NURS12154: Pharmacology for Nursing - Drug Protocol & Discussion

This report presents a detailed analysis of a patient case involving diabetes and related complications, focusing on the pharmacological interventions required for effective management. It includes a comprehensive drug protocol outlining the use of medications like Metformin, Glibenclamide, and Atorvastatin, with specific attention to their mechanisms of action, pharmacokinetics, potential drug interactions, and adverse effects. The report emphasizes the importance of patient education by nursing professionals regarding medication adherence, lifestyle modifications, and potential side effects. It also addresses the cultural considerations related to alcohol consumption and its interaction with the prescribed medications. The document provides a thorough discussion on the role of each medication in managing diabetes, high cholesterol, and associated risks, highlighting the significance of a holistic approach involving medication, diet, exercise, and lifestyle changes for optimal patient outcomes. This resource is available on Desklib, a platform offering a wide range of study tools and solved assignments for students.

Running head: PHARMACOLOGY
PHARMACOLOGY
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The patient named Mavin is a 45-year-old indigenous woman who is presently caring for
her husband who has faced leg amputation due to vascular disorders. On close analysis of the
different disorders that the patient is going through, it is noticed that she is having a wound that
is not healing well at all. This is mainly seen that the person is suffering from diabetes from the
past ten years and had not been able to maintain the symptoms well. She is often seen to forget
the medications on the right time and therefore, it becomes extremely difficult for the patient to
maintain her symptoms properly. When she had visited the healthcare centre, she had quite high
values in different tests conducted by the healthcare professionals. Her blood pressure was quite
high for about 180/90 that is quite higher than the normal blood pressure of 120/80 (Madiraju et
al. 2014). The pulse was 94 that were within the safe range of 60 to 100. The serum cholesterol
level was found to be 8.4 mmol/L. The normal value mainly should state below 5.2 mmol/L.
when it becomes higher than 6.2 mmol/L, it is considered to be high. So the patient has high
cholesterol level. The triglyceride level was found to be above the high level of 5.6 mmol/L and
therefore, it becomes extremely important to consider these abnormal tests results while
developing care plan and developing medication plans. The HbA1c level is also found to be 8.
Researchers are of the opinion that a value of below 65 is extremely important to be set for
maintaining proper glucose level in blood (Aroda et al., 2015).
The term HbA1c mainly means glycated haemoglobin. When the protein called
hemoglobin present within the red blood cells are attached with glucose present in the blood and
carries oxygen throughout the body, it is seen to become glycated. With the help of measuring
the glycated hemoglobin, the healthcare professionals can successfully understand the overall
picture of the blood sugar levels that have been present over a period (Balselles et al., 2015). It is
evident from the case study, that the patient has high levels of HbA1c that in turn indicates

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poorly maintained diabetic condition in the patient. The increase of the serum cholesterol level
and the increase of the triglycerides are well associated with the improper maintenance of
diabetes. Researchers are of the opinion that when the patients do not effectively control the
diabetes, there will be high level of glucose as well as insulin in the blood. When insulin is
present, it results in the conversion of glucose into the glycogen that thereby helps in the storage
of glycogen in the liver. When the liver is seen to become too much saturated with glycogen,
glucose is seen to be utilized for the creation of the fatty acids that are realized in the blood
stream (Cafes et al., 2015). In course of time, it is seen that these fatty acids are seen to make
more number of glycerides that result in building up of fat in the cells. This is in turn seen to
result in development of body fat that creates a situation of obesity. Researchers are of the
opinion that high levels of glucose caused by the occurrence of diabetes over time affect the
nerves resulting in neuropathy and thereby they can lead to poor circulation of blood. Therefore,
blood required for skin repairment for reaching the areas of the body affected by sores and
wounds cannot be obtained (Stokum et al., 2017). These mainly result in the wounds remaining
open as well as unhealed for months resulting in gangrene, fungal infections as well as bacterial
infections.
Therefore, effective medications need to be taken by the patient so that she can
effectively control the symptoms of diabetes and thereby get free from the disorders that are
resulting from the source of poor management of diabetes. Therefore, in such situation,
metformin can be used. The nursing professionals should help the patient develop education and
knowledge about the use of medication so that the patient becomes careful about her approach
towards medication and aligns with the medication regime to keep her fit (Farmer et al., 2016).
The professionals should provide metformin with proper diet and exercise along with other

