NSG 6005 Advanced Pharmacology FL02 Week 2 Completed A

NSG 6005 Advanced Pharmacology FL02 Week 2 I would ask Ms. GM the reason for self-administration and herbal medicine including questions on feedback and overall health including any side effects from prescription medicines that would lead to her decision. I would also discuss the use of the Cassia cinnamon as it relates to compliance with prescription medications. Additionally, any log of glucose readings, signs of altered glucose, and dietary practices along with questions about any memory loss or forgetfulness if any. Cinnamon has the potential to be a useful add-on therapy in the discipline of integrative medicine in managing type 2 diabetes. The American Diabetes Association dispute the claim that cinnamon can be used to treat diabetes, however, cinnamon is safe and does not counteract prescribed diabetic medicines. At present the evidence is inconclusive and long-term trials aiming to establish the efficacy and safety of cinnamon is needed. However, high coumarin content of Cinnamomum cassia is a concern, but Cinnamomum zeylanicum with its low coumarin content would be a safer alternative (Medagama, 2015). Liver disease is an important cause of death in type 2 diabetes, as such, liver monitoring is essential when taking medications for type 2 diabetes. Some tests that would be completed for Ms. GM would include ALT, ULN, blood tests, also including scans of the liver and glucose tolerance (Irons, & Minze, 2014). For an alternative recommendation, I would recommend coumadin, which is an anticoagulant blood thinner. The main use of coumadin is useful in reducing the formation of blood clots. Proper dosage should be given to the patient as well as proper guidance on side effects. Some side effects include bleeding gums, blood in the urine, bloody stools, blurred vision, chest pain or discomfort, confusion and coughing up blood. Additionally, black box notes that coumadin can cause major or fatal bleeding. Coumadin is stereoselectively metabolized by hepatic microsomal enzymes to inactive hydroxylated metabolites predominant route and by reductases to reduced metabolites (Irons, & Minze, 2014). Ms. GM should be notified of these side effects and would be adviced to have regular checks up since this would be the first time using the medication. Additionally, it is recommended to limit foods in vitamin K. Nutrition and diet can affect your treatment with coumadin. Therefore, it is important to keep the vitamin supplement and food intake steady throughout treatment. Thus, increasing vitamin K levels in the body can promote clotting and reduce the effectiveness of coumadin (Irons, & Minze, 2014). For preventitative measures, the most cost-effective methods include getting regular physical activity and maintaining a healthy weight. This means following a healthy diet plan. A diet enriched with monounsaturated fatty acids and low-glycemic carbohydrates is recommended. Also, Ms. GM would also have regular visits to a healthcare provider if there are any questions, concerns about medication or overall health. I would also warn Ms. GM about keeping blood pressure within recommended limits, checking her glucose levels, keeping your low-density lipoprotein cholesterol and triglycerides levels low as well as warning against alcohol intake. Additionally, since oxidative stress has been shown to be important in the pathogenesis of NASH, I would recommend Ms. GM to try therapy with antioxidants (Loria, Lonardo, & Anania, 2013). Reference Irons, B. K., & Minze, M. G. (2014). Drug treatment of type 2 diabetes mellitus in patients for whom metformin is contraindicated. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 7, 15–24. Loria, P., Lonardo, A., & Anania, F. (2013). Liver and diabetes. A vicious circle. Hepatology Research : The Official Journal of the Japan Society of Hepatology, 43(1), 51–64. Medagama, A. B. (2015). The glycaemic outcomes of Cinnamon, a review of the experimental evidence and clinical trials. Nutrition Journal, 14, 108.