The purpose of this assignment is to use concepts from both pathophysiology and pharmacology to discuss the management of those diagnosed with diabetes, hypertension and dyslipidemia. This assignment is worth 10% of your course grade. This assignment will address the following course objectives:1.Explain the pathophysiological rationale supporting the use of drug therapy in relation to the drug purpose, metabolism, dosage, and effect on patient outcomes for commonly occurring health problems across the lifespan. 2.Use evidence based practices to promote risk reduction related to medication errors. 3.Examine potential drug-drug interactions and drug-food interactions based on physiologic responses to pharmacological agents. After completing this assignment,you will be able to:1.Use concepts from psychophysiology and pharmacology to explain the clinical manifestations and pharmacotherapy associated with diabetes mellitus, hypertension, obesity and dyslipidemia.2.Determine congruence between a prescribed plan of care and current, evidence-based clinical practice guideline recommendations.3.Identify precautions to be taken during treatment of patients with multiple co-morbidities receiving multiple pharmacological agents.Instructions. Review the assessment data provided forMary and address the discussion points located at the end of this document. It is expected that clinical practice guidelines and evidence reports (providedin Modules 2 -4) along with information from your course textbook, videos, journal articles and web resources be used to support your answers. Additional outside research is encouraged. The grading rubric for this assignment is included with this case study. At least three professional references (peer-reviewed articles, professional websites….) published within the past five years are required, and your paper should follow APA7thed.formatting guidelines.The body of the paper is limited to 3-5pages, not including the title and reference pages.Module 4 Analysis DataMary is a 38-year-old African American female who is reporting to her primary care provider for a follow-up visit for evaluation of herdiabetes, hypertension and dyslipidemia. At her last visit one month ago, the provider prescribed phentermine to assist with weight loss. Medical Diagnoses: Stage 2 hypertension, dyslipidemia, type 2 diabetes mellitus, obesityCurrent Medications:Metformin (IR) 1000 mg by mouth twice dailyInsulin glargine 100 units/Lixisenatide 33 mcg per mL (100/33) 30 units SQ once dailyCaptopril 25 mg by mouth three times dailyHydrochlorothiazide 25 mgby mouth dailyAtorvastatin 40 mg by mouth dailyPhentermine 30mg by mouth daily before breakfast
Review of Systems Subjective Data General: Well-groomed, alert, steady gaitSkin:Denies rashes, lesion, pruritus or dry skin HEENT:Denies visual or hearing changes, or dizziness; reports allergies and has been taking Claritin-D by mouth twice a day for 4 days with some reliefCardiac:Denies chest pain or tightness; reports heart racing on occasionRespiratory:Denies shortness of breath, cough or breathing difficultyGI:Reports occasional bloating and GI upset GU:Denies pain, burning, hesitancy, blood or urgency with urinationMS:Denies muscle pains, cramps or issues with range of motionNeuro:Denies weakness, paresthesiaor changes in speech or memoryPsych:Denies feeling depressed or down Physical Examination Ht:66inches, Wt:200 poundsBMI: 33.3General: No acute distressnotedBP142/86, T98.1°F, P110, R22Heart:Regular rhythm, S1 and S2, no murmursLungs:Clear to auscultation bilaterallyAbdomen:Soft, non-tender, no bruits; Normoactive bowel sounds x 4Lower Extremities:Pedal pulses 2+ bilaterally; skin warm and dry; capillary refill < 3secondsLaboratory Results:Basic Chemistry PanelGlucose: 150 (fasting)Creatinine: 1.1mg/dlCarbon dioxide: 28mEq/LChloride: 100 mEq/LPotassium: 3.6mEq/LSodium: 139 mg/dlCalcium: 9 mg/dlBUN 14mg/dlUrine Microalbumin 50 mg/24 hourseGFR 58mL/minHA1C:8.2%Vitamin B12:170pg/mL
Module 4 Case Analysis Discussion Points1.Using psychophysiology terms, discuss the impact obesity has on blood glucose values and diabetes management. Use professional language and terms to discuss what is occurring within the body secondary to obesity that ultimately contributes to elevated glucose values. You must identify and thoroughly discuss at least 2processes associated with obesity that ultimately lead to elevated blood glucose. Lastly, analyze Mary’s assessment data and identify any findings that may indicate that Mary’s diabetes is not being controlled as desired to achieve desired goals of treatment? Be sure to include what the ultimate goals of treatment are(refer to the ADA standards for these parameters). For example, what are the blood glucose value targets for a patient such as Mary, and how do her values compare to those targets? Also consider if she is demonstrating any S/S of complications that might occur with diabetes, which could also indicate that management of her disease has not achieved the desired outcomes.2.Are Mary’s pharmacological interventions congruent with recommendations outlined in the American Diabetes Association Standards of Medical Care in Diabetes –2020? When analyzing these guidelines and comparing to Mary’s plan of care, be sure to consider ALL of her co-morbidities when determining if her prescribed care is in alignment with current recommendations (DM, HTN, dyslipidemia, obesity). For example, would the recommendation for treating hypertension be different in someone who has diabetes versus someone who does not have diabetes? When completing this section, cite the actual ADA standards, concisely state what is recommended as first-line treatment (and second-line if appropriate), and provide rationale as to why these recommendations are considered the best options (what positive outcomes have they been shown to have that makes them preferred over other agents?) Then state whether or not Mary’s care is in alignment with those recommendations. 3.Analyze Mary’s pharmacological treatment plan and her clinical presentation. Discuss any special considerations you identify or specific concerns you may have regarding her treatment or response to the treatment. You must address at least 3 special considerations with thorough explanations as to why it is a concern for Mary. While analyzing herregimen, ask yourself the following questions: Are there any special considerations related to dosages?Are there any special considerations related to metabolism and excretion?Are there any special concerns related to side effects, adverse effects, or drug-to-drug interactions?When asking yourself these questions, consider what a normal dosage would be, how drugs are normally metabolized and excreted, common interactions or side effects that might occur, special precautions noted, and do not forget about all of Mary’s comorbidities. Pull in assessment data as appropriate and explain why you have these concerns in this specific case and what actions may need to
There are many different types of drugs, and each drug has its own mechanism of action. The way that a drug works is called pharmacology. It consists of the study of how drugs affect the body and how they interact with other chemicals or nutrients in our system. Pharmacological science can help us understand why certain treatments work better than others when treating certain health problems such as:
Drugs are chemicals that can be used to treat health problems. The relationship between drugs and pathophysiology is complex, but it can be explained as follows:
The dose is the amount of drug given. It’s determined by body weight, age, and other factors like gender or race. The dose may also be determined by how the body responds to the drug. For example, if you have high blood pressure (hypertension), it means that your heart needs more blood flow than usual in order to meet its needs for oxygen and nutrients. If this happens despite taking medication for it already, then your doctor might want to increase your medicine dosage so as not only treat existing symptoms but also prevent further damage from occurring over time due to lack of control over how much does actually get through into circulation each day—that would mean less pressure being exerted on other parts like arteries leading away from heart chambers where most work gets done during normal times when little else goes wrong besides getting old fast enough so there’s nothing left but bones rattling around inside cagey spaces between ribs before going completely numb all over again just like before when things weren’t quite so bad yet because nobody knew how bad things could get until now either way?
If you’ve chosen to pursue a career in health care, you will inevitably be faced with a wide variety of patients and their health concerns. Being able to identify common diseases, understand what causes them and how drugs can treat them is crucial for providing the best care possible. In this article we have provided some basic guidelines on how pharmacology plays an important role in helping people live healthier lives.
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