Question

Mrs. Sweet is a 44 year old women who has just been diagnosed with type 2 diabetes mellitus. She is 50lb overweight and is hypertensive, for which she takes metorolol (Lopressor). She is prescribed to take metformin (Glucophage) twice daily and aloglitpin (Nesina) once daily. She asks why she isn't prescribed insulin like her granmother, who also had "sugar." 1. What will you tell her about insulin therapy and why it isn't necessary for her at this time? 2. What class of drugs are metformin and alogliptin, and what are their possible side effects? 3. Is there any problem with taking these two different drugs for the same health problem? Why or why not 4. Are there any problems or interactions tha are likely with Mrs. Sweet's new drugs and her antihypertension therapy? 5. What will you teach this patient about her drug therapy>

Answer 1

1.Insulin is indicated if patient is diagnosed with type 1 diabetes because the pancreas responsible for producing insulin will not be able to produce it. This externally insulin is needed to be administered

In type 2 diabetes there is production of insulin in pancreas but it will not be able to be released ,so medication is sufficient to stimulate the beta cells of pancreas to release insulin and keep blood sugar under control.

As she is classified into type 2 insulin therapy is not recommended

2.Metformin

Classification :Biguanide

Side effects :

GIT:Nausea,vomiting,indigestion,constipation ,weight loss,flatulence ,lactic acidosis

Muscleculoskeletal:Muscle pain

General:Vitamin B12 deficiency,weakness

Respiratory :infection

CNS:Dizziness

Endocrine :low blood glucose

Alogliptin:Gliptin

Side effects :

GIT:abdominal pain ,nausea,vomiting,anorexia

Urinary tract:Dark

Sensory:blurred vision, icterus

CNS: dizziness

Endocrine :decreased blood glucose levels

Caution :abdominal pain ,dark urine, rash, dypnea to be reported immediately

3.When these both medications are combined it can lead to severe hypoglycemia which can be often fatal .Apart from this a severe complication is pancreatitis .

4.These drug can interact with antihypertensive drugs .There are chances of other cardiovascular issues .

5.The following teaching has to be provided

• Monitor blood glucose levels
• Stop in case of severe hypoglycemia, acute abdominal pain
• Avoid alcohol
• Avoid OTC medications
• Not to drive