Advancedpharmacology
The alternative and complementary medicines refer to all healthcareservices administered outside the scope of conventional medicine.Several theories have shown that CAMs control various diseases but itis yet to be proved through more research (Salomonsen et al.,2011). Research analyses have shown that CAMs contraindicate withcertain prescriptions and diagnosis. This is well explained in thisstudy case below.
CAMsContraindicated to the Prescriptions
Coenzyme Q.10 is known to lower the blood pressure. Mr. NX is onmedication to control the high blood pressure. A combination ofcoenzyme Q.10 and the prescribed drugs will cause too low bloodpressure because he will be using an overdose of the prescription.Some herbs are also to known to reduce the blood pressure (Ekinci etal, 2011). Mr. NX is using kava kava which might also contributeto excessively low blood pressure instead of regulating the bloodpressure to normal. The current prescription lisinopril, which isused to control high blood pressure, helps also to control thecondition in diabetic type 2 patients this might lead to too lowblood glucose because Mr. NX is under the prescription of otherdiabetic drugs such as glyburide. Lisinopril works by relaxing theblood vessels and results to the widening of the blood vesselsbecause it is an angiotensin enzyme inhibitor. Lisinoprilcontraindicates with glyburide, it should not be used by diabeticpatients as it results in an adverse effect. Glyburide is alsoassociated with weight gain leading to constriction of muscles whichresults in an increase in blood pressure.
CAMsContraindicated with the Diagnosis
CAM contraindication is exhibited with the control of highblood pressure. Mr. NX uses Creatine, which is known for causinghypertension. Creatine affects kidneys properties of sodium and waterretention. High dosage leads to an increase in the levels ofdeoxycorticosterone, which is a mineralocorticoidfound in theadrenal glands of the kidney. This leads to an increase in the sodiumlevel in the body which results in an increase in water retention.This condition results in an elevation in the blood pressure.Research results explain that bodybuilding doses result in a rise inthe level of sympathetic hormones, the epinephrine, andnorepinephrine (Salomonsen et al., 2011). The increase in thishormones results in an increase in smooth muscle contraction in thearteries, which eventually lead to an increase in the blood pressure.This CAM contradicts Mr. NX diagnosis to lower the blood pressure andinstead increases the blood pressure.
On diabetes type 2, creatine is known to cause insulinresistance. This causes problems in glucose movement into the bloodstream. This would cause a more severe condition to Mr. NX. He wasalso diagnosed with recurrent DVT which is caused by the use ofcoenzyme Q 10. This contradicts his diagnosis of deep veinthrombosis.vessels because it is an angiotensin enzyme inhibitor.
Prescriptionfor Back Pain
Use of non-steroidal anti-inflammatory drugs such as naproxen 2mgdaily and Motrin 3mg. muscle relaxants can also be used (Cherkin etal, 2013). Most health care providers encounter the trouble onthe choice of the most effective drug. In making treatment thepatient and the health care provider must discuss on druginteraction, drug cost and the side effects caused by the drug. Thebest treatment is assumed to be the one that works best with theleast side effect. Angiotensin receptor blocker drugs can be used tocontrol the high blood pressure for example captopril. In addition tocontrolling high blood pressure, the drug also lowers the glucoselevel. Mr. NX is also advised to take a healthy diet, reduce saltintake and get involved in exercises. Recurrent DVT should becontrolled by avoiding coenzyme Q.10 supplement.
Changesin Prescribed Drugs
Changes in the prescribed drugs should be done in case they haveadverse effects on Mr. NX. If the prescription is not effective incontrolling the condition, a change in prescription should be done.Diabetes type two can be controlled by use of glumetza which works byincreasing the sensitivity of insulin to the body tissues. It can beadministered 3mg daily. Prescription for high blood pressure isacebutolol 4mg daily which is a beta blocker. A combination ofacebutolol and glumetza will work best. Mr. NX should stop using bodybuilding stimulant creatine.
TimeFrame
Mr.NX should attend follow-up clinics once weekly for the first onemonth. If notable improvement conditions realized, he can startattending the clinic after three weeks. This will ensure that theblood pressure and glucose level is maintained through regular checkup. The back pain should cease within two weeks after the start ofmedication.
Strategiesfor Evaluating Side Effects
The adverse side effect of prescribed drugs is among the leadingcauses of death. Health care providers should examine the patientvery well to avoid adverse effects to the body. These effects can beevaluated by checking on body swellings, allergies and other unusualeffects such as increased body temperatures and dizziness. Thesefeatures should be checked during the clinics.
Strategiesfor Evaluating Effectiveness
A drop in the blood pressure and glucose level should be realized.The blood glucose level should be below 140mg/dl and the bloodpressure around 130/90mm/Hg. The back pain should cease in about twoweeks. If this range is achieved, then the prescription are said tobe effective. If no notable changes are realized, there should be achange in prescription. The most effective drug is the drug thatworks best and fast.
Reference
Cherkin, D. C., Deyo, R. A., Battié, M., Street, J., & Barlow,W. (2013). A comparison of physical therapy, chiropracticmanipulation, and provision of an educational booklet for thetreatment of patients with low back pain. New England Journal ofMedicine, 339(15), 1021-1029.
Ekinci, E. I., Clarke, S., Thomas, M. C., Moran, J. L., Cheong, K.,MacIsaac, R. J., & Jerums, G. (2011). Dietary salt intake andmortality in patients with type 2 diabetes. Diabetes care,34(3), 703-709.
Salomonsen, L. J., Skovgaard, L., Cour, S., Nyborg, L., Launsø, L.,& Fønnebø, V. (2011). Use of complementary and alternativemedicine at Norwegian and Danish hospitals. BMC complementary andalternative medicine, 11(1), 1.