Medication Management Report: Case Study of Patient Medication

This report provides a detailed analysis of a 27-year-old single mother with type 2 diabetes, focusing on her physical status, current medications, and potential drug interactions. The patient, Marnie Brown, presents with symptoms including low blood pressure, rapid respiration, elevated temperature, and a fruity breath odor, indicative of diabetic ketoacidosis. The report examines her medications, particularly canagliflozin, ethinyl oestradiol, and clotrimazole, highlighting contraindications and potential adverse effects. It emphasizes the need to avoid canagliflozin due to risks of hypotension, ketoacidosis, and renal impairment. The analysis also considers interactions between medications and the patient's current health status, recommending a thorough assessment before administering medications to manage her condition effectively. References are included to support the findings.

MEDICATION
MANAGEMENT
GROUP MEMBER

PATIENT INFORMATION
Name – Marnie Brown
Age – 27-year-old
Status – Not-married
Aboriginal Single mother
3 children from previous Relationship
CURRENT
STATUS
Considerable
Weight Gain
Smoking – To
keep away from
food.
Physical Status of patient
and Interpretation
Assessment/Examination Results Interpretations
Blood pressure 100/65 mm Hg Low Blood pressure against
120/80 mm of Hg
Pulse rate 86 bpm 60-100 beats per minute
normal
Respiration rate 29/min (deep and rapid) Rapid and Deep ventilation
implicate hyperventilation.
It can be due to any lungs
disease, or anxiety and
panic or medication side
effects (Lehtinen & Martin,
2018).
Body Temperature 38.0◦C Slight fever can due to any
infection or illness or
medication side effects.
Appearance Agitated, dry skin. Red itchy
patches under breasts and
abdominal skin folds.
Dehydration, and might be
intertrigo that affects skin
folds and frictional force
that is increased due to heat
and moisture producing skin
irritation. Obesity, humidity
and heat are risk factors
(Mutasim, 2015)
Breath Sweet, fruity odour Symptom of diabetic
ketoacidosis as insulin is
unable to use sugars
therefore takes fat and fat
metabolism breakdown
leads to production of
ketones (Rosenstock, J., &
Ferrannini, 2015)
Height 1.75 m
Weight 105 kg Excessive weight or obese .
Ideal weight for female is
64-79 kg.
Urine dipstick test – glucose +++ Glucose High indicative of
diabetes
Urine dipstick test – nitrites +++ Could be due to poor kidney
function due to diabetes
but hematouria must not be
disregarded. Obesity and
Non-steroidal anti-
inflammatory drugs could
be causal factor (Mills et al.,
2015).
Current medication Paracetamol and ibuprofen
for pain
CURRENT
DIAGNOSIS
Type II Diabetes
mellitus
Poly Cystic
Ovarian Disease
CURRENT MEDICATIONS
AND INDICATIONS
MEDICATIONS INDICATIONS
canagliflozin 100
mg
Indicated for control
of glycemic index in
patients with type II
diabetes mellitus.
Reduce the risk of
cardio-vascular
problems.
ethinyl oestradiol Oral contraceptive
Clotrimazole Fungal infections or
skin infections
STATUS DURING ADMISSION
Marnie was lying on bed crying with her three
children in hungry . Brought by her
grandmother as she believes, Marnie never
neglect her kinds
Canagliflozin –
• Contraindicated in patients with
renal impairment, breast feeding, and
diabetic ketoacidosis.
• Not indicated in hypotension and
genital mucotic infections (Neal et
al., 2015).
Ethinyl Oestradiol
• Contraindicated in patients with
heart problem issues and smoking is
prohibited.
• Increased side effects such as blood
clots has been reported.
• Nausea, vomiting and cramps can
occur. Swelling, itching , rashes
indicate allergic reactions (Ezuruike
et al., 2018).
MEDICATION
INTERACTIONS AND
PROBLEMS
MEDICATION MANAGEMENT
Thus, based on the above analysis it is evident that
• Canagliflozin should be avoided as it is associated with hypotension, ketoacidosis and renal
impairment.
• The patients, physical health assessment indicates she is suffering from thirst and her breath is
smelling fruity. Continuing the medication increases the chances of these symptoms (Erondu,
Desai, Ways & Meininger, 2015).
• Adverse reactions can increase vaginal mucolytic infections.
• Since the patient have been prescribed clotrimazole for infections therefore, this medication side
effects can interfere with indications of clotrimazole (Yale et al., 2013).
• In context of Ethinyl Oestradiol, the interaction with paracetamol is minor and research suggest
might delay the action of acetaminophen.
• Therefore, in case of the current patient, proper assessment must be done prior to administration
of medication.

REFERENCES
• Erondu, N., Desai, M., Ways, K., & Meininger, G. (2015). Diabetic ketoacidosis and related events in the canagliflozin type 2 diabetes clinical program. Diabetes care, 38(9), 1680-1686.
• Ezuruike, U., Humphries, H., Dickins, M., Neuhoff, S., Gardner, I., & Rowland Yeo, K. (2018). Risk–Benefit Assessment of Ethinylestradiol Using a Physiologically Based Pharmacokinetic
Modeling Approach. Clinical Pharmacology & Therapeutics, 104(6), 1229-1239.
• Lehtinen, P., & Martin, M. (2018). Psychophysical regulation of breathing. In Breathing as a Tool for Self-Regulation and Self-Reflection (pp. 25-61). Routledge.
• Mills, C. E., Govoni, V., Casagrande, M. L., Faconti, L., Webb, A. J., & Cruickshank, J. K. (2015). Design and progress of a factorial trial testing the effect of spironolactone and inorganic nitrate on
arterial function in people at risk of or with type 2 diabetes. Artery Research, 12, 48-53.
• Mutasim, D. F. (2015). Skin Folds Diffuse Rash. In Practical Skin Pathology (pp. 117-120). Springer, Cham.
• Neal, B., Perkovic, V., de Zeeuw, D., Mahaffey, K. W., Fulcher, G., Ways, K., ... & Jiang, J. (2015). Efficacy and safety of canagliflozin, an inhibitor of sodium–glucose cotransporter 2, when used in
conjunction with insulin therapy in patients with type 2 diabetes. Diabetes Care, 38(3), 403-411.
• Rosenstock, J., & Ferrannini, E. (2015). Euglycemic diabetic ketoacidosis: a predictable, detectable, and preventable safety concern with SGLT2 inhibitors. Diabetes care, 38(9), 1638-1642.
• Yale, J. F., Bakris, G., Cariou, B., Yue, D., David‐Neto, E., Xi, L., ... & Meininger, G. (2013). Efficacy and safety of canagliflozin in subjects with type 2 diabetes and chronic kidney
disease. Diabetes, Obesity and Metabolism, 15(5), 463-473.