1. What are the indications and actions of the prescribed medications?
Metformin Hydrochloride is one of the oral hypoglycemic drugs used to treat Type II Diabetes (Allen, Brock et.al. 2009) which Mrs. Polly Pharm is diagnosed with. Because of her type II diabetes, which is known as having impaired insulin secretion and insulin receptor insensitivity (Allen, Boucher, Cain & Cooper, 2007), this drug activates Mrs. Polly’s pancreatic beta cells to release insulin although her pancreas is considered to be least functioning. Metformin decreases hepatic glucose production and absorption of glucose in the intestines and also improves insulin receptor sensitivity.
Ibuprofen belongs to the Non-Steroidal Anti-Inflammatory drugs which has three prevailing
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(Adams, Holland & Urban, 2011)
Herbal Medicines Ginseng- increases hypoglycemic effects Feverfew, Garlic, Ginger, or Gingko – Increases risk of Bleeding
White Willow- drug has same components. Do not use together. (Kizior & Hodgson, 2015) Gingko and St John’s Wort – Decrease plasma concentration of drug (Adams, Holland & Urban, 2011)
Other Drugs Beta Blockers- Hypoglycemia may be difficult to distinguish.
Calcium channel blockers, Corticosteroids, Diuretics- May produce hyperglycemia. “Diabex” (2012) Anticoagulants, other modifiers – Avoid use as drug can affect platelet function.
Aspirin – Decreases anti-inflammatory effects
Lithium – Ibuprofen may increase lithium plasma levels thus increasing risk of toxicity
(Adams, Holland & Urban, 2011) Diazepam, phenytoin, other CNS depressants- Increased drug levels in blood.
Warfarin – Increase bleeding
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Discuss the medication management education that is required to enable Polly to manage her medications at home.
As the Nurse in charge of the unit where Polly was admitted, it is essential that I make it a point that she has been well educated and advised of the proper medication management in order to maintain the effectiveness of her Drug Regimen; Instructions as follows:
Metformin Hydrochloride
• Advise polly that these oral anti-diabetics do not work by themselves, it acts as an aid to lower blood sugar levels in combination of improving good lifestyle habits such as adding exercise and eating healthy foods especially the ones with low glycemic index. Spratto & Woods (2006, p.512)
• Encourage polly to report if any signs of nausea, vomiting or fever occurs. (Vallerand, Sanoski & Deglin, 2012)
• Advise polly to bring with her any form of simple sugars in case a hypoglycemic event attacks. (Vallerand, Sanoski & Deglin, 2012)
• Do not skip or delay meals as this will require adjustment of dosage. (Vallerand, Sanoski & Deglin,
Sarah should determine the LPN’s knowledge base regarding the current patient cases she is responsible in caring for. For instance, the LPN may have extensive knowledge regarding the care of the diabetic patient and may be able to provide patient education to them on her own. However, Sarah should still assess the LPN’s knowledge regarding the teaching and may be able to advise the LPN of specifics to educate on. Additionally, Sarah should still speak with the diabetic patient and assess their understanding of the teaching and serve as a resource for any questions the patient might
Scheen AJ. Antidiabetic agents in subjects with mild dysglycaemia: Prevention or early treatment of type 2 diabetes. Diabetes and Metabolism. 2007;33:3-12.
Metformin is prescribed for long-term treatment of Type II Diabetes Mellitus. It can be used alone or in combination with other drugs for diabetes management as part of a health plan that includes proper diet and exercise. Metformin, which has a low affinity for plasma protein binding, limits glucose production in the hepatic system, lowers absorption of glucose in the intestines and improves insulin sensitivity by enhancing uptake and utilization of glucose (FDA, 2008). This drug does not cause an increase in insulin, making it less likely to cause a patient to become hypoglycemic compared with other common antihyperglycemic medications.
Nurse’s should have a strong pharmaceutical knowledge background and be aware of the potential harm a medication could cause. In the process of medication administration, registered nurses are responsible to “determine that each medication order is clear, accurate, current and complete”. Medications should be withheld when a medication order is incomplete, illegible, ambiguous or inappropriate; with concerns being clarified with the prescriber (CNO, 2015)”. The critical care nurse demonstrated ineffective communication, which was shown by failing to ask the physician for clarification. Another instance of miscommunication is during medication reconciliation, which is a formal process in which healthcare providers work together to ensure that patient medication information is communicated consistently and accurately across transitions of care (Etchells, 2012).
