Safe Administration of a Drug

This case study focuses on the safe administration of a drug and its importance in curing diseases. It explores the relation between diabetes and kidney disease, measurement of blood glucose levels, application of alternative medicine, and suggestions for new medications. The study also provides insights into preparing a nursing care plan for patients.

Runing head: SAFE ADMINISTRATION OF A DRUG
SAFE ADMINISTRATION OF DRUG
Name of the Student
Name of the University
Author note

1SAFE ADMINISTRTAION OF A DRUG
Table of Contents
Introduction......................................................................................................................................2
Relation of diabetes and kidney disease and pharmacodynamics of metformin.............................2
Measurement of blood glucose level values....................................................................................3
Application of alternative medicine Glucovance............................................................................3
Suggestion of two new medications................................................................................................4
Preparation of a nursing care plan...................................................................................................5
Conclusion.......................................................................................................................................5
References........................................................................................................................................7

2SAFE ADMINISTRTAION OF A DRUG
Introduction
Medicines are needed to be administered properly to a patient. Safe administration of
medicines are required in order to get cured early. This case study is related with safe
administration of a drug. If a drug is not properly administered the patient will not be able to get
cured within the specified period of time and in that case, either the drug has to be changed or
some other alternatives method of that particular drug needs to be taken.
Relation of diabetes and kidney disease and pharmacodynamics of metformin
In the given case study, Sharon was suffering from type 2 diabetes since 3 years. She was
taking the medicine Metformin. Due to type 2 diabetes, the level of glucose in the blood
increases a lot (Kerner and Brückel, 2014). A person suffering from diabetes need to change his
diet plan, need to take medicines and need to do checking regularly. Sharon was suffering from
diabetes mellitus, in which the glucose concentration increases in the blood. This is one of the
causes of kidney failure. With ages of time, the increased levels of glucose damage the tiny
filtering units present within each kidney. This finally leads to failure of kidney. Many people
suffering from this diabetes suffer from kidney issues but not all of them had kidney failure
(Chawla, Chawla and Jaggi, 2016) This is called diabetic nephropathy. Actually there is no
method to cure diabetic nephropathy, the patient has to change his lifestyle in order to control the
disease. In the given case, Sharon do not suffer from kidney failure but she is found to have
proteinuria. The drug helps the patients of diabetes to respond to the insulin of their own body
better. It decrease the sugar amount in the liver and also lowers the amount of sugar absorbed by
the intestines. The pharmacodynamics of metformin involves the activation of AMP- activated
protein kinase. This enzyme has its utility in insulin signalling pathways, it maintains the energy
balance of the body and in the metabolism of glucose and fats ( Forslund et al, 2015). The
activity of this enzyme is required to increase the expression of heterodimers of small size which
then inhibits the expression of phosphoenolpyruvate carboxylase and glucose 6 phosphatase.
Though other mechanisms of actions of metformin has been revealed like inhibition of the
respiratory chain of mitochondria, inhibition of glycerophosphate dehydrogenase of
mitochondria and it also effects on the microflora of our guts ( Kapitza et al, 2013).

3SAFE ADMINISTRTAION OF A DRUG
Measurement of blood glucose level values
BGL stands for blood glucose level and it describes how much glucose is present in the blood of
humans and also in other animals. Glucose is the simplest of all sugars and normally only 4
grams of glucose must be present in a human of weight 70 kilograms. An increase in
concentration of blood glucose leads to glucose toxicity. This condition is so crucial that it leads
to malfunction of body cells and also the pathology. This stage is considered as complications of
glucose. A high range of glucose in the blood is called hyperglycemia and likewise a low range
of glucose in the blood is called hypoglycaemia (Zhu et al, 2013).
Normally the value of blood glucose in blood varies from libraries to libraries. Actually
this value depends on many factors. In the fasting conditions the level of glucose in the blood
should be in the range of about 4.4 to 6.1 millimolar/ litre. The persons who do not have diabetes
should have glucose level in between the range of 3.9to 7.1 mmol/L. The mean value of this is
5.5 mmol/L. Fluctuations are there in this value throughout the day. For the persons suffering
from diabetes, the value of blood glucose should be in the range of 5-7.2 millilomar/litre in the
fasting conditions and a range of values less than 10 after the patient have their meals (Lindström
et al, 2013). Sharon’s level of blood glucose was 8 to 11 mmol/L in all the day throughout and 7
to 8 mmol/L at the time of waking up, meaning in the fasting conditions. If compared with the
standard values it can be seen that both fasting value and after meal value of glucose of Sharon
are high. She is critically a diabetic patient. The value of blood glucose should have lowered as
she is taking metformin since a long time.
Application of alternative medicine Glucovance
In the given case study, Sharon is found to take metformin twice a day daily. But after
even taking the medicine she has high levels of glucose in blood both in the fasting conditions
and in the after meal conditions. After having meals normally the blood glucose levels remains a
little bit high for not only the diabetic persons but also for the non diabetic persons (Tabatabaei-
Malazy et al, 2016). Sharon’s blood glucose levels are seriously high, so it is really needed for
her to add glucovance along with the present medicines she is taking. Glucovance is used mainly
when proper diet, exercises along with metformin is unable to bring the blood glucose level to
the normal conditions. This medicine is also used in patients whose glucose level has been
controlled properly by the usage of metformin along with sulfonylurea (AlShehri et al, 2013).

