UNIVERSITY OF CEBU - BANILAD

Gov. M. Cuenco Ave, Cebu City, 6000 Philippines

College of Nursing
Telephone No: (032) 231- 8631

NCM 106 – Pharmacology

Course Outputs /Assessment of Learning for CILO # 1

Written Outputs (Mental Models, Group Activity and Reflection Journal)

Name of Student : Trisha Faye Y. Pasay________ Yr.& Sec. : BSN 2 - A____ __

Module/Topic : Module 9 – Elaborate _______ Date : 12/12/2021______

I. Create a Drug Study on Endocrine Drugs that are commonly used in clinical
settings. Utilize the drug study template.

a. Medical Ward (Internal & Non-communicable) Service Ward (3 Medications)

b. Surgical Ward – Male/Female (3 Medications)

c. Pediatric Non-Critical) Ward (2 Medication)

II. Briefly organize and bring together main ideas. Explain in your own words.
(50 – 150 words for each question)
1. TC, a 32-year-old patient, was diagnosed with diabetes mellitus after the birth of
her first child; her blood glucose level was 180 mg/dL. Her serum glucose level
has been maintained within the normal range with metformin 500 mg/day.

A. It is given that after giving birth to baby, a 32-year-old patient, TC has been
diagnosed with diabetes mellitus. The sugar level of the patient was 180
milligram per deciliter. The serum glucose level is managed with metformin
of 500 milligrams per day. The effectiveness of the oral glucose load is more
when compared to insulin. Therefore, patient TC is recommended to take an
oral antidiabetic drug instead of insulin. Metformin is a compound of
biguanide. This medication acts by decreasing the hepatic production of
glucose from the stored glycogen. Metformin medication helps in decreasing
the formation of serum glucose after the consumption of meal. Hyperglycemia
is being controlled with the help of this medication.

B. Metformin is under the class of drugs called biguanides. Metformin helps to

control the amount of glucose (sugar) in the blood. It decreases the amount of
glucose one absorbs from food and the amount of glucose made by the liver.
It is indicated in type 2 diabetes. You should not give it with type 1 diabetes,
people with prediabetes over the age 60 and not with stage 4 or 5 kidney
disease. Metformin should not be used by patients with an estimated
glomerular filtration rate (eGFR) below 30 mL/minute/1.73 m2 and starting

Pharmacology Module 1st Semester S.Y. 2021- 2022 UCBC Page 1

 UNIVERSITY OF CEBU - BANILAD
Gov. M. Cuenco Ave, Cebu City, 6000 Philippines
College of Nursing
Telephone No: (032) 231- 8631

metformin in patients with an eGFR between 30-45 mL/minute/1.73 m2 is not

recommended.

C. Regular monitoring is a particularly helpful way to manage the patient’s

diabetes and help control her blood sugar, so it's important to know how to
properly use the home glucometer device. If one has type 1 diabetes, type 2
diabetes, latent autoimmune diabetes in adults, or were diagnosed with
gestational diabetes during pregnancy, a major part of a patient’s treatment
plan should be regularly testing the blood glucose levels with a glucometer.
Frequent glucometer use can help patient: check how controlled her blood
sugar is and whether it's high or low, recognize patterns when she is more
likely to have a spike or crash in glucose, see how her glucose levels respond
after exercise or in times of stress, monitor the effects of diabetes medications
and other therapies and assess how well she is meeting specific treatment
goals.

D. When patient TC became pregnant, she will not be able to take antidiabetic
medication as a way to control blood sugar because the safety of using these
medications during pregnancy has not been established. It means that it can be
harmful to the pregnant woman and more especially to the developing fetus,
which is why the doctor will probably have to switch to insulin immediately.
The drug of choice for the management of diabetes in pregnancy is insulin
which was decided based on high efficacy and safety since there is lack of any
well-studied alternative medication in pregnancy. The reason why physicians
stick to insulin as a treatment of choice for diabetes in pregnancy because it is
the only standard for treatment when lifestyle measures do not maintain
glycemic control during pregnancy.

E. Human insulin is under a class of medications called hormones. Human insulin

is used to take the place of insulin that is normally produced by the body.
Human insulin is available in two forms, a short acting (regular) form and an
intermediate acting (NPH) form. Some examples of human insulin are:
• Regular (short acting): Humulin S, Actrapid, Insuman Rapid
• NPH (intermediate acting): Humulin I, Insuman basal, Insulatard
• Premixed human insulins: Humulin M2, M3 and M5, Insuman Comb
15, 25 and 50
These insulins have four advantages over highly purified animal insulins: they
induce lower titers of circulating insulin antibodies; their subcutaneous
injection is associated with fewer skin reactions; they are absorbed more
rapidly from the injection site; and less degradation occurs at the site of
injection.

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 UNIVERSITY OF CEBU - BANILAD
Gov. M. Cuenco Ave, Cebu City, 6000 Philippines
College of Nursing
Telephone No: (032) 231- 8631

F. Before administering the insulin, wash your hands, put on gloves, and clean
the injection site with an alcohol swab. Now you are ready to inject the insulin,
choosing between two injection techniques: inserting the needle into the skin
at a 90-degree or at a 45-degree angle. Insulin should be injected into the fat
just underneath the skin rather than into muscle, which can lead to quicker
insulin action and greater risk of low blood sugar. The stomach, thighs,
buttocks, and upper arms are common injection sites because of their higher
fat content.