Overall, I retain three goals for this clinical day: Safely and efficently administer medication, enhance my nursing/CNA skills, and determine how to implement infection control into a health care setting. This week reflects my assigned time to administer medication in a health care setting for the first time, with a resident who retains nearly twenty medications. I except this experience will be a great learning experience, but it will also subsist slightly stressful. With the assistance of my FOR, my goal is to administer all of my resident 's medications without complications. To ensure that medication safety, I will perform the six medication rights and three checks prior to administration. Along with medication administration, a goal
Henderson, L., Yue, Q. Y., Bergquist, C., Gerden, B., & Arlett, P. (2002). St John's wort (Hypericum perforatum): drug interactions and clinical outcomes. British journal of clinical pharmacology. 2002; 54(4):349-356.
The rationality of the product and its combination will now be discussed. The criteria used in order to gauge the safety and effectiveness of the medication
Administration of medicines is a key element of nursing care. Every day some 7000 doses of medication are administered in a typical NHS hospital (Audit Commission 2002). So throughout this essay I will be evaluating and highlighting the learning that took place whilst on placement at a day unit.
Firstly, nurses are expected to practice evidence-based health care hence a mastery of information about the essential and safe dose of drugs for a patient is very important for a nurse. Consequently, it could be the determinant between the life and the death of the patient. Pharmacology is a discipline which is mandatory for the nurse to excel in to be efficient in discharging his/her duties. Understanding which drug to use, the right dosage, the expected side effects which may occur and the contra-indications of the various drugs are key in the preservation of
...t compliance, and medication adherence is highly correlated with positive health outcomes. Thus, a medicine that maximizes patient adherence, delivers the same efficacy as previously used drugs, and shows no additional adverse effects is exceedingly likely to become the drug of choice. Of particular interest to researchers currently are the medications glyburide and metformin. As more and more research continues, it is hypothesized that these drugs will become part of the pharmaceutical regime in the treatment of gestational diabetes mellitus. In fact, both glyburide and metformin have been successfully prescribed to treat GDM in other countries for several years. Glyburide, especially, is predicted to gain the approval by the FDA in the coming years as, at least, a second line medication since it has shown to only cross the placenta in insignificant quantities.
Watts, S. & Anselmo, J. (2006). Nutrition for diabetes—all in a day’s work. Nursing, 36(6), 46-48. Retrieved from EBSCOhost database.
“To manage diabetes, patients must take treatment for diabetes. There are two major treatments. They are diet treatment and tablet treatment. Oral anti diabetes drugs sulphonamide (sulphonylureas) and guanidine derivaties (biguanides) are used by 30% of all diabetes.” (6)
Diabetes Mellitus is a disease in which the pancreas produces little or no insulin. Insulin is a hormone that helps the body’s tissues absorb glucose which is sugar, so it can be used as a source of energy. Glucose levels build up in the blood and urine which causes excessive urination, thirst, hunger, and problems with fat and protein metabolism in a diabetic person. Diabetes is very common in the United States; it is the seventh leading cause of all deaths. Women have been diagnosed with diabetes more than men. There are two forms of diabetes, Type one and Type two diabetes. Type one diabetes is when the body does not produce insulin or produces it in very small quantities. This usually occurs in younger people under twenty years of age, mostly around puberty. Type two diabetes is when the body’s balance between insulin production and the ability of cells to use insulin doesn’t work properly. This is more common than type one; about 90-95% people in the United States have it. There are no cures for diabetes now but there are many researchers investigating factors through new technologies to cure them. Meanwhile, technological advancements are being made to keep glucose at a good level for diabetes.
I was also responsible for monitoring medication orders and reviewing patient profiles to ensure that the proper drugs and dosages were prescribed and that the pharmacy technician had prepared them properly. In many instances there were mistakes made in the preparation phase and sometimes even before, with incorrect dosages or drugs being prescribed and prepared, which could result in serious adverse effects for the patient. A clinical pharmacist’s role, however, is to make sure that these mistakes never reach the
Secondly, they advise their patients in assuring the appropriate use of medications. It is important to tell the patient about the name of the drug, what is it for, when to take the drug, how many times per day, whether it should be taken before meals, after meals or with meals, the method of taking the drug and its side effects and possible drug-drug interactions. (Swanson, 2005)