Table of contentsDrugs for controlling blood sugarDrugs for controlling blood pressureAdvice pointsPatients with diabetes mellitus are either prone to resistance to insulin, or insufficient production of insulin by the pancreas, causing hyperglycemia and leading to various microvascular and macrovascular complications, including “hypertension” [1-2]. This mission will demonstrate the use of two classes of drugs to treat blood sugar and hypertension. Say no to plagiarism. Get a tailor-made essay on “Why violent video games should not be banned”?Get the original essayBlood sugar control medicationsMetformin (Biguanides)Metformin is an antidiabetic medication that contains the ingredient metformin hydrochloride, which belongs to the biguanide class of chemical drugs. Metformin is the first-line and initial drug treatment prescribed specifically for newly diagnosed patients living with type 2 diabetes, particularly overweight and obese patients who do not have adequate control over their diet and exercise or who do not are not achievable, resulting in uncontrolled blood sugar levels. Metformin medications help promote normal blood sugar levels and maintain them consistently. This is improved by reducing the amount of glucose from the liver that is released into the bloodstream and decreasing the amount of glucose taken up by the intestines; therefore, making the body cells more adequate and responsive to insulin and improving the insulin sensitivity mechanisms of muscle cells. Metformin also uses its positive effects on glycemic control, improving peripheral and hepatic insulin sensitivity and can improve modest weight loss or maintain current weight stable. Metformin alone acts to lower postprandial blood sugar, fasting blood sugar, HbA1c levels and prevents episodes of hypoglycemia. Metformin treatment initially begins with a single daily dose at breakfast; the dose then gradually increases up to 2 to 3 times per day with main meals. Side effects Common side effects of metformin usually include: drowsiness, dizziness, fatigue, muscle pain and cramps, abdominal discomfort, vomiting, diarrhea, and nausea; all these side effects cannot manifest themselves [16]. Lactic acidosis is the most serious side effect, mainly due to the buildup of metformin in the body, but it is very rare for this side effect to occur. Precautions Several precautions should be considered when prescribing metformin. Patients with kidney complications could experience lactic acidosis due to higher amounts of metformin in the system, which prevents the kidneys from functioning properly. Second, patients with heart complications should not take metformin because the heart is unable to send a sufficient amount of blood to the kidneys, which prevents the kidneys from eliminating metformin from the body, leading to risk. lactic acidosis. However, GPs can test the kidneys and prescribe metformin if appropriate. Drinking large amounts of alcohol while taking metformin could cause lactic acidosis and hypoglycemia; therefore, it is essential to educate patients about the health effects of alcohol when taking metformin. Metformin monitoring may predispose to vitamin B12 deficiency, resulting in elevated homocysteine ​​concentrations. However, this can bepreventable and regular vitamin B12 monitoring should be considered during long-term treatment with metformin. It is essential to identify whether patients have an allergic reaction to metformin ingredients before prescribing them. Advice points It is important to advise patients to take metformin at the same time each day with meals. Second, educate patients about hypoglycemia and how to overcome low blood sugar. Although metformin is unlikely to cause hypoglycemia, other medications that patients may take at the same time as metformin may predispose to low blood sugar levels. It is therefore important to inform patients of the following: Monitor your blood sugar regularly, especially before driving and exercising. Finally, it is important that patients are aware of all minor and major side effects (especially lactic acidosis) related to metformin and explain what actions should be considered if these side effects occur. Sitagliptins (DPP-4 inhibitors) Sitagliptin is an antidiabetic drug in the dipeptidyl peptidase-4 (DPP-4) inhibitor class of drugs, which is usually prescribed to patients living with type 2 diabetes mellitus to help lower blood sugar levels, which can also be combined with other antidiabetic drugs, for example metformin. Sitagliptins' main role is to block the action of DPP-4, which is an enzyme that primarily destroys the gastrointestinal hormones incretins. Incretins are a hormone that produces insulin when needed (after eating) and decreases glucagon production by the liver organ when not needed (during digestion). Glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic peptide (GIP) support the action of incretin. Diabetic patients do