing Paper” for a 100% custom writing tailored to your instructions: Pharmacology case study discussion

Taking a position on the patients use of alternative supplements as the only treatment of a chronic serious disease such as type 2 DM can be a delicate balance of looking at the patient’s preferences and safety and efficacy.  Using cassia cinnamon to treat Type II diabetes has been studied in several scholarly articles and show improvement in A1C results. I would monitor her more closely if she insists on using cassia cinnamon exclusively treating her type 2 DM.  Cassia cinnamon is contraindicated in people with an allergy to cinnamon or Peru balsam and should be used with caution in patients with hepatic disease as it may cause toxicity and also affect blood glucose (Kwak, Park, & Kwon, 2017).  The patient should have INR, platelet counts and closely monitor for signs and symptoms of a declining state of dementia (Wilson, Shannon, & Sheilds, 2015).

Due the patient’s history of type 2 DM , I would assess her lab results – A1C, fasting blood glucose, CMP, CBC, liver and kidney function and overall health and my first choice drug would be a prescription for Metformin 500 mg, PO, BID , with meals (Buttaro, Trybulski, Polgar-Bailey, & Sandberg-Cook, 2017). The decision is based on evidence that an additional drug should be added to the regimen of treatment with the cassis cinnamon, based on evidence and trials and regulations, unlike the cassis cinnamon alone, which is not regulated by the FDA(Woo & Robinson , 2014).   Metformin is classified as antidiabetic, its mechanism of action is a binding of insulin to the receptors and potentiates insulin action, improves tissue sensitivity to insulin, and is effective in lowering serum glucose (Wilson, Shannon, & Sheilds, 2015). Metformin is 50-60% absorbed in the systemic circulation, is not metabolized, eliminate in urine, and has a half-life of 6.2-17.6 hours. Contraindications include hypersensitivity to metformin, hepatic or cardiopulmonary insufficiency and most serious cardiac issues, DKA, renal disease and impairment with creatinine clearance of 1.5 md/dl, and should be stopped 48 hours prior to surgery (Wilson, Shannon, & Sheilds, 2015). Metformin does carry a black box warning of being associated with potentially fatal lactic acidosis (Wilson, Shannon, & Sheilds, 2015).

Educating the patient on proper diet, exercise, taking all medications as prescribed and notifying the HCP of any side effects or missed doses as well as monitoring BG and moderate use of alcohol.  Signs and symptoms of hypoglycemia and lactic acidosis should be given with a return demonstration (Buttaro, Trybulski, Polgar-Bailey, & Sandberg-Cook, 2017).  Patient should  also be made aware of bleeding precautions (Wilson, Shannon, & Sheilds, 2015). Follow up appointments every three months should be adhered to.

 

Discussion #2

 

Is there any additional subjective or objective information you need for this client? Explain.

What would be your position on the Ms. GMs use of alternative supplements for her diabetes and memory? Explain and include contraindications, if any.

Are there any additional test/assessments you would complete for this patient given this list of medications? Explain.

How might your treatment plan, in terms of medications, differ for this patient? Include the class of the medication, mechanism of action, route, the half-life; how it is metabolized in and eliminated from the body; contraindications and black box warnings.

What health maintenance or preventive education is important for this client based on your choice medication/treatment?