Discuss insulin glargine, listing any potential benefits this therapy may offer and the specific aspects of the formulation in relation to its action. Include appropriate counselling points regarding the administration of this agent.

I’ve attached a file that contains all my instructions and case study.

Therapeutics Endocrine and Metabolism Endocrine Case Studies

My main Instructions:

1- Below is1 case study relating to Pharmacy Practice and Therapeutics Endocrine Case Study.

2- This assessment is worth 80% of my final grade in my subject. It has a strict limit of 1000 words (range 900 to 1200), not including any inserted items (table, diagrams) or references.

3- Please answer the questions carefully accompanying each clinical scenario, and reference the answers well.

4- You are required to answer the specific questions associated with the following cases.

5- Please consider each aspect and address the issues in terms of providing the best available pharmaceutical care.

6- Support your responses through appropriate research, using various sources (i.e. not just text books, but also journal articles). .

8- You are to pay particular attention to proper referencing, both in text, as well as at the end of your assignment.

9- Please make sure to answer the question more academic and more more professional.

Case study:

MR RS a 46yr old retired hobby farmer who developed an infected wound following a mid-foot amputation. It presented as a fungating ulcer with clear signs of infection and inflammation to the mid-foot area. He was sent to theatre for further debridement of wound.

Medications on admission Amlodipine 10mg in the morning

Atenolol 50mg daily

Metformin 500mg twice a day

NovoRapid 25 units mane, 20 units noon, 25 units nocte

Prazosin 1mg twice a day

Ramipril 10mg daily

Simvastatin 40mg at night

BP 156/74 Creatinine 144 μmol/L (60 – 110 μmol/L)

eGFR 40 mL/min/1.73 m2

Nil tobacco, Alcohol occasionally

Mr RS developed hyperglycaemia post-surgical procedure.

He was commenced one insulin glargine (Lantus) 34 units mane and 20 units nocte whilst in hospital. Other medications and adjustments made during admission were as follows.

Cephalexin 500mg orally QID

Sitagliptin and Metformin (Janumet) 50/500mg BD

Metformin 500mg BD

NovoRapid 14 units TDS (before meals)

Ibuprofen 400mg three times a day and Oxycodone 5mg to 10mg every 3 hours when needed for severe pain.

Questions: Your answers according to information in this case study.

Describe the microvascular and macrovascular issues in diabetes and how these may have impacted Mr RS.
Discuss diabetes management in relation to his surgical procedure.
Discuss insulin glargine, listing any potential benefits this therapy may offer and the specific aspects of the formulation in relation to its action. Include appropriate counselling points regarding the administration of this agent.
Discuss the new oral medication for this patient and any concerns that you would have with its use specifically in this patient taking into account the information presented?
What considerations need to be made regarding this patient’s pain relief?

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