not produce sufficient amounts of incretin compared to people without diabetes. So the drug Sitagliptin plays its role by inhibiting DPP-4 which basically helps the incretin hormone to stay longer in the body which helps in improving the active levels of GLP-1 and GIP during meals about two to three times. A single dose of 100 mg of sitagliptin provides 24-hour persistent prevention of the DPP-4 enzyme, which increases the activation of GLP-1 and GIP, leading to an increase in insulin and a decrease in C-peptide glucogons, which improves oral glucose tolerance. As a result, this prompts the release of insulin, which helps lower blood sugar to a healthy level, slows digestion and decreases appetite. The DPP-4 inhibitor (Sitagliptin) can help reduce HbA1c by approximately 0.5% to 0.8%. Side effects Many unwanted side effects occur with sitagliptins (DPP-4), such as: headache, diarrhea, nausea, stomach pain, sore throat. , skin reactions may occur and increase the risk of pancreatitis (constant abdominal pain) leading to vomiting and nausea. Monitoring Advise patients to consider regular physical examinations, e.g. blood tests, urine tests to be sure that any medications (in this case: DPP-4 medications) are not causing serious side effects on the health of the patient and be assured that the prescribed medication is effective for the patient [29]. Doctors would monitor kidney function in patients with kidney complications and may prescribe lower doses (normally 25 to 50 mg). Precautions The drug DPP-4 should not be prescribed as first-line treatment fordiabetes, but as a second line, for example after metformin. Sitagliptins should not be prescribed to patients with type 1 diabetes to treat diabetic ketoacidosis. Sitagliptins are associated with discomfort of acute pancreatitis; Healthcare professionals should inform patients of any severe abdominal discomfort and, if suspected, immediate discontinuation of sitagliptin treatment as well as any allergic reactions. In patients with a history of pancreatitis, precautions should be taken immediately. There is a dosing order for sitagliptins when prescribed to patients with renal complications. Therefore, patients should undergo renal function assessments before being prescribed sitagliptins, among other antidiabetic medications, and should be reassessed after being prescribed an appropriate dose, in order to maintain monitoring of renal function.Points adviceAdvise patients to take sitagliptin regularly at the prescribed dose. If patients accidentally miss a dose, it should be taken as soon as possible. If it is closer to the next dose, patients should eliminate the double dose and return to a regular dosing schedule. Medications for blood pressure control. Acebutolol (beta-blockers). beatwhich acts on the heart and blood vessels. Acebutolol works by slowing down the action of the heart by preventing messages sent by the nerve to the heart. This is done by blocking the beta-adrenergic receptors where messages are recognized by the heart, causing the heart to beat more slowly with essentially less force which helps the blood vessels and the heart to stay relaxed. This therefore reduces hypertension by lowering the pressure of the blood in the blood vessels and, as the heart uses less energy, it also helps reduce chest pain if patients suffer from angina; also works to lower the heart rate and the heart's oxygen demand. Like any other medicine, acebutolol has many side effects and the most common ones are: headache, blurred vision, dizziness, diarrhea, indigestion, fatigue and muscle pain. When blood pressure and heart rate are low, patients may experience severe dizziness and fainting. They may therefore need medication. NICE guidelines suggest that healthcare professionals should monitor lung and kidney function in patients with a history of respiratory and kidney disease before prescribing acebutolol. This is to monitor whether these organs are working well, which would help decide whether this medication would be safe to use and also whether the dose needs to be reduced. Before prescribing acebutolol to female patients, healthcare professionals should consider whether they are pregnant or planning to become pregnant, as acebutolol should not be used during pregnancy as it could pose a harmful risk to the unborn baby. Patients suffering from asthma, heart failure, hyperthyroidism and renal failure; Doctors would prescribe patients a small dose of acebutolol with caution, modify the medication, or avoid it altogether depending on the situation. Special caution should be suggested to patients with a history of hypersensitivity, as beta-blockers may cause susceptibility to allergic reactions, which could lead to serious hypersensitivity reactions. Points of Counseling Advise patients to take this medicine regularly as prescribed and not to stop this medicine suddenly, as this may cause patients to develop hypertension and .