BIOM 2009 Assignment: Human Physiology and Pharmacology

Question:

In essence, the issue surrounding diabetes has no doubt gain traction in the clinical discourses particularly in the contemporary world. According to researches, the number of individuals diagnosed with diabetes has recently gone up something which medical scientists attribute it to the overall change of lifestyle. Consequently, there are various medications procedures that have been set aside with an aim of treating this illness across the globe. One main medication that has been tipped for this purpose is the metformin. Ideally, metformin is a type of medication that is used to treat patients with type 2 diabetes. The overall function of metformin is to lower the level of blood sugar by improving the manner in which an individual’s body handles insulin (Zaccardi et al., 2016).

Notably, this medication is often prescribed particularly for diabetes in case diet as well as exercise has not been sufficient in controlling the level of blood in a patient’s blood. This paper proposes to discuss in detail a pharmacotherapy plan supporting the choice and need to prescribe a metformin and discuss the pharmacotherapeutic considerations in relation to dosing, drug to drug interactions and potential treatment-related outcomes, discuss expected therapy goals and desired outcomes from introduction of metformin including monitoring and evaluation of treatment outcomes, make recommendations for continued therapy based on patient factors and disease management (Sonesson, Johansson, Johnsson, & Gause-Nilsson, 2016). Discuss patient education in relation to drug adherence. Discuss the risk and benefits of drugs and conditions that may need a dose adjustment. The paper will do this in reference to 45 years patient in respite care.

Pharmacotherapy Plan Supporting the Choice and Need to Prescribe a Metformin

In essence, metformin often comes along with a rather information of patients inserted in a plan. In case of this 45 years old patient who is in respite care, he is required to read the overall information in a careful manner and ensure that he or she understands it before taking the required metformin. At this point, patients are supposed to ask any question to their doctors if they have any.

Primarily, the 45 year old person is then supposed to follow the meal plan as provided by their doctors. Notably, this is considered a crucial step especially for controlling a person’s condition and is essential if the medicine is intended to work (Tahrani, Barnett, & Bailey, 2016). Additionally, there is a need for a directed exercise in a regular manner while testing for sugar in a patient’s blood or rather their urine.

Metformin is supposed to be taken alongside meals with an aim of helping reduce stomach or rather bowel side effects that may happen within the first weeks of treatment. The 45 years old patient should swallow the tablet or instead of the extended-release table, where some part of the tablet may then pass through a person’s stool especially after their bodies have already absorbed the medicine. Notably, this should be a normal occurrence and there should be no need for panic. The tablet should be swallowed by taking a glass full of water while not crushing or even chewing it.

Furthermore, the oral liquid is to be measured by the use of a marked measuring spoon, oral syringe, or even medicine cup. Apparently, this is because the average household teaspoon may sometimes fail to hold the right amount of intended liquid. One thing that a patient has to keep in mind is the fact that they are supposed to use only the metformin that their doctors have prescribed for them. Notably, this is because various brands may not work for the purpose of treating diabetes.

Within approximately one to two weeks, the 45 year old patient may be able to notice some improvement. However, full effect regarding blood glucose regulation takes nearly two to three months (Lu, Min, Chuang, Kokubo, Yoshida, & Cha, B2016). At this point, a patient may feel free to ask his or her doctor any question that one might have regarding the same.

Need To Prescribe a Metformin

Primarily, there are various reasons why there is a need to prescribe a metformin to a diabetic individual. One clear reason for the medical practitioners to prescribe metformin to a patient is because it is proven to extend the life of an individual in the long run. According to research, metformin has for long been associated with nearly 24 percent lower causes of mortality as compared to patients who chose not to take metformin. Additionally, metformin is tipped to produce a modest weight loss strategy while normalizing hypertension. In this case, it ought to be useful to the patient at hand given that he has some hypertension complication. The use of metformin is as well thought to improve heart failure while preserving the kidney thus regarded as one of the best medication for diabetes type 2. In this light, there is a need for prescribing metformin. Metformin would help the 45 year patient in this case to control diabetes illness and, therefore, helping an individual’s body responds well to insulin a body naturally produces.

Pharmacotherapeutic Consideration In Relation To Dosing and Drug To Drug Interaction

There is a various consideration that medical practitioners set aside before they decide the type of dosing an amount that a particular patient requires a treatment process. In this light, the dosing of metformin is no doubt different for different type of patient. One has to follow the orders that are given by the doctors as well as the directions on the label. In case the dose of a particular patient is different, one is not supposed to change anything unless there is a clear direction by the doctor to change on the same. Moreover, the amount of medicine that an individual takes hugely depend on the on the overall strength of that particular medicine. Another factor of consideration in the dosing process is the medical problem that one might be facing in which the medicine is prescribed. Consequently, this defines the number of dosses one take every day, the overall time allowed between each dose, as well as the number of doses one take each day that an individual takes.

Despite the fact that it is not advisable to use certain drugs together, there are some cases where two or more medicines are used together even though an interaction may occur. In such cases, doctors can sometimes change the overall doses that are prescribed to a patient or even use other precautions that may be relevant. In case one is taking metformin it is important if an individual’s health care professional understand if one is taking any other medicine. There are some medicines that are not advisable to be taken alongside metformin. Some of these medicines include Iopanoic Acid, Diatrizoate, Iobenzamic Acid, Iopromide, and Iodipamide. Nonetheless, there are those medicine that although they are not often recommended to be taken with metformin, it can be can be used at some stages. Some of these medicines include Aspirin, Norfloxacin, Balofloxacin, and Bupropion. The reason why it may not be advisable to sometime take these medicines alongside metformin is simply that they can result in a rather increased risk of various side effects. BIOM 2009 Assignment: Human Physiology and Pharmacology

Amlodipine Use in Pre-diabetes to Control Hypertension

Primarily, amlodipine besylate is active alone as a rather add-on therapy diverse classes of agents. In this light, Amlodipine in most cases improves the endothelial function as well as inflammation. Notably, the use of this medication can be helpful in improving cardiovascular outcomes.

