Diabetes and Kidney Failure Approaches to Care Case Study

Pharmacology Case StudiesScenario 1: Mary\'s Hypothyroidism ManagementProblem DescriptionMary, aged 35, has been diagnosed with hypothyroidism, as evidenced by an elevated Thyroid-Stimulating Hormone (TSH) level of 20. Alongside, she suffers from iron deficiency anemia, as indicated by low MCV, MCHC, Ferritin, and high Total Iron Binding Capacity (TIBC) values. Her current regimen includes non-prescription Kelp tablets, ibuprofen as needed, and a contraceptive pill.Medication PrescriptionGiven Marys high TSH levels and symptoms, I would initiate treatment with Levothyroxine to regulate her thyroid function (Wilson et al., 2021). An appropriate starting dose considering her condition (assuming she weighs around 70 kg) would be the following prescription.Medication OrderLevothyroxine 75 mcg orally, once daily in the morning on an empty stomach, do not eat for 30 minutes post-administration.Monitoring and Follow-UpMonitoring would involve checking TSH and free T4 levels in 6-8 weeks post-initiation to adjust the dosage accordingly. Continuous monitoring every 6-12 months after stabilization would be necessary (Ross, 2022).Patient EducationMary should be informed about the importance of taking Levothyroxine alone, without other concurrent medications or supplements, especially iron, which can interfere with its absorption (Wiesner et al., 2021). The necessity of consistent daily intake at the same time each day should be emphasized to ensure effective treatment of hypothyroidism.ReferencesRoss, D. S. (2022). Treating hypothyroidism is not always easy: when to treat subclinicalhypothyroidism, TSH goals in the elderly, and alternatives to levothyroxine monotherapy.Journal of Internal Medicine,291(2), 128-140.Wiesner, A., Gajewska, D., & Pa?ko, P. (2021). Levothyroxine interactions with food and dietarysupplementsa systematic review.Pharmaceuticals,14(3), 206.Wilson, S. A., Stem, L. A., & Bruehlman, R. D. (2021). Hypothyroidism: Diagnosis andtreatment.American family physician,103(10), 605-613.Scenario 2: Joe\'s Type II Diabetes and Renal ConcernsProblem DescriptionJoe, a 48-year-old male with Type II Diabetes Mellitus, presents with poorly controlled blood glucose levels as indicated by a fasting blood glucose of 225 mg/dL and HbA1c of 7.5%. Additionally, he has chronic kidney disease (CKD) with an eGFR of 28 and elevated creatinine levels.Treatment Plan and MedicationsGiven Joe\'s diabetic condition coupled with CKD, a careful choice of antidiabetic medication is crucial. Metformin is generally first-line; however, his renal function prohibits its use (Song et al., 2021). A suitable alternative would be:Medication OrderDapagliflozin 10 mg orally, once daily before breakfast.Monitoring and Follow-UpJoe\'s response to Dapagliflozin should be closely monitored through regular kidney function tests and HbA1c levels every 3 months to assess efficacy and kidney health (Jabbour et al., 2020). Blood pressure and…

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…Pharmacology Case StudiesScenario 1: Mary\'s Hypothyroidism ManagementProblem DescriptionMary,…