In order to ascertain the reasons for polypharmacy, an interview was conducted with a client who takes several medications at once. Every precaution was taken to ensure the interviewee’s comfort, including the lack of recording equipment and information privacy. A client is a man struggling with Type 2 Diabetes, which is a disease, with numerous misconceptions about the choice of medicine used in treating it. The goal of the interview was to disclose the rationale behind the client’s use of medication.
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The interview yielded several noteworthy details about the client. The medications in use were glipizide and metformin. Glipizide is a sulfonylurea, which lowers blood sugar, while metformin is a biguanide, which also decreases blood sugar. Both are common antidiabetic drugs used in the long-term treatment of Diabetes (Gedawy, 2020). This is exactly the client’s case, as he has been taking these drugs for almost five years.
The interviewee referred to his doctor as the reason why he started taking glipizide and metformin. At the same time, the client explained that the main health issue of Diabetes is the excess sugar in the blood. He also recalled the doctor’s explanations about insulin as the key to maintaining glucose. Once the body loses the ability to properly use insulin, blood sugar rises. This is why the doctor initially prescribed metformin but then added glipizide.
The client asked some clarifying questions concerning the compatibility and the effectiveness of glipizide and metformin. The doctor explained in a clear and concise manner that it is a normal practice to combine these drugs. However, the client was left unsatisfied with the answer to the question about effectiveness. Despite the doctor’s assurance of the results produced by taking these medications, the interviewee felt doubtful of their usefulness. He shared his concern that the doctor was merely following the clinical practice guidelines without actually considering the real state of affairs.
Nevertheless, the interviewee said that he was anxious about purchasing any medications without the doctor’s prescription. Therefore, he was following the doctor’s instructions to the letter. As such, he takes metformin twice a day, with the evening and the morning meals. Glipizide is taken each day thirty minutes before breakfast.
The major difficulty was taking glipizide precisely thirty minutes before breakfast. The subsequent problem was that he constantly missed the appropriate time because there was no set time for his breakfast. The interviewee has confided that sometimes, he experiences diarrhea. The first time it became evident, the client stopped taking the medications on his own, which was the only instance when he acted without the doctor’s permission.
The client was afraid that he would damage his intestines if he continued taking medicine. The doctor explained that diarrhea is a common side effect, and it can be managed with antidiarrheal medicine, such as Imodium. The only reason for the client to stop taking medicine is if it continues to appear ineffective. Finally, the client commented that although the medicine did not produce any immediate results, at least it was predictable, and the side effects were manageable.
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The goal of this teaching plan is to educate the client on polypharmacy, its consequences for the organism and how to manage them. It is evident from the client’s interview that all inconveniences are caused by his lack of knowledge about the medications, which resulted in the irrational following of the doctor’s instructions. Therefore, raising the client’s medicine awareness is key in enabling him to resolve his issues.
The first strategy is educating the client on the general conditions of Type 2 Diabetes. Knowing how the disease usually manifests and its causes are essential in ascertaining the most effective treatment. The second strategy is teaching the client to analyze the medications so that he could decide what to use without consulting the doctor. By simply studying the necessary information on the educational resources, the interviewee could avert several of his problems.
First, the US Food and Drugs Administration has free pdf brochures and articles available for download (Educational resources: Ensuring safe use of medicine, n.d.). Second, WebMD Medical Team provides accurate information about medication, with a list of possible side effects (Glipizide, n.d.). Lippincott NursingCenter has a database containing journals, articles, and blog posts on the variety of diseases, including Diabetes (Patient education – Tools for the patient, n.d.).
Overall, there are several instructions the client should follow regarding glipizide and metformin. First, it is important to realize that thirty minutes rule is not obligatory, however, the glipizide should be taken before breakfast, whereas metformin should be taken twice a day with a meal. Second, the dosage for glipizide is 5 mg, while for metmorfin, it is 500 mg. Third, possible adverse effects include hypoglycemia, constipation, diarrhea, nausea, weakness, and headache.
A possible adverse effect precipitated by the adherence to these medications is hypoglycemia. In essence, it is Diabetes reversed, meaning that blood sugar is lower than the norm. It can be overcome with the consumption of fast carbohydrates and glucose. It is possible for family members to insist upon regular checks of the client’s blood sugar level and the necessary action if it is not controlled.
Educational resources: Ensuring safe use of medicine (n.d.). Web.
Gedawy, A., Al-Salami, H., & Dass, C. R. (2020). Advanced and multifaceted stability profiling of the first-line antidiabetic drugs metformin, gliclazide and glipizide under various controlled stress conditions. Saudi Pharmaceutical Journal, 28(3), 362-368. Web.
Glipizide. (n.d.). Web.
Patient education – Tools for patients (n.d). Web.