The action of Metformin in Diabetes

In essence, metformin is regarded as an antihyperglycemic agent that is tasked with improving the overall glucose tolerance in the 45 years old with type 2diabtes. In this light, the point of action of metformin is lowering not only the basal but as well the postprandial plasma glucose. Primarily, this is considered as a pharmacological tool of action is quite different from other common antihyperglycemic agents. Consequently, metformin is tasked at decreasing hepatic glucose production, reduces the overall absorption of glucose by the intestine, while improving the sensitivity of insulin through increased peripheral uptake and utilization of glucose. Different from sulfonylureas, metformin does not tend to produce hypoglycemia in type 2 diabetes patient or on a person in a normal state.

The Expected Therapy Goals, Outcomes, and Monitoring and Evaluation of Treatment Outcomes When Using Metformin

Goals

Ideally, every medication strategy is guided by some specific goals to achieve a particular intended outcome. In this light, there are various general goals for a therapy in treating diabetes when using metformin. Consequently, the general goal of this therapy when treating a diabetic patient is to minimize the overall acute decompensation,  maintain a good quality of life, and prevent or rather delay the appearance of other late illness and complications. In this light, a patient has to meet therapeutic objectives in the treatment of diabetes. Notably, Glycosylated hemoglobin (HbA₁c) is often regarded as the best index of the overall control of diabetes given the fact that it tends to provide information regarding the degree of the glycemic control particularly in the last two or rather three months thus remaining below 7 percent.

However, in patients who are older and have low expectancy, it is imperative to get a therapeutic target due to the fact that that it entails a rather higher risk of resulting in severe hypoglycemia. Regarding the target value particularly for the lipid profile as well as the blood pressure of a patient, it is important to keep in mind that some diseases such as the ischemic heart illness are the major cause of death among the diabetic patients. Consequently, the overall cardiovascular for the diabetic patients is often the same to the patients who are free from diabetes and have already ischemic heart illness. Therefore, the overall targeted values that are required for the diabetic populace has to be strict as well as similar to those need in patients that have established coronary illness. BIOM 2009 Assignment: Human Physiology and Pharmacology

Desired Outcomes

By using metformin, there is no doubt various outcome that is expected in the 45 years old patient suffering from diabetes type 2. It is clear that heart failure has become very common in patients suffering from diabetes. In this light, one expected outcome of using this therapy is to lower the risk of a patient developing heart failure (Hadjadj, Rosenstock, Meinicke, Woerle, & Broedl, 2016). Another endpoint of conducting metformin therapy is the aspect surrounds the quality of life of a particular patient. In this light, the medication is aimed at lowering other risks that a diabetes patient may be exposed to such as heart failure. Life expectancy is another outcome that is of high concern particularly for patients who are considered as old adult. In this case, the current therapy is tipped to increase the overall life expectancy of a patient. Moreover, metformin therapy intends to reduce cognitive impairment or rather the overall cognitive status of a patient in the long run.

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Monitoring and Evaluation of Treatment Outcome of Metformin

Monitoring a patient’s progress especially within the first few weeks that a patient takes metformin is important for a full recovery stage. In this light, various blood samples, as well as urine tests, are essential in checking the unwanted effects during medication.

In some cases, metformin may tend to interact with the dye that is often used for the X-ray or rather the CT scan. Consequently, doctors are supposed to advise a patient to stop taking the medicine before having any particular medical examination or rather diagnosis test that may tend to cause less output of urine. For a good monitoring, one may be advised to begin taking metformin in close to 48 hours after an examination in case the kidney functioning of that particular patient is tested and thereafter found to be normal.

Furthermore, it is important to make sure that any particular doctor or even dentist that is under the care of a diabetes patient understands that the patient is using metformin. It is as well advisable if on stops using a metformin some days before undergoing a surgery or rather a medical test (Chrvala, Sherr, & Lipman, 2016). In some cases, taking too much metformin can result in a lactic acidosis in a patient body. In this case, monitoring a patient is important and therefore making he or she take medical assistance before it such situation worsens.

For the purpose of evaluation, it is clear that the use of metformin goes a long way in controlling and treating patients with type-2-diabetes (Shanbhogue, Mitchell, Rosen, & Bouxsein, 2016). However, there is a need for a close monitoring of patients under medication to achieve the desired outcome in the long run (Bilezikian et al., 2016). For this to happen doctor have to be aware at every point if a patient is under the metformin therapy. This is the only way that a close and successful monitoring process can be done.

Recommendation

It is true that one of the foundation treatments of diabetes type two especially for older adult is adherence to lifestyle change particularly focusing on diet, increasing overall physical activities as well as exercise, and the reduction of weight that is often reinforced by various consultations with a registered body of dietitians and through self-management of diabetes (Shyangdan, Uthman, & Waugh, 2016).

After undergoing a rather successful response of metformin therapy, most patients often fail to keep up the targeted levels of glycated hemoglobin (A₁C) particularly during consecutive three to five years of medication. For most patients, it is recommended that they undergo a second medication especially when the individualized glycemic treatment objectives or rather goals have not been achieved after metformin as well as lifestyle intervention (Dujic et al., 2016). In essence, this decision is often grounded on the A1C examined outcomes that are usually undertaken after every three to about six months after the first therapy.

In case there are patients who fail to achieve their objective on the first therapy, there are various recommended classes of medications that are often tipped to be used alongside metformin. Notably, these options include insulin, …

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