BIOM2009 Human Physiology And Pharmacology A1

Table of Contents


45 year old woman in respite care. She has cellulitis in her left limb and is not managed with lifestyle changes.

High risk of cardiovascular disease-patient is already taking amlodipine 10mg daily for hypertension. Recent blood tests have shown she has diabetes (HbA1c – 63). She is now on metformin 500mg twice daily.

Provide a pharmacotherapy program supporting the decision and need to prescribe metformin. Also discuss the pharmacotherapeutic considerations related to dosing and drug-to-drug interactions.

Discuss the expected treatment goals and desired outcomes of metformin introduction, including monitoring and evaluation of treatment results. Make recommendations for continued therapy based upon patient factors and disease management.

Talk about patient education and drug adherence.

Discuss the risks and benefits of drugs, and any conditions that might require dose adjustments.


The issue of diabetes is gaining traction in clinical discourses, especially in today’s world.

Researches show that diabetes prevalence has increased in recent years. Medical scientists attribute this increase to a change in lifestyle.

There are many medications that can be used to treat this condition.

Metformin is one of the most popular medications that have been suggested for this purpose.

Metformin is an ideal medication to treat type 2 diabetes.

Metformin’s main function is to lower blood sugar levels by improving insulin sensitivity (Zaccardi and co-authors, 2016).

This medication is frequently prescribed for patients with diabetes, especially if diet and exercise have not been effective in controlling blood sugar levels.

This paper will discuss in detail the pharmacotherapy plan that supports the prescription of metformin. It will also discuss potential treatment-related outcomes such as dosing, drug-to-drug interactions, and possible treatment-related outcomes. We will discuss treatment goals and outcomes including monitoring and evaluation of treatment outcomes. Finally, we will make recommendations for continued therapy based upon patient factors and disease management (Sonesson Johansson Johnsson & Gause–Nilsson (2016)).

Talk about patient education regarding drug adherence.

Discuss the risks and benefits of drugs, and any conditions that might require a dose adjustment.

This paper will discuss 45-year-old patient in respite.

Pharmacotherapy plan supporting the choice and need to prescribe Metformin

Metformin is often accompanied by a list of patients, which is usually included in a treatment plan.

This 45-year-old patient in respite care must read all information carefully and make sure he understands it all before he takes the metformin.

Patients are encouraged to ask their doctors any questions at this stage.

The 45-year-old person should then follow the doctor’s meal plan.

This is a critical step, especially for managing a person’s illness, and it is necessary if the medicine works (Tahrani Barnett, Bailey, 2016).

It is important to do a controlled exercise program in a regular fashion while testing for sugar levels in the blood or urine of a patient.

Metformin should be taken with meals in order to reduce side effects such as upset stomach or bowel.

The patient must swallow the tablet, or the extended-release tablet. This is because some of the medication may pass through the stool of a 45-year-old patient.

This should not be considered a panic situation and should not be considered a problem.

You should swallow the tablet with a glass of water.

The oral liquid must be measured using a marked measuring spoon or syringe.

This is because an average household teaspoon might not hold enough liquid.

Patients should remember that they must only use the prescribed metformin.

This is because different brands of metformin may not be effective in treating diabetes.

The 45-year-old patient might notice some improvement within one to two weeks.

The full effect on blood glucose regulation can take nearly three months (Lu Min, Chuang Kokubo Yoshida, Cha, B2016).

A patient can ask their doctor any questions regarding this condition at this point.

You Will Need to Prescribe Metformin

There are many reasons that a doctor may need to prescribe metformin to diabetic patients.

Metformin is known to prolong the life expectancy of patients. This is why doctors will often prescribe it to them.

Research has shown that metformin is associated with nearly 24% lower rates of death in patients who take it.

Metformin can be used to normalize hypertension and weight loss.

It should be helpful to the patient in this instance, as he may have hypertension.

Metformin is a well-known medication that can improve the health of diabetics. It also preserves the kidneys.

Metformin should be prescribed in this light.

Metformin would be helpful to the 45-year-old patient in this case. It would also help to control diabetes and improve the body’s ability to produce insulin naturally.

Pharmacotherapeutic considerations in Relation to Dosing and Drug To Drug Interaction

Before deciding the amount of metformin to be administered, medical professionals must consider several factors.

Metformin dosages will differ for each patient.

You must follow all instructions on the label and the orders of your doctor.

If the dosage of a patient is different, it is forbidden to alter the order unless the doctor has given clear instructions.

The strength of the medicine will also affect the dosage.

The medical condition that the medicine was prescribed for is another factor to consider when dosing.

This determines the daily dose, time between each dose, and the total number of doses an individual takes each day.

Although it is not recommended to take certain drugs together, there may be instances when two or more medications are combined even though they could interact.

Sometimes doctors will alter the doses or take other precautions to protect patients in such situations.

It is crucial that a patient taking metformin tells their doctor if they are taking any other medicines.

Some medicines are not recommended to be taken with metformin.

These medicines include Iopanoic Acid and Diatrizoate as well as Iobenzamic Acid, Iopromide and Iodipamide.

