Role as a Nurse Practitioner for prescribing medication

Presentation: Utilization of Metformin in Type 2 Diabetes Management Drug Information: - Brand Name: Glucophage - Generic Name: Metformin - Drug Class: Biguanide - Pharmacology: Decreases hepatic glucose production, increases insulin sensitivity, and enhances peripheral glucose uptake. - Pharmacokinetics: Absorbed in the small intestine, excreted unchanged through the kidneys. Dosing: - Initial dose: 500 mg twice daily or 850 mg once daily with meals. - Maintenance dose: 1500-2000 mg daily in divided doses. - Maximum dose: 2550 mg/day. Indications for Use: - Type 2 diabetes mellitus to improve glycemic control. Side Effects: - Gastrointestinal disturbances (nausea, diarrhea) - Lactic acidosis (rare but serious) - Vitamin B12 deficiency Contraindications: - Renal impairment - Hepatic disease - Alcoholism Pregnancy Class: - Category B Cost Analysis: - Average cost for a month's supply of generic metformin: $4-$20 - Average cost for a month's supply of brand-name Glucophage: $30-$100 Patient Case Study: - Patient: Mr. T, a 55-year-old male with newly diagnosed type 2 diabetes. - Medical History: Hypertension, hyperlipidemia. - Presentation: Elevated fasting blood glucose levels. - Treatment Plan: Initiate metformin therapy at 500 mg twice daily with meals. Peer-Reviewed Studies: 1. Study by UK Prospective Diabetes Study Group: Demonstrated the efficacy of metformin in reducing macrovascular complications in overweight patients with type 2 diabetes. 2. Research by American Diabetes Association: Found that metformin is associated with a lower risk of cardiovascular events in diabetic patients compared to other oral antidiabetic agents. Patient Education: - Educate Mr. T on the importance of taking metformin with meals to reduce gastrointestinal side effects. - Emphasize the need for regular monitoring of blood glucose levels and potential vitamin B12 deficiency. - Provide dietary recommendations and encourage regular exercise to enhance the drug's effectiveness. Nurse Practitioner Role: - As a Nurse Practitioner, prescribing metformin to Mr. T involves assessing his medical history, monitoring treatment response, and adjusting doses as needed. - Educate Mr. T on proper medication administration, potential side effects, and the importance of adherence to treatment. Monitoring and Follow-Up: - Schedule follow-up appointments to monitor glycemic control, assess side effects, and adjust treatment as necessary. - Monitor renal function regularly due to metformin's potential impact on kidney function. - Collaborate with other healthcare providers to ensure comprehensive diabetes management for Mr. T. In conclusion, metformin (Glucophage) is a cost-effective and commonly prescribed medication for type 2 diabetes management. By understanding its pharmacology, indications, side effects, and monitoring requirements, Nurse Practitioners can effectively prescribe and monitor metformin therapy for patients like Mr. T, promoting optimal glycemic control and improved long-term outcomes in diabetes management.

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