Pharmacotherapy for gastrointestinal and hepatobiliary disorders

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Case study assigned.

Patient HL comes into the clinic with the following symptoms: nausea, vomiting, and diarrhea. The patient has a history of drug abuse and possible Hepatitis C. HL is currently taking the following prescription drugs:

  • Synthroid      100 mcg daily
  • Nifedipine      30 mg daily
  • Prednisone      10 mg daily
  • Flagyl      500 mg TID
  • Metronidazole      250 mg daily

Vitals: 

Temp:     98.8oF

Wt:           155 lbs

Ht:            5’7”

BP:            136/82

HR:           90 bpm 

PE:

Eyes: EOMI

HENT: Normal

GI: Nondistended, minimal tenderness

Skin: Warm and dry

Neuro: Alert and Oriented

Psych: Appropriate mood

  1. Introduction
  2. Explain      your diagnosis for the patient, including your rationale for the      diagnosis. What labs would you order?
  3. Describe      an appropriate drug therapy plan based on the patient’s history,      diagnosis, and drugs currently prescribed. Discuss each of the patient’s      medications. Create an updated drug therapy plan.
  4. How      might you evaluate specific signs and symptoms between these potential      disorders and body systems? What drug therapy plans will best address      these disorders for your patients?
  5. Justify      why you would recommend this drug therapy plan for the patient. Be      specific and provide examples. Use and cite at least 4 sources for written      assignments.
  6. conclusions

TOPIC: Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders

Case study assigned.

Patient HL comes into the clinic with the following symptoms: nausea, vomiting, and diarrhea. The patient has a history of drug abuse and possible Hepatitis C. HL is currently taking the following prescription drugs:

· Synthroid 100 mcg daily

· Nifedipine 30 mg daily

· Prednisone 10 mg daily

· Flagyl 500 mg TID

· Metronidazole 250 mg daily

 

Vitals: 

Temp:     98.8oF

Wt:           155 lbs

Ht:            5’7”

BP:            136/82

HR:           90 bpm
 

 

PE:

Eyes: EOMI

HENT: Normal

GI: Nondistended, minimal tenderness

Skin: Warm and dry

Neuro: Alert and Oriented

Psych: Appropriate mood

1. Introduction

2. Explain your diagnosis for the patient, including your rationale for the diagnosis. What labs would you order?

3. Describe an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed. Discuss each of the patient’s medications. Create an updated drug therapy plan.

4. How might you evaluate specific signs and symptoms between these potential disorders and body systems? What drug therapy plans will best address these disorders for your patients?

5. Justify why you would recommend this drug therapy plan for the patient. Be specific and provide examples. Use and cite at least 4 sources for written assignments.

6. conclusions

RUBRIC FOR GRADING

Explain your diagnosis for the patient, including your rationale for the diagnosis. = The response accurately and clearly explains in detail the diagnosis for the patient, including an accurate and thorough rationale for the diagnosis that supports clinical judgment.

This criterion is linked to a Learning OutcomeDescribe an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed. = The response accurately and completely describes in detail an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed.

Justify why you would recommend this drug therapy plan for this patient. Be specific and provide examples. =
The response provides an accurate, clear, and detailed justification for the recommended drug therapy plan for this patient. … The response includes specific, accurate, and detailed examples that fully support the justification provided.

Written Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and

Patient HL comes into the clinic with the following symptoms: nausea, vomiting, and

diarrhea. The patient has a history of drug abuse and possible Hepatitis C. HL is currently taking

the following prescription drugs:

Synthroid 100 mcg daily

Nifedipine 30 mg daily

Prednisone 10 mg daily

Consider whether the patient has a disorder related to the gastrointestinal and

hepatobiliary system or whether the symptoms are the result of a disorder from another system or

other factors such as pregnancy, drugs, or a psychological disorder.

Consider an appropriate drug therapy plan based on the patient’s history, diagnosis, and

drugs currently prescribed.

Based on information given, and the patient exhibiting symptoms of nausea, vomiting,

and diarrhea, a diagnosis of some form of a stomach virus also medically termed acute

gastroenteritis. Acute gastritis is a sudden inflammation or swelling in the lining of the stomach.

Symptoms can also cause abdominal pain, coupled with nausea, vomiting and fever may also

occur with these symptoms (Diskin, 2017). How the illness begins, spreads from contact to

contact with someone that may have already has been affected or eating contaminated food.

To alleviate the present symptoms and have the patient in the most comfortable care as

possible, a treatment protocol would consist of rehydration via saline fluids from loss of

vomiting and diarrhea. As a provider giving medical assistance, staff must always be cognizant

of reducing symptoms while preventing further complications (Arcangelo & Peterson, 2013).