G. Neutral Protamine Hagedorn (NPH) insulin, also known as isophane insulin,

is an intermediate-acting insulin given to help control blood sugar levels in
people with diabetes.
Pros
• Available over the counter without a prescription, but usually also
covered by many insurance plans
• Insulin works quite well to lower her blood sugar. When used
correctly, it'll lower blood sugar every time she will use it and prevent
the harmful, long-term effects of high sugar levels on her organs and
blood vessels.
• Starting insulin early in the treatment of type 2 diabetes can keep her
body's insulin-producing cells working and slow down the worsening
of her diabetes.
• Can be used even if she has liver or kidney problems, unlike many
other blood sugar-lowering medications

Cons
• Patient must be comfortable with checking her blood sugar regularly
to take insulin
• She must be comfortable giving herself injections
• Can cause weight gain and fat buildup
• Has higher risk of low blood sugar compared to medications taken by
mouth
• Can cause low blood sugar (hypoglycemia), especially if she doesn’t
take it every day or have a random meal and exercise schedule
• Only available as a brand name, so it can be expensive

H. A hypoglycemic reaction, also called an insulin reaction, insulin shock, or low

blood sugar reaction, occurs when blood glucose drops to a point where the
individual becomes confused and disoriented. Symptoms of low blood sugar
reaction can be divided into two general stages. The first stage, usually
occurring early in a reaction, can include shakiness, sweating, nervousness,
fast pulse, dizziness, headache, and pale skin color. Symptoms may appear
suddenly. The second, more advanced stage of hypoglycemia, includes
mood/behavior changes, confusion, poor coordination, and difficulty in
speaking.

Pharmacology Module 1st Semester S.Y. 2021- 2022 UCBC Page 3

 UNIVERSITY OF CEBU - BANILAD
Gov. M. Cuenco Ave, Cebu City, 6000 Philippines
College of Nursing
Telephone No: (032) 231- 8631

I. What should be included in patient teaching?

Patient teaching should include:
• Education in insulin therapy, including reasons for insulin
treatment, contraindications, complications, and appropriate
aftercare
• Education on use of the equipment used in the procedure and its
safe disposal
• An understanding of different insulin’s, their action and safe dose
adjustments
• Discuss the process of starting insulin with the patient; encourage
the patient to have a family member present if they so desire
A step-by-step approach is provided to teaching the patient the basics about
starting insulin. The provider or staff performing the teaching should check off
each item as it is completed to document teaching.

References:

• Bryant, E. (n.d.). HYPOGLYCEMIA. Nfb.Org. Retrieved December 12, 2021, from

https://nfb.org//images/nfb/publications/vod/vsum9911.htm

• Comerford, K. C., & Durkin, M. T. (2021). Nursing 2021 drug handbook. 41st edition. Philadelphia:

Wolters Kluwer.

• Doenges, Marilynn E., Moorhouse, Mary Frances, Murr, Alice C. (2014). Nursing care plans:

guidelines for individualizing client care across the life span (9th). Philadelphia: F.A. Davis

Company.

• Karch, A. M. (2017). Focus on nursing pharmacology. Philadelphia: Lippincott Williams & Wilkins.

• Karch, A. M. (2014). 2014 Lippincott's nursing drug guide. Philadelphia: Wolters Kluwer

Health/Lippincott Williams & Wilkins.

Pharmacology Module 1st Semester S.Y. 2021- 2022 UCBC Page 4

 UNIVERSITY OF CEBU - BANILAD
Gov. M. Cuenco Ave, Cebu City, 6000 Philippines
College of Nursing
Telephone No: (032) 231- 8631

• Kee, J. LeFever, Hayes, E. R., & McCuistion, L. E. (2015). Pharmacology: A Patient-Centered Nursing

Process Approach. 8th edition. St. Louis, Missouri: Elsevier/Saunders.

• Manzella, D. (2021, September 25). 10 Steps for Using a Glucometer. Verywell Health.

Retrieved December 12, 2021, from https://www.verywellhealth.com/how-to-use-a-

glucometer-1087304

• Mayo Foundation for Medical Education and Research (MFMER). (2020, March 13).

Hypoglycemia - Symptoms and causes. Mayo Clinic. Retrieved December 11, 2021, from

https://www.mayoclinic.org/diseases-conditions/hypoglycemia/symptoms-causes/syc-

20373685

• NANDA International & Herdman, T. H. (2012). NANDA International Nursing diagnoses:

Definitions and classification 2012-14. Wiley-Blackwell.

• National Library of Medicine. (2021, December 6). Metformin: MedlinePlus Drug Information.

Medlineplus.Gov. Retrieved December 12, 2021, from

https://medlineplus.gov/druginfo/meds/a696005.html

• The Global Diabetes Community. (2019, January 15). Human Insulin. Diabetes.Co.Uk.

Retrieved December 12, 2021, from https://www.diabetes.co.uk/insulin/human-

insulin.html

Pharmacology Module 1st Semester S.Y. 2021- 2022 UCBC Page 5

 UNIVERSITY OF CEBU - BANILAD
Gov. M. Cuenco Ave, Cebu City, 6000 Philippines
College of Nursing
Telephone No: (032) 231- 8631

Prepared by:

Trisha Faye Y. Pasay

Students Signature over
Printed Name

Submitted to:

Lemuel C. Candelasa, EdD(c) ,MAN,RN

ProfeAmeliaor – Pharmacology

Pharmacology Module 1st Semester S.Y. 2021- 2022 UCBC Page 6