There are some medicines that can be taken with metformin.

These medicines include Aspirin and Norfloxacin as well as Balofloxacin and Bupropion.

These medicines can increase the risk of side effects and it is not advisable to take them with metformin.

Primarily, amlodipine is not active as an individual agent but rather as an adjunct therapy to other agents.

This means that Amlodipine improves endothelial function and inflammation.

This medication may be beneficial in improving your cardiovascular health.

Metformin’s Diabetes Action

Metformin is an antihyperglycemic drug that improves glucose tolerance in type 2 diabetics over 45 years.

Metformin’s primary function is to lower the basal and postprandial plasma glucose.

This is a pharmacological action tool that is different from other antihyperglycemic drugs.

Metformin’s primary purpose is to decrease hepatic glucose and reduce the total absorption of glucose from the intestine. It also improves insulin sensitivity by increasing peripheral glucose uptake and utilization.

Metformin is not a sulfonylurea that causes hypoglycemia in patients with type 2 diabetes or in people in a healthy state.

Metformin: Expected Therapy Outcomes and Monitoring And Evaluation of Treatment Outcomes


Every medication strategy should be guided by a specific goal to achieve a desired outcome.

Metformin therapy can be viewed in this way. There are many goals.

The general goals of the therapy for diabetic patients are to reduce acute decompensation, preserve a high quality of life, and prevent or delay the appearance of any other late-onset illnesses and complications.

A patient must meet therapeutic goals in order to treat diabetes.

Glycosylated hemoglobin is often considered the best indicator of overall diabetes control. It provides information about the level of glycemic control, particularly the last two to three months. This index remains below 7 percent.

Patients with low life expectancy and older patients should be given a therapeutic target. This is because it has a higher chance of severe hypoglycemia.

It is important to remember that diabetes patients are most likely to die from ischemic heart disease.

The overall cardiovascular risk for diabetic patients can be as high as those who have not been diagnosed with diabetes or are already suffering from ischemic heart disease.

The overall target values for diabetic patients must be exact and similar to those required in patients with established coronary disease.

Desired Outcomes

Metformin can be used to treat type 2 diabetes in patients over 45 years of age.

Heart failure is becoming more common among diabetic patients.

This therapy has one goal: to reduce the chance of heart disease in patients with diabetes (Hadjadj. Rosenstock. Meinicke. Woerle. & Broedl. 2016).

Metformin therapy also has an impact on the patient’s quality of life.

Metformin therapy is designed to lower the risk of diabetes patients being exposed to other complications, such as heart disease.

Patients who are older than 65 years old should be concerned about their life expectancy.

The current therapy is expected to increase the patient’s overall life expectancy.

Metformin therapy is also intended to decrease cognitive impairment, or the overall cognitive status, of a patient over the long-term.

Metformin Treatment Outcomes Monitoring and Evaluation

It is crucial to monitor a patient’s progress, especially in the first few weeks after they start taking metformin.

This light is why it is important to take blood samples and perform urine tests to check for any unwanted side effects.

Metformin can interact with some dyes that are used in X-rays or CT scans.

Doctors should advise patients to stop taking metformin before they have any medical examination or other diagnostic test. This may result in a decrease in urine output.

In order to ensure good monitoring, it may be recommended to start metformin within 48 hours of an examination. This is in case the patient’s kidney function is checked and found to be normal.

It is also important that any doctor, dentist or nurse who is treating a diabetic patient knows that metformin is being used.

It is also a good idea to stop using metformin a few days before you have surgery or a medical test (Chrvala Sherr & Lipman 2016, 2016).

Sometimes, too much metformin can cause lactic acidosis.

This is why it is crucial to monitor a patient and get medical help before the situation gets worse.

It is evident that metformin can be used to control and treat type-2 diabetes. This evaluation was done by Shanbhogue, Mitchell Rosen, & Bouxsein (2016).

To achieve the desired outcomes, it is important to closely monitor patients on metformin therapy (Bilezikian and colleagues, 2016).

This is why doctors must be aware of every patient who is on metformin therapy.

This is how a successful and close monitoring process can occur.


It is true that lifestyle changes are a key factor in diabetes type 2, especially for older adults. This includes a focus on diet and exercise as well as lifestyle modifications such as changing your diet and increasing your overall physical activity.

Patients who have received a successful metformin response often struggle to maintain their targeted levels of glycated haglobin (A1C), especially after a period of three to five years.

Most patients will need to be prescribed a second medication if their individualized glycemic treatment goals or objectives have not been met after taking metformin and lifestyle intervention (Dujic, et al. 2016).

This decision is often based on A1C-examined outcomes, which are typically done after three to six months of the first therapy.

If patients fail to reach their goals on the first therapy, there is a range of recommended medications that can be used in conjunction with metformin.

These options include insulin, GLP-1 agonists, insulin, repaglinide and insulin (Kohler, et al. 2016).

Patients should be aware that each recommended medication has its advantages and disadvantages, especially in terms of their overall effect on a patient.

Patients with A1C greater than 8.5 percent or obstinate hyperglycemia (American Diabetes Association 2016) should be advised to add insulin.