In being aware of the patient’s current medications and previous drug history, drug

therapy and treatment plan would be consisting of non-habit-forming medications such as

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Phenergan and Zofran. Imodium A-D will also be prescribed to assist with diaherra. Patient will

be advised and instructed to be placed on a liquid diet which will consists of clear liquids,

electrolytes such Gatorade and Powerade will be strongly encouraged. Food recommendations

such as clear liquid broth, Jell-O, and Saltine crackers will also be recommended. Since the

patient is may also have Hep-C, additional testing may also be explored to test the patient’s liver

and conduct Hepatis C testing to see if the patient is at risk. During treatment of

Review of Case Study:

Patient HL comes into the clinic with the following symptoms: nausea, vomiting, and

diarrhea. The patient has a history of drug abuse, and possible Hepatitis C. HL is currently taking

the following prescription drugs: It is essential to complete a thorough health history and

examination before diagnosing HL. There are several necessary questions related to HL’s

medication list that should ask:

• Duration and reason for the Prednisone?

• Recent recreational drug use?

• Duration of the symptoms/ weightloss?

• Description and number of the stools/emesis per day?

• Synthroid 100 mcg daily

• Nifedipine 30 mg daily

• Prednisone 10 mg daily

History of Present Illness and Medical History

Patient presents with symptoms of diarrhea, nausea, and vomiting. Learning from HL’s

medical history, HL appears to have some possible chronic conditions based on his current

medications; Synthroid 100 mg daily, Nifedipine 30mg daily, and prednisone 10mg daily.

Synthroid is a hormone replacement that is used to treat hypothyroidism, thyroid

cancer and goiter (Drugs.com, 2017). Synthroid can have adverse effects if not taken correctly or

if misused, thorough assessment and review of patients understanding of medication regimen is

needed. Diarrhea is a common side effect of Synthroid. N/V are classified as severe/adverse

reaction and should be reported the health practitioner immediately (Drugs.com, 2017). Healthy

adults age 50 years or less with a weight of 70kg or more; initial dose of 100-125 mcg/day be

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taken for a few months. HL’s medical history and chronicity of the hepatitis could warrant

decreasing the current dose of Synthroid. Thyroid levels should be checked every 6-8 weeks

(Drugs.com, 2017). No warnings were identified with the use of Synthroid and Hepatitis C upon

review.

Nifedipine is a calcium channel blocker that is used to treat hypertension and chest

pain (angina). There are no warnings with Hepatitis C and the use of calcium channel blockers.

Initial dose recommended 30-60mg orally (Drugs.com, 2017). Nifedipine has also been linked to

several instances of clinically apparent acute liver injury, and dosing should be decreased for

Adenike B.docx
by Adenike Balogun

Submission date: 20-Jun-2023 01:38PM (UTC-0500)
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This is what I put together myself. It has 19% similarity when I submitted it to Turn-in.

Rationale for diagnosis

The clinical manifestations of gastroenteritis are diarrhea, vomiting, dysuria, abdominal pain, and infection. Patient HL has symptoms of nausea, vomiting and diarrhea. Although HL has history of drug abuse and hepatitis C. The neuro and psych assessment show normal results that means he is not undergoing drug abuse again. The Synthroid 100 mcg daily is probably for the patient’s hypothyroid problem. Symptoms of the patient does not support hypothyroidism. Nausea and vomiting can be a sign of high blood pressure, but the patient’s BP is 136/82mmhg which is within normal range. So, the nausea, vomiting and diarrhea might be cause by Gastroenteritis. The patient’s symptoms are most likely due to a gastrointestinal infection, possibly viral, and the prednisone is exacerbating the symptoms. The patient’s history of drug abuse and possible hepatitis C are also risk factors for GI infections.

The labs that I would order would include a CBC, CMP, stool culture, and stool ova and parasites. I would also order a viral panel, including tests for norovirus, rotavirus, and adenovirus. A liver panel and an antibody test for hepatitis C would be the diagnostic tests that would be ordered to confirm this diagnosis in the laboratory. If the results of these tests came back positive, the patient would be given antiviral medicine in order to treat the condition.  A complete blood count (CBC) would be ordered to evaluate for anemia, which can be a complication of GI bleeding. A comprehensive metabolic panel (CMP) would be ordered to assess for electrolyte abnormalities, which can occur with vomiting and diarrhea. A stool culture would be ordered to identify the causative organism of the infection. Stool ova and parasites would be ordered to rule out parasitic infections, which are common in developing countries but can also occur in developed countries. The viral panel would be ordered to identify the specific virus causing the infection. The norovirus is a common cause of viral gastroenteritis and is often responsible for outbreaks of vomiting and diarrhea. The rotavirus is the most common cause of severe diarrhea in young children and can also cause vomiting. The adenovirus is another virus that can cause gastroenteritis, although it is less common than the norovirus and rotavirus.

 

Appropriate Drug Therapy

The patient’s current medication regimen does not appear to be related to the symptoms. The patient is taking Synthroid for hypothyroidism, Nifedipine for hypertension, Prednisone for an unknown reason, Flagyl for an unknown reason, and Metronidazole for an unknown reason. I would re

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