4SAFE ADMINISTRTAION OF A DRUG
This drug is comprised by glibenclamide and metformin hydrochloride. If the levels of blood
glucose is not controlled properly then hyperglycemia or hypoglycaemia occurs (John, Gopinath,
and Kalra, 2015)
There is one thing which needs much considerations is that the patient is recently
suffering from kidney diseases and some proteinuria though complete kidney failure is not
reported in this case. This drug cannot be used in patients having severe or light kidney
problems. This thing seriously need much considerations as if the drug is applied along with the
previous medicines the problem of kidney failure may get increased. So the other medicines are
needed along with these give medicines regarding the kidney, so that the condition of the kidney
do not get decreased.
Suggestion of two new medications
The medicines used for treating diabetes mellitus in case of Sharon was unable to cure
the disease. Medicines of some better qualities if invented hopefully can cure diabetes mellitus.
This type of diabetes is caused because of the increase in the blood sugar level. Increased
concentration of blood sugar level may lead to short or long term issues regarding health like
nerve damage, damage of kidney, blindness and heart diseases. A drug which is a sodium
glucose co transporter inhibitor can be invented which can prevent the kidney from the
reabsorption of the glucose. Thus if this medicine is invented then the excretion of glucose will
get increased and obviously the blood glucose level will get decreased (Klara, Kim, and Ross,
2018) This medicine will surely become an additional treatment along with the well known
medicines that are used today to cure diabetes mellitus. If such a drug is there then she can be
cured.
The kidney diseases caused due to diabetes mellitus has become one of the major
problem of almost all diabetic patient. The patients suffering from diabetes mellitus have
proteins grown up within their tissues that lead to the formation of scars in the tissues which
ultimately lead to the failures of kidneys. The conditions that are created are very severe which
lead to the dialysis and even transplantations of kidneys. If a medicine is invented which can
reduce the scars formed and reduce the lesions made in the nephrons then the kidney diseases
can be cured (Klinkhammer et al, 2017). Sharon can be cured by using this type of medicines.

5SAFE ADMINISTRTAION OF A DRUG
Preparation of a nursing care plan.
The registered nurse standards provides an ideal way about how to take care of a patient.
In the given case study if Sharon is given a proper nursing care by following the rules of the
registered nurse standards then Sharon may get improved a lot. The nurse must do the following
things for Sharon :
 The nurse must do the assessment of all the data available and the evidences that are
best available in order to prepare the care plan.
 She should make the collaborative plan including the goals, the options which are the
priorities, the actions, the goals and the options in relative to the person. In this case
Sharon suffers from diabetes mellitus and chronic kidney problems. So the nurse should
prepare the diet chart for the patient, give her medicines according to her needs.
 In order to get the proper outcome, the nurse must prepare the documents and should
record daily how the patient is improving daily. She also do the evaluation of the
records and she is only responsible for modifying the care plan. The patient upon
improvement needs different care plan.
 She is the one who do the planning and negotiation of the evaluates and also the time
frame of the engagement. She should prepare a proper time frame for Sharon and
proceed by following that time frame only.
 She coordinates about all the resources that are available effectively and also very
effectively for preparing the action plan for the patient. In this case, the nurse must
make sure that all the things that are required for her to treat her is available to her. She
needs the medicines time to time and also she needs proper economic facilities so that
she can arrange the diet plan also effectively (Mather, Gale and Cummings, 2017)
Conclusion
The assignment has almost come to an end. From this assignment much about the
disease diabetes and safe administration of a drug can be learnt. In the case study, Sharon was
found not to be cured with the subscribed medications and even she was suffering from the side
effects of taking the medicines. She was found to suffer from neuropathy and slight proteinuria.

