NURS 5334 Advanced Pharmacology Diabetic Case Study

NURS 5334 Advanced Pharmacology Diabetic Case Study: A Comprehensive Analysis

Introduction

Diabetes mellitus is a multifaceted endocrine disorder that necessitates a thorough understanding of pharmacologic interventions. In NURS 5334 Advanced Pharmacology, students encounter rigorous coursework that includes analyzing case studies to refine their clinical decision-making skills. The NURS 5334 Diabetic Case Study provides an in-depth evaluation of patient presentations, pharmacological treatments, and potential complications. This case study is instrumental in bridging theoretical pharmacology with practical patient care.

Pathophysiology of Diabetes Mellitus

Diabetes mellitus is categorized primarily into Type 1 and Type 2, with gestational diabetes and other secondary forms occurring in specific conditions. Type 1 diabetes results from autoimmune destruction of pancreatic beta cells, leading to absolute insulin deficiency. Conversely, Type 2 diabetes arises from insulin resistance coupled with a progressive decline in pancreatic insulin secretion. The NURS 5334 Advanced Pharmacology Syllabus ensures that students comprehend the cellular and molecular mechanisms underpinning these conditions, allowing for a strategic approach to pharmacological management.

Pharmacologic Management

Insulin Therapy for Type 1 Diabetes

For patients diagnosed with Type 1 diabetes, exogenous insulin remains the cornerstone of treatment. NURS 5334 Quiz 1 often evaluates the pharmacokinetics of various insulin preparations, including rapid-acting (e.g., insulin lispro), short-acting (e.g., regular insulin), intermediate-acting (e.g., NPH insulin), and long-acting (e.g., insulin glargine) formulations. Each insulin type has specific pharmacodynamic properties that dictate its administration and clinical use.

Oral and Injectable Agents for Type 2 Diabetes

Management of Type 2 diabetes encompasses an array of oral hypoglycemic agents and non-insulin injectables. NURS 5334 Quiz 2 challenges students to differentiate among drug classes, including:

• Biguanides (Metformin): First-line therapy that decreases hepatic gluconeogenesis and improves insulin sensitivity.

• Sulfonylureas (Glipizide, Glyburide): Stimulate pancreatic beta cells to secrete insulin, though with an increased risk of hypoglycemia.

• DPP-4 Inhibitors (Sitagliptin): Enhance incretin hormones to promote insulin release and inhibit glucagon secretion.

• GLP-1 Receptor Agonists (Exenatide, Liraglutide): Slow gastric emptying, promote satiety, and improve glycemic control.

• SGLT2 Inhibitors (Canagliflozin, Empagliflozin): Promote renal glucose excretion, reducing blood glucose levels independent of insulin.

Students often encounter these drug classes in the NURS 5334 Test Bank, reinforcing their ability to select appropriate pharmacotherapies based on individual patient presentations.

Case Study Analysis

A prototypical diabetic case study in NURS 5334 Advanced Pharmacology may present a 55-year-old male with uncontrolled Type 2 diabetes, hypertension, and dyslipidemia. The patient’s laboratory findings might include an HbA1c of 9.2%, fasting blood glucose of 200 mg/dL, and microalbuminuria.

Pharmacologic Plan

1. Initiation of Metformin: Given the patient’s elevated HbA1c and obesity, metformin is initiated at 500 mg BID, titrated to 1000 mg BID as tolerated.

2. Addition of GLP-1 Receptor Agonist: To enhance glycemic control and promote weight loss, liraglutide is introduced at 0.6 mg daily, increased to 1.2 mg based on response.

3. Hypertension Management: An ACE inhibitor (lisinopril) is prescribed to control blood pressure and mitigate nephropathy progression.

4. Lipid Management: A statin is recommended for cardiovascular risk reduction.

These interventions reflect evidence-based practices that students must master for the NURS 5334 Advanced Pharmacology Final Exam.

Complications and Drug Interactions

Pharmacologic treatments are not without risks. NURS 5334 Exam 3 delves into adverse effects such as metformin-induced lactic acidosis, sulfonylurea-induced hypoglycemia, and GLP-1 agonist-associated pancreatitis. Additionally, students explore drug-drug interactions, such as the potentiation of hypoglycemia with beta-blockers and the increased risk of lactic acidosis with concurrent use of iodinated contrast media.

Antimicrobial Considerations in Diabetic Patients

Diabetes predisposes individuals to infections, necessitating judicious antimicrobial use. The NURS 5334 Antimicrobial Recall Quiz tests students on the selection of appropriate antibiotics for diabetic foot infections, urinary tract infections, and pneumonia. Knowledge of renal dose adjustments and potential interactions with antidiabetic medications is crucial in these scenarios.

Conclusion

The NURS 5334 Diabetic Case Study is a pivotal learning tool, reinforcing the integration of pharmacological knowledge with clinical acumen. By understanding the nuanced management of diabetes, including drug selection, adverse effects, and complications, students are better equipped to deliver evidence-based patient care. The challenges posed in coursework, quizzes, and exams ensure that graduates of NURS 5334 Advanced Pharmacology emerge as competent and confident healthcare providers, ready to tackle the complexities of diabetic management in clinical practice.

Below are sample Questions and Answers:

Must have 5 prescriptions and no advice or other input. Just Drugs. Titrate and give
prescriptions for the titrate and match the days to the drug. Metformin 500mg once a
day for 2 weeks is #14, then 500mg twice a day is #28 then Metforming 1000mg once a
day for 2 weeks is #14 and then 1000mg twice a day for a month is # 60. These are
examples please verify your own work.
Advanced Pharmacology
Diabetic Case study
Jack a 47-year-old white male presents to your office for a follow-up visit.
He was seen 2 weeks ago for an upper respiratory infection and noted incidentally to
have a blood pressure of 164/98.
 He vaguely remembered told in the past that his B/P was “borderline”.
Labs were also done last visit and you are going over the results with him today.
He brings his B/P diary in and it is showing elevated pressures from 144/94 to 176/96
Today: V/S: Right arm: 172/98; Left arm: 170/96; P 76; resp 16; 70 inches tall ideal
body weight
weighs 210 ideal body weight
DOB: 3-12-77
Labs from last week: CBC normal; CMP normal; A1C 7.4; TSH normal; Lipids: Total
cholesterol is 250; LDL is 190; HDL 35 correct with diet; Trigs 170 correct with dietassess willingness…feels fine
He feels fine, has no complaints.
PMH
Broken arm at age 12.
Hernia repair 10 years ago
No eye examination for about 1.5 years-eye exam referral? How many years
Meds: zero
Allergies: NKDA
Fam hx:
Father died of stroke at age 69; diabetic
Mother alive at age 69 with HTN, DM
2 sisters ages 45 and 43; the older sister has DM
Social hx: Married. Son age 22 and daughter 20 both healthy. Sedentary job
(Accountant) does not exercise. Smokes 1ppd for 10 years. Has “a couple of beers
every weekend” – smoking cessation- AAAAA’s ? what are they
ROS:
Unremarkable except for above
Physical examination
No thyromegaly or lymphadenopathy
Fundoscopic exam is within normal limits
Cardiac exam: S1 and S2 are normal and no murmurs are auscultated
Lung and abdominal examinations are normal.