Gami is a 48-year-old who you discover when completing a health history is taking cinnamon to treat Type II Diabetes. She is specifically using cassia Cinnamon. You also discover that she is taking Ginseng to assist with memory. Her prescribed medications are Aricept and Coumadin.
Ms. GM is a 48-year-old who presents to your clinic to establish care. During the health history, you learn that she has a history of Type II Diabetes. When asked about prescription and non-traditional medications, she reports being prescribed Aricept, Coumadin, Cassia cinnamon for Type II Diabetes and Ginseng for memory.
- Is there any additional subjective or objective information you need for this client? Explain.
- What would be your position on the Ms. GMs use of alternative supplements for her diabetes and memory? Explain and include contraindications, if any.
- Are there any additional test/assessments you would complete for this patient given this list of medications? Explain.
- How might your treatment plan, in terms of medications, differ for this patient? Include the class of the medication, mechanism of action, route, the half-life; how it is metabolized in and eliminated from the body; contraindications and black box warnings.
- What health maintenance or preventive education is important for this client based on your choice medication/treatment?
Expert Solution Preview
Introduction: This case presents a patient who has Type II diabetes and is taking prescription medications along with alternative supplements to manage her condition. As a medical professional, it is essential to evaluate the patient’s current health status and determine the best course of treatment for optimal health outcomes.
1. Is there any additional subjective or objective information you need for this client? Explain.
Yes, additional information is needed to properly evaluate the patient’s health status and determine the effectiveness of her current treatment plan. Objective information such as blood glucose levels, HbA1c levels, and current medication dosages would be useful. Subjectively, questions regarding the frequency and duration of the use of alternative supplements and any side effects experienced must be asked.
2. What would be your position on Ms. GM’s use of alternative supplements for her diabetes and memory? Explain and include contraindications, if any.
While alternative supplements may have potential benefits in disease management, their effectiveness and safety have not been scientifically proven. Therefore, it is essential to caution patients regarding their use and consult with a healthcare provider before starting any new supplement(s). In this case, cassia cinnamon has been shown to have potential blood-thinning effects, which can be problematic when combined with Coumadin. Ginseng may also have potential blood sugar-lowering effects, which can be hazardous when combined with diabetes medications. Therefore, Ms. GM’s use of alternative supplements must be closely monitored and adjusted accordingly.
3. Are there any additional test/assessments you would complete for this patient given this list of medications? Explain.
Yes, additional tests and assessments would be necessary to manage Ms. GM’s conditions. Blood tests to monitor glucose levels and coagulation levels must be performed regularly alongside annual eye and foot examinations for diabetic patients. Additionally, monitoring and managing potential side effects of Aricept and Coumadin, such as gastrointestinal bleeding, dementia, and cognitive impairment, is critical.
4. How might your treatment plan, in terms of medications, differ for this patient? Include the class of the medication, mechanism of action, route, half-life; how it is metabolized in and eliminated from the body; contraindications, and black box warnings.
The treatment plan for Ms. GM would be tailored to her specific conditions and needs. Insulin therapy and oral hypoglycemics may be necessary to control blood glucose levels. Coumadin may also need to be adjusted or substituted with an alternative anticoagulant that doesn’t interact with cinnamon. Alternatives to Aricept may be necessary if the patient experiences adverse side effects. The route of administration and dosage of chosen medications will be based on the patient’s age, weight, and renal and hepatic function. Contraindications and black box warnings must also be considered to avoid adverse drug reactions.
5. What health maintenance or preventive education is important for this client based on your choice medication/treatment?
Patient education on proper medication administration, avoiding potential drug interactions, and the importance of regular medical checkups and blood glucose monitoring is critical for optimal health outcomes. Additionally, Ms. GM must be educated on lifestyle modifications such as diet, exercise, and smoking cessation that can improve her diabetes management and overall health.