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medications for controlling the high blood sugar. She should be taught that controlling the high
blood sugar level may result in prevention of the kidney damage, blindness, loss of limbs, nerve
problems as well as sexual function problems. Proper controlling of the diabetes would also help
the patient to be safe from heart attack and stroke. All these education would help het to become
more serious about her health and take medications diligently. Metformin mainly acts by two
ways. It helps in restoring the proper response of the body to the insulin that is naturally
produced by type 2 diabetes patients. It also helps in the decreasing of the amount of sugar that
the liver makes and the amount of sugar that the intestine absorbs (Harshman et al., 2017). This
would prevent in the formation of triglycerides in the body. In most of the cases, the sugar level,
which increases in the blood, becomes very difficult for the patients to maintain. Although many
of the patients can maintain them through proper diet with absence of glucose but in other cases,
patients need the help of gibenclamide. Gibenclamide is mainly seen to be a fast acting oral-
antidiabetic medication that helps in controlling the blood sugar level in type 2 diabetic patients
(forslund et al., 2015). Researchers are of the opinion that for betterment of the affectivity of the
medication, healthcare professionals should influence the patients to have that drug along with
controlled diet and exercises regularly so that better results can be obtained. Atorvastatin is one
of the drug that when taken with proper diet mainly helps in the lowering the bad cholesterol or
fats such as the LDL and triglycerides. It helps in raising the good cholesterol or the HDL in the
blood (Moss et al., 2017). This drug is mainly seen to work by the reduction of the amount of
cholesterol made by the liver. This drug mainly helps in decreasing the risk of the heart diseases
and thereby helps in prevention of strokes as well as heart attacks. The nursing professionals
should educate the patient that all these medications will only show benefit when they are
combined with low cholesterol and low fat food. Lifestyle changes that will result in helping

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these medications to work mainly include exercising, losing weight when overweight and
stopping smoking (Adams et al., 2015) . The nursing professionals should also educate the
patients about the various kinds of side effects that each of the medication may result. They
should also provide the patient with effective coping strategies so that the patient do not suffer
and rather live a better quality life.
The culture of the indigenous people makes them highly vulnerable for alcohol
consumption as well as tobacco smoking throughout the entire period of their life. Therefore, the
professional should warn the patient about the interaction of alcohol with atorvastatin that might
result in harmful liver disorders (Rosenquist et al., 2015). Researchers have stated that alcohol
consumption in large quantities with gidenclamide should be stopped as that might have adverse
effects on the individuals by the improper control of the blood sugar levels after drinking
alcohol. Researchers have also stated that drinking of alcohol with that of metformin should be
limited as it may result in lactic acidosis and development of low blood sugar level (Horta et al.,
2015).

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References:
Adams, I. (2015). Diabetes and Cholesterol [2015].
Aroda, V. R., Christophi, C. A., Edelstein, S. L., Zhang, P., Herman, W. H., Barrett-Connor,
E., ... & Knowler, W. C. (2015). The effect of lifestyle intervention and metformin on
preventing or delaying diabetes among women with and without gestational diabetes: the
Diabetes Prevention Program outcomes study 10-year follow-up. The Journal of Clinical
Endocrinology & Metabolism, 100(4), 1646-1653.
Balsells, M., García-Patterson, A., Solà, I., Roqué, M., Gich, I., & Corcoy, R. (2015).
Glibenclamide, metformin, and insulin for the treatment of gestational diabetes: a
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Caffes, N., Kurland, D. B., Gerzanich, V., & Simard, J. M. (2015). Glibenclamide for the
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Forslund, K., Hildebrand, F., Nielsen, T., Falony, G., Le Chatelier, E., Sunagawa, S., ... &
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Horta, B. L., Loret de Mola, C., & Victora, C. G. (2015). Long‐term consequences of
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Jurczak, M. J. (2014). Metformin suppresses gluconeogenesis by inhibiting mitochondrial
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Stokum, J. A., Keledjian, K., Hayman, E., Karimy, J. K., Pampori, A., Imran, Z., ... & Simard, J.
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