Primary Care Medication Management
Q1. Classes of Weight Neutral or Weight Loss Inducing Diabetes Medications
Sodium-glucose cotransporter 2 (SGLT-2) inhibitors and glucagon-like peptide 1 (GLP-1) agonists are major classes of diabetes medications that are weight-neutral or cause patients to lose weight during treatment. An example of a GLP-1 agonist class medication is Dulaglutide, usually sold under the brand name Trulicity.
Q2. Recommended Monotherapy Agent, Trade Name, Generic Name, Dosage and Route
Based on the current guidelines of the ADA, I would recommend metformin as the first-line monotherapy agent for treatment. Biguanide metformin is usually sold under the brand names Fortamet, Glucophage and Glucophage XR. The dosage for the metformin monotherapy drug is sequential. The initial dosage is 500 mg taken orally twice a day or 850 mg once a day. The maximum dose taken orally per day is 2550 mg.
Q3. Metformin Contraindications
The potential contraindications for metformin monotherapy include renal dysfunction, elevated serum creatine levels, although the serum creatine levels vary across gender and race, and tissue hypoxia (Corcoran & Jacobs, 2021). Congestive heart failure is also contraindicated with metformin use in advanced-age patients.
Q4. Lab Workup
I would carry out blood tests, including total thyroid-stimulating hormone (TSH), T4, T3, and thyroid antibody tests and TSH levels tests to evaluate thyroid function. For hypothyroidism, the results would show high TSH levels and low levels of T4. For hyperthyroidism, the results will show low TSH levels and elevated T4 levels. High thyroid antibody levels may indicate active thyroid problems.
Q5. Treatment for Hypothyroidism-Initial Dose, Trade, and Generic Name, Route, Frequency and Mechanism of Action
The treatment of choice for the patient is hormone therapy. The generic for synthetic hormone therapy is Levothyroxine. It is sold under the brand names Synthroid, Levothroid, and Levoxyl, among others. It should be taken orally once a day, an hour before meals, at a dose of 50mg. As a synthetic form of T4, Levothyroxine normalizes T4 levels TO regulate body functions (Bianco & Taylor, 2020).
Q6. Adverse Effects of Thyroid Replacement Therapy
Thyroid replacement therapy may have some common side effects. However, there are adverse effects that the patient may experience, including shortness of breath, hives, rash, stomach pain, nausea, and swelling of hands, feet, or ankles (Bianco & Taylor, 2020). The patient should never use Levothyroxine as a treatment for obesity in weight loss. The patient also should report to a qualified physician if she experiences adverse side effects or has any allergies that may be linked to the therapy.
References
Bianco, A. C., & Taylor, P. (2020). Levothyroxine treatment and cholesterol in hypothyroidism. Nature Reviews Endocrinology, 16(4), 193-194.
Corcoran, C., & Jacobs, T. F. (2021). Metformin. In StatPearls [Internet]. StatPearls Publishing.
ORDER A PLAGIARISM-FREE PAPER HERE
We’ll write everything from scratch
Question 
Post your answers to the 6 questions corresponding to this week’s primary care medication management content. Provide your responses and rationales. Support your rationales with high-level evidence. (See Post Expectations).
Primary Care Medication Management
An obese patient, age 45, comes to your office. She recently moved from another state three weeks ago and told you that her FNP diagnosed her with type 2 diabetes mellitus. She is currently not on any medicine for her diabetes, and she wishes to avoid insulin if possible. She is a non-smoker. Her blood pressure is 138/74 mmHg. Labs from 3 weeks ago were haemoglobin A1C = 8.4%; total cholesterol = 260 mg/dL, triglycerides = 290 mg/dL, HDL = 49 mg/dL, LDL = 170 mg/dL (calculated 10-year ASCVD risk = 6.2%). You discuss current treatment goal recommendations endorsed by the ADA regarding glycemic control, blood pressure control, and lipid management. She agrees to start any medications that you recommend with lifestyle modification and a DASH diet to treat hypertension.
Q1. Which classes of diabetes medications are either weight-neutral or cause weight loss? Please give one (1) example of a drug’s generic and trade name in that class.
Q2. Based on the current guidelines of the ADA, it would be appropriate to treat her with monotherapy since the patient is hesitant to take any injections. What agent would you recommend? Please provide the trade name, generic name, the dose you would start the patient with, the frequency, and the route.
Q3. What are the contraindications of your selected diabetic therapy?
The patient returns to your office six months later, complaining of fatigue for the past two months, constipation, and heavy, irregular menses. Upon examination, you note that her skin is dry, and her fingernails are brittle. You suspect she has hypothyroidism.
Q4. What lab workup should you obtain? What sort of results will you see in patients who have hypothyroidism and hyperthyroidism?
Q5. What is the treatment of choice for hypothyroidism? What is the mechanism of action? Please provide the initial dose, trade, and generic name of the drug, route, and frequency.
Q6. What are the adverse effects, and what important teaching will you provide this patient on thyroid replacement therapy?
Complete the order form and upload all of your files, including any instructions, rubrics, or other materials provided by your instructor. 
Complete the order payment after filling in the order form. We’ll receive your order and assign it to a writer.
The assigned writer will complete your paper and forward it to our Editing Team for review and approval.
Once approved by the editor, the completed paper will be uploaded to your account for you to download, review and approve.