Question

AR is a 46yo African-American male who presents to his doctor with excessive thirst, urination, and hunger for the past 2 months. Other past medical history includes obesity, hypertension, hyperlipidemia, and occasional tension headaches. He is a non-smoker and participates in minimal weekly cardiovascular activity. He is currently taking hydrochlorothiazide 25mg daily, atorvastatin 20mg QHS, acetaminophen 500mg daily PRN pain. Pt denies any drug allergies. His doctor draws fasting labs with the following results: Glucose 168, Scr 1.01, BUN 14, Hemoglobin A1c 7.4, TSH 1.23, Total Cholesterol 208, LDL 165, and HDL 42. Vitals include: BP- 145/83, HR- 78bpm, temp- 98.6, height 65 inches, and weight 85kg. He is diagnosed with type 2 diabetes.

1. What medication would likely be started in this patient to treat his diabetes? (fill in the blank)

2. What would be the starting dose? Select all that apply.

a. IR-500mg BID

b. 10mg BID

c. 850mg daily

d. 10 units with breakfast

e. 15mg daily

Can someone please help me with these questions.

Answer 1

Type 2 diabetes mellitus is a chronic metabolic disorder that affects the normal metabolism of sugar in the body.

Adult onset of diabetes is called type2 diabetes mellitus, but nowadays more children are also getting affected with this condition due to obesity in them.

symptoms are polyurea in which excessive urination occurs, polyphagia in which excessive hunger is seen and polydipsia is the condition of feeling more thirsty than normal.

it develops due to a decrease in the production of insulin in the body or the body becomes resistant to the insulin or both, some other factors like overweight, genetic, or environmental factor, etc.

above condition says that the patient has type 2 diabetes mellitus along with obesity and hypertension for which he is getting treatment as well.

hydrochlorothiazide is the diuretics the patient takes to treat hypertension and also the swelling associated with it.

atorvastatin is the lipid-lowering agent used to reduce the cholesterol level.

acetaminophen is antipyretics and analgesics used for headache

1 answer.

the drug that is to be started in type 2 diabetes mellitus is biguanides it is metformin ( Glucophage), its action is to decrease the production of glucose by the liver and makes the cell more sensitive to the insulin.

  2. answer.

A) initially, 500 mg   of IR   metformin is prescribed to the patient with type 2 diabetes mellitus,

doses are 500 mg PO Q 12 HOURLY IS PRESCRIBED,

SO OPTION 1 CAN BE CONSIDERED AS THE STARTING DOSE OF METFORMIN.

B) For the adult client, the minimum dose of metformin is 500 mg so the option B CANNOT BE CONSIDERED.

C) As the client is obese so, for obese client metformin 850 mg once daily is prescribed when the diabetes is not managed by exercise and dietary control, but the initial dose is 500 mg, and the dose of 850 mg starts gradually when no control over diabetes is gained by 500 mg.

D) 10 UNITS OF INSULIN DAILY IS GIVEN TO THE PATIENT DURING BEDTIME OR MORNING TIME, BUT IT IS NOT RECOMMENDED FOR THE START AND ALSO IT SHOULD BE STARTED WHEN GLUCOSE IS NOT CONTROLLED WITH ORAL MEDICATIONS, BUT INITIALLY, IT SHOULD BE CONTROLLED WITH ORAL DRUGS.

E) PIOGLITAZONE AND METFORMIN ARE THE TWO MAIN DRUGS WHICH IS USED IN COMBINATION TO CONTROL BLOOD GLUCOSE LEVEL IN TYPE 2 DIABETES AND ALSO WHEN PATIENT IS NOT USING INSULIN,

PIOGLITAZONE IS THE DRUG WHICH IS USED TO CONTROL TYPE 2 DIABETES MELLITUS BUT DOESNT CURE IT.

PIOGLITAZONE IS THE DRUG WHICH IS GIVEN AS THE STARTING DOSE WITH 15 TO 20 MG DAILY WITH METFORMIN.

SO, OPTION ( E ) CAN BE CONSIDERED.

FINALLY, OPTION (A ), (C ), AND ( E) WILL BE THE RIGHT ANSWER.