GLP-1 receptor antagonist is an option. Basal insulin is still the preferred medication to be added to metformin therapy, especially when A1C is high.

There are also patients who have been diagnosed with a heart disease or other cardiovascular problems (Storgaard Bagger, Knop and Vilsboll & Rungby 2016, 2016).

This is why it’s possible to use a GLP-1 receptor antagonist that initially has cardiovascular benefits, while still assuming the desired outcome.

Patients with an A1C less than 8 should have their choice of second metformin individualized based on efficacy, comorbid conditions, weight and hypoglycemia. (Steven et. al., 2016).

Patients with inadequate glycemic control, especially on double therapy, should be given the same selection criteria as those for mono-therapy failure. They must also be given the opportunity to evaluate the overall efficacy of the treatment.

Patients who fail to reach their target A1C after the first dual therapy should be referred to insulin (Lipska Krumholz, Soones & Lee 2016, 2016).

Patients who are taking metformin or sulfonylureas in the early stages of insulin use may need to be tapered and discontinued.

The metformin should be continued in this instance.

Patients with a history or stroke or myocardial infarctions should be advised to continue taking metformin.

Patients who are close to achieving their glycemic goals should consider using three goals.

Patient Education in Relation to Drug Adherence

Medication adherence refers to whether or not a patient follows the doctor’s recommendations and whether or not they do so consistently (Sastre Vernooij Harmand, Martinez, 2017).

In recent years, the topic of non-adherence to medication has been gaining popularity, especially among pharmacists (Rosenstock and al. (2016)).

Even worse is the fact that only a small amount of medication adherence is measured in modern clinical practice.

It is therefore important to develop a reliable strategy for patient education regarding drug adherence.

There are many reasons why patients may not adhere to prescriptions. However, this does not mean that all prescription misuse is intentional (Softeland and co., 2016).

Unintentional non-adherence occurs when patients want to follow their treatment plan but are confronted with challenges they cannot control.

Engaging patients in prescribing drugs is one way nurses can reduce drug non-adherence.

This is why nurses can involve patients in the decision-making process, especially when issuing prescriptions (Goldstein & MullerWieland (2016)).

In this instance, it is possible to improve patient cooperation by using a collaborative approach.

Medical practitioners can make patients feel more involved in decision-making, which gives them a sense that they are in control of their recovery.

Car providers can also help with prescription compliance by creating a simple drug regimen.

Care providers can communicate with patients to clarify the details of a prescription and how it should be used (Tseng 2016, 2016).

Medical practitioners can then educate patients about the medication they have been prescribed and how they should be used.

It is also important to inform patients about possible side effects of a prescription (Nauck and al., 2016).

Metformin therapy can be very delicate so it is important for patients to know how to follow the prescribed prescription.

Non-adherence can be caused by forgetfulness.

Nearly half of patients who are prescribed medication forget to take it (Qaseem Barry Humphrey & Forciea 2017, 2017).

Nurses tend to use a common tool to help patients remember to follow their treatment plan, which includes voice and text messages, postal mails, emails, and voice messages (Chapman, Darling, & Brown, 2016,).

Nurses can remind patients to check their email regularly and follow their prescribed therapy.

To avoid confusion, nurses can assist patients in understanding the details of prescribed medication.

This is especially helpful for patients with complicated prescriptions that are spread throughout their day.

Risk and Benefit of Drugs, as well as the possibility that a Dose may be adjusted

There is no medicine that is completely safe. Every medicine can have side effects, which may sometimes be experienced by some patients (Gaede and al., 2016).

This is why the benefits of a medicine should always be greater than the risks.

Metformin is a great medication for diabetes type 2 because it has many benefits.

Metformin is thought to promote good gut bacteria growth (Chatterjee Khunti, Davies, 2017).

Recent research suggests that metformin may be able to alter the microbiota of the gut in a favored direction.

This is possible because metformin allows mucin-degrading to occur.

Metformin is also used to prevent pre-diabetes developing type-2 diabetes (Tian and co., 2016).

Pre-diabetes, especially those who are pre-diabetic, can be prevented by changing their lifestyle. This helps to prevent type 2 diabetes from happening.

Metformin also protects glaucoma patients.

Metformin has many benefits, which have resulted in its adaptation to medical discourses for diabetes. However, there are still some risks.

Metformin can cause some side effects in diabetic patients. These include diarrhea and gastrointestinal adverse reactions. This is a rare problem (Wu et. al., 2016).

Metformin’s life-threatening side effects are rare and should be avoided.


Diabetes has become a major problem in modern society. This can be largely attributed to lifestyle.

In addition to diet, obesity has been linked to a lack of exercise and poor physical activity.

Diabetes has mainly affected older people. In this example, the 45-year-old woman with cellulitis in her left is a case in point. This exposes people to risk such as stroke, heart failure, hypertension, and hypertension.

It is therefore important to establish measures that improve the quality and life of diabetic patients.

Metformin therapy has been used for diabetes control for many years.

Although there are some risks, the benefits of this medication outweigh them and make it an effective treatment for diabetes.

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