6SAFE ADMINISTRTAION OF A DRUG
So from this it can be concluded that she immediately needs to change the medicine from
metformin which she was using to some other medicines which can cure the diabetes and as a
result, the kidney problems will also get cured. Medicines except metformin are there which can
cure the disease.

7SAFE ADMINISTRTAION OF A DRUG
References
AlShehri, M., Al Zoman, N., AlHarbi, H., AlSulaihim, K. and AlOdaib, F., 2018. A Validated
HPLC-PDA Method for Simultaneous Quantitation of Four Oral Antidiabetic Drugs and
Application to Pharmaceutical Preparations. Journal of the Chemical Society of Pakistan, 40(3).
Chawla, A., Chawla, R. and Jaggi, S., 2016. Microvasular and macrovascular complications in
diabetes mellitus: distinct or continuum?. Indian journal of endocrinology and
metabolism, 20(4), p.546.
Forslund, K., Hildebrand, F., Nielsen, T., Falony, G., Le Chatelier, E., Sunagawa, S., Prifti, E.,
Vieira-Silva, S., Gudmundsdottir, V., Pedersen, H.K. and Arumugam, M., 2015. Disentangling
type 2 diabetes and metformin treatment signatures in the human gut
microbiota. Nature, 528(7581), p.262.
John, M., Gopinath, D. and Kalra, S., 2015. Triple fixed drug combinations in type 2
diabetes. Indian journal of endocrinology and metabolism, 19(3), p.311.
Kapitza, C., Forst, T., Coester, H.V., Poitiers, F., Ruus, P. and Hincelin‐Mery, A., 2013.
Pharmacodynamic characteristics of lixisenatide once daily versus liraglutide once daily in
patients with type 2 diabetes insufficiently controlled on metformin. Diabetes, Obesity and
Metabolism, 15(7), pp.642-649.
Kerner, W. and Brückel, J., 2014. Definition, classification and diagnosis of diabetes
mellitus. Experimental and Clinical Endocrinology & Diabetes, 122(07), pp.384-386.
Klara, K., Kim, J. and Ross, J.S., 2018. Direct-to-consumer broadcast advertisements for
pharmaceuticals: off-label promotion and adherence to FDA guidelines. Journal of general
internal medicine, 33(5), pp.651-658.
Klinkhammer, B.M., Goldschmeding, R., Floege, J. and Boor, P., 2017. Treatment of renal
fibrosis—turning challenges into opportunities. Advances in chronic kidney disease, 24(2),
pp.117-129.

8SAFE ADMINISTRTAION OF A DRUG
Lindström, J., Peltonen, M., Eriksson, J.G., Ilanne-Parikka, P., Aunola, S., Keinänen-
Kiukaanniemi, S., Uusitupa, M., Tuomilehto, J. and Finnish Diabetes Prevention Study (DPS,
2013. Improved lifestyle and decreased diabetes risk over 13 years: long-term follow-up of the
randomised Finnish Diabetes Prevention Study (DPS). Diabetologia, 56(2), pp.284-293.
Mather, C.A., Gale, F. and Cummings, E.A., 2017. Governing mobile technology use for
continuing professional development in the Australian nursing profession. BMC nursing, 16(1),
p.17.
Tabatabaei-Malazy, O., Nikfar, S., Larijani, B. and Abdollahi, M., 2016. Drugs for the treatment
of pediatric type 2 diabetes mellitus and related co-morbidities. Expert opinion on
pharmacotherapy, 17(18), pp.2449-2460.
Zhu, W.W., Yang, H.X., Wei, Y.M., Yan, J., Wang, Z.L., Li, X.L., Wu, H.R., Li, N., Zhang,
M.H., Liu, X.H. and Zhang, H., 2013. Evaluation of the value of fasting plasma glucose in the
first prenatal visit to diagnose gestational diabetes mellitus in China. Diabetes Care, 36(3),
pp.586-590.