Professional Documents
Culture Documents
PRESENTED BY:
Cristine Joy Ponseca Alcones
OBJECTIVES
1. Define hypertension and identify the risk factors and
complications of hypertension.
2. Define Diabetes Mellitus, outline the risk factors.
3. Discuss the current medications prescribed
• Glipizide
• Metformin
• Beta Methasone
4. Explain the rationale for starting Mrs Goh on insulin therapy.
5. Discuss Prednisolone and the responsibilities in administering
it.
6. Explain the rationale for the discontinuation of Prednisolone .
7. Discus the mechanism of action and key patient education
points with regards to Mrs Goh’s oral anti diabetic drugs.
CASE STUDY
Name :Mrs Ivy Goh
Age : 66
Gender : Female
Ethnic : Chinese
Date of Admission : 22nd of May
Drug Allergy: NKDA
Social History :House wife, stays with her son’s family. Helped to look after four
grandchildren during weekdays. Occasionally visits the casino during the weekends.
Medical History : Well controlled DM for the past 9 years, severe dermatitis
(developed about two weeks ago) due to the unknown application of topical medication
for the rashes on her back. Doctor prescribe prednisolone and beta metasone 1%.
Chief Complaints :
•Passing of abnormally large quantity of urine, especially at night.
• Accompanied with the need of drinking large amount of water.
•2 days ago She complained that her vision is blurring with this she constantly have to
rub her eyes as she had difficulty focusing.
CASE STUDY
Physical Examination:
•Blood Pressure 146/82
•13.8 mmol/L (2 HR post prandial blood glucose level)
•12 ECG – no signs of myocardial infarction.
•Chest X-ray – no evidence of cardiomegaly
Impression/Diagnosis
•Hypertension
•Diabetes Mellitus
Current Medication
•Betamethasone 1% cream om
•Glipizide 5mg BD
•Metformin 850 TDS
•Prednisolone 20mg OM
Treatment
•Stop Prednisolone immediately, start short term insulin therapy
HYPERTENSION
Definition
Medical condition in which increase force that moves blood around the body
Risk factors
high blood overweight (BMI of
smoker DM
cholesterol levels 23kg/m2 or higher).
Complications
coronary heart
heart failure stroke arteriosclerosis kidney failure
disease
DIABETES MELLITUS
• Diabetes is a chronic disease, which occurs when
the pancreas does not produce enough insulin, or
when the body cannot effectively use the insulin it
produces. This leads to an increased concentration
of glucose in the blood (hyperglycaemia).
SIGNS AND SYMPTOMS OF
DIABETES MELLITUS
• Unusual thirst (polydipsia)
• Excessive hunger (polyphagia)
• Frequent urination (polyuria)
• Unusual weight loss (emaciation)
• Extreme fatigue or lack of energy
• Blurred vision,
• Frequent or recurring infections,
• cuts and bruises that are slow to heal,
• tingling &/or numbness in hands &/or feet.
TYPES OF DIABETES
MELLITUS
Type 2:
(formerly called non-insulin-dependent or adult-onset diabetes) is caused
by the body’s ineffective use of insulin. It often results from excess body
weight and physical inactivity.
Risk factors:
• Obesity, family history
• Age group >35
START SULFONYLUREAS
CONTROLLED
NOT CONTROLLED WITH ADEQUATE DOSAGE
• It also causes to increase the blood sugar level in the blood as a result elivation of
the diabetes mellitus will occur.
• Prednisolone has a drug interaction with the anti diabetic drugs
therefore the doctor ordered to stop taking this medication.
• The main important key point when educating the patient taking glipizide is to take
it 30 minutes before the meal to achieve better result
• The patient must know the signs of hypoglycaemia such as sweaty palm.
• Avoidance of alcohol is necessary to prevent elevation of blood sugar level.
REFERENCES
• Minitry of Health (2006). MOH clinical practise guideline: Diabetes mellitus.
Singapore: Ministry of Health.