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May 22, 2024

D.B. is a 37-year-old Hispanic female who is in the OB clinic for an acute sick visit, and she is an established patient.

General Question

D.B. is a 37-year-old Hispanic female who is in the OB clinic for an acute sick visit, and she is an established patient. Her chief complaint is “I feel like I can not drink enough water” ” Her past and current medical and surgical history include: Primigravida 25-week gestation, Appendectomy. Her current medications are Prenatal vitamin 2 capsules daily PO. Her family history is: Mother: Type 1 Diabetes, COPD and Father: Hypertension

Recent Labs:

3 hour glucose tolerance test:

Fasting: 85 mg/dL

1Hour: 170 mg/dL

2Hour: 160 mg/dL

3 Hour: 152 mg/dL

She currently is being diagnosed today with Gestational Diabetes Mellitus in pregnancy.

In this discussion forum

1. Review the case, what would you recommend for first line treatment for this patient?

2. What are the pharmacokinetics and mechanism of action of the therapy you have chosen for this patient?

3. Discuss the safety profile of the medication in pregnancy.

4. What are the risks of breastfeeding on this medication?

READING & RESOURCES

Read Chapters 4, 54-56 in Arcangelo et al. (2022). Pharmacotherapeutics for advanced practice: A practical approach (5th ed.). Wolters Kluwer.

Shamy, T.E., & Tamizian, O. (2018). Principles of prescribing in pregnancy. Obstetrics, Gynaecology & Reproductive Medicine, 28(5), 136-140.

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