The drugs given to the patient for diabetes are insulin glargine and insulin aspart, and the patient has been taking them from the past seven years. The dosage of drugs was given for a longer duration which helped her to keep her blood glucose levels under control. Insulin glargine involves replacing the insulin naturally released by the system and by assisting to transfer blood sugar into other body cells where it is being used for energy (Tibaldi et al., 2019). She also has reduced her dose to half without consulting the doctor which is giving her negative outcomes. Levonorgestrel and ethinyl estradiol combination are used to prevent pregnancy. Since the patient is in a relationship with a female partner she does not require it now. Taking ethinyl estradiol and levonorgestrel for such a long duration and at a young age can increase the risk of blood clots, stroke, or heart attack. The drugs are responsible for causing abdominal cramps which the patient is facing. The patient is at high risk because she has diabetes, and overweight (Xin et al., 2016). The patient is also taking Phenoxymethylpenicillin, an antibiotic that was prescribed for her when she encountered a respiratory infection six months back (Eliassen et al., 2018). She should stop it as she has acquired wrong information about the drug usage against acne from the internet. St John's wort is herbal remedy, developed to act as a supplement, working alongside these lifestyle factors to aid in supporting a healthy mood and relieving mild anxiety (Ng et al., 2017). But the patient is using it as a replacement of the prescribed drug which will give her negative outcomes.
Eliassen, K. E., Reiso, H., Berild, D., & Lindbæk, M. (2018). Comparison of phenoxymethylpenicillin, amoxicillin, and doxycycline for erythema migrans in general practice. A randomized controlled trial with a 1-year follow-up. Clinical Microbiology and Infection, 24(12), 1290-1296.
Ng, Q. X., Venkatanarayanan, N., & Ho, C. Y. X. (2017). Clinical use of Hypericum perforatum (St John's wort) in depression: A meta-analysis. Journal of Affective Disorders, 210, 211-221.
Tibaldi, J., Hadley‐Brown, M., Liebl, A., Haldrup, S., Sandberg, V., Wolden, M. L., & Rodbard, H. W. (2019). A comparative effectiveness study of degludec and insulin glargine 300 U/mL in insulin‐naïve patients with type 2 diabetes. Diabetes, Obesity and Metabolism, 21(4), 1001-1009.
Xin, X., Wu, Y., Liu, X., Sun, C., Geng, T., & Ding, L. (2016). Pharmacokinetics of oral combination contraceptive drugs containing ethinyl estradiol and levonorgestrel in healthy female Chinese volunteers. Drug Research, 66(02), 100-106.
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