Pharmacology Paper
Jane is 28 years old. She is diagnosed with Diabetes mellitus Type 2 and severe hypertension. The history of her disease includes a wide range of health complications, but diabetes and hypertension remain the issues of the major medical concern. For many years, Jane has been able to control the level blood sugars. Active diet and exercise worked to improve her well-being. Nevertheless, she regularly takes a whole set of prescription drugs, including Norvasc, Cozaar, Avandamet, and Ortho Tri-Cyclen for contraception purposes.
Norvasc is indicated for treating hypertension in different groups of patients. It can either be used alone or in combination with other antihypertensive preparations. Beyond treating hypertension, Norvasc is well-known for being effective in treating chronic stable angina, and can also be used alone or with other antianginal agents (RxList, 2008b). Vasospastic angina and angiographically documented CAD are also listed among the major Norvasc indications. Cozaar is another effective component of a well-developed anti-hypertension therapy.
As in case of Norvasc, Cozaar can either be used alone or in combination with other antihypertensive agents, as well as diuretics (RxList, 2008a). Cozaar works to reduce stroke risks in patients diagnosed with both hypertension and left ventricular hypertrophy; in type 2 diabetic patients, Cozaar is expected to treat diabetic nephropathy combined with proteinuria and elevated serum creatinine (RxList, 2008a). Cozaar is particularly effective for patients with combined history of hypertension and diabetes type 2.
In case of Jane, and beyond the need to control the development and treatment of hypertension, she should constantly monitor the level of sugars in her blood. She was prescribed Avandamet as “an adjunct to diet and exercise to improve glycemic control” (Drug Library, 2008). Avandamet is usually prescribed to patients, who could not be adequately controlled with metmorfin. The use of Avandamet, however, does not replace the need for diet control in patients with Type 2 diabetes mellitus. Jane effectively combines the use of Avandamet with diet, exercise, and continuous calories control.
Due to the fact that the safety and effectiveness of Avandamet as the instrument of initial medical intervention has not been established, this medication should work only in combination with related therapeutic approaches, including weight loss. For the purposes of contraception, Jane is also prescribed Ortho Tri-Cyclen. The tablets are indicated to prevent pregnancy in women. Very often, this type of medication is used to treat mild acne in teenagers and adult females. The effectiveness and reliability of oral contraceptives depends on whether a woman uses them correctly and consistently (USA Today, 2008).
Jane seems satisfied with the complex of medical preparations she regularly takes to resolve her health and personal issues. However, she should not forget about potential side effects, which each of these drugs may produce. For Norvasc, and with the doses that do not exceed 10mg daily, patients do not usually display any adverse effects, although these may include edema and headache (RxList, 2008b). For Cozaar, the list of adverse effects is much bigger and includes fatigue, edema, chest pain, abdominal pain, headache and nausea, diarrhea and insomnia (RxList, 2008a).
All groups of patients regardless their race, age, and gender are vulnerable to these side risks. Small decreases in hemoglobin and occasional serum bilirubin elevation are also associated with Cozaar. In case of Avandamet, and when combined with similar diabetes agents, patients are more likely to develop hypoglycemia symptoms (Drug Library, 2008). Small numbers of patients show edema and anemia, but for Jane neither of these side effects has even been relevant. Given that contraceptives are likely to cause breakthrough bleeding or amenorrhea, Jane should be particularly attentive to these dysfunctional signs and symptoms.
None of the prescribed drugs Jane currently takes is known for having significant drug-drug interactions and impacts. Norvasc does not have any significant effect on either human plasma protein or warfarin. Cimetidine, Maalox, and Digoxin can also be safely combined with Norvasc. In case of Cozaar, “no significant drug-drug pharmacokinetic interactions have been found in interaction studies with hydrochlorothiazide, warfarin, cimetidine and digoxin” (RxList, 2008a). Avandamet, however, displays serious interactions with metformin, nifedipine, and cationic drugs.
The effects of coadministration in these drugs should be taken with caution. Finally, hypertension and the need to take contraceptives may become the cause of pharmacological conflict, for antihypertensive agents may decrease effectiveness of oral contraceptives. However, Jane never reported any adverse effects or problems with any of the prescribed drugs she takes. None of these drugs display any interactions with food, and are equally effective when taken with or without food.
In the context of hypertension symptoms, and seeking to increase the effectiveness of traditional medication, Jane also takes Hypernil – a herbal supplement to her diet that works to support balanced blood pressure (Zion Herbs, 2008). It is an effective combination of Asian herbs, which as stated, does not have any side effects. Hypernil does not display any serious interactions with either food or other drugs which Jane currently takes. She supposes that Hypernil significantly increases effectiveness of Norvasc and Cozaar which she takes to lower her blood pressure.
Jane is one of those who are well aware of indications, side effects, and dosage for each prescribed drug she takes. She is well informed about possible interactions, and realizes the dangers which contraceptives may create with regard to her hypertension. Although my interview with Jane was overfilled with useful information about the medication course she has been prescribed, she seems to have extensive practical experience, which is also understandable in her health state. Conclusion
The combination of type 2 diabetes mellitus and hypertension requires that medical professionals thoroughly reconsider all potential drug-drug interactions and side effects each drug may cause on patients’ health. More importantly, medical professionals are to prescribe drugs in ways that do not decrease their effectiveness, but make them work together to increase efficiency of all medical interventions. References Drug Library. (2008). Avandamet. HealthCentral. com. Retrieved May 7, 2009 from http://www. healthcentral. com/druglibrary/408/avandamet-drug_description.
html RxList. (2008a). Cozaar. The Internet Drug Index. Retrieved May 7, 2009 from http://www. rxlist. com/cozaar-drug. htm RxList. (2008b). Norvasc. The Internet Drug Index. Retrieved May 7, 2009 from http://www. rxlist. com/norvasc-drug. htm USA Today. (2008). Ortho Tri-Cyclen. USA Today. Retrieved May 7, 2009 from http://www. healthscout. com/rxdetail/68/62/7/main. html Zion Herbs. (2008). Hypernil. Zion Herbs. Retrieved May 7, 2009 from http://www. corporate. zionherbs. com/index. php? page=products&theme=1&sess_id=16ab2036a6b059e30abdba844963cbbc
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