Pharmology for Sx the GI system
Gastrointestinal (GI) and hepatobiliary disorders affect the structure and function of the GI tract. Many of these disorders often have similar symptoms, such as abdominal pain, cramping, constipation, nausea, bloating, and fatigue. Since multiple disorders can be tied to the same symptoms, it is important for advanced practice nurses to carefully evaluate patients and prescribe a treatment that targets the cause rather than the symptom.
Once the underlying cause is identified, an appropriate drug therapy plan can be recommended based on medical history and individual patient factors. In this Assignment, you examine a case study of a patient who presents with symptoms of a possible GI/hepatobiliary disorder, and you design an appropriate drug therapy plan.
- Review the case study assigned by your Instructor for this Assignment
- Reflect on the patient’s symptoms, medical history, and drugs currently prescribed.
- Think about a possible diagnosis for the patient. 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.
By Day 7 of Week 4
Write a 1-page paper that addresses the following:
- Explain your diagnosis for the patient, including your rationale for the diagnosis.
- Describe 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.
Week 4 Case Assignment
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
Explain your diagnosis for the patient, including your rationale for the diagnosis.
From the symptoms provided, the patient is likely suffering from gastroenteritis. Gastroenteritis is a GIT condition characterized by the inflammation of the stomach and intestines caused by bacterial and viral infections, medications such as corticosteroids, excessive alcohol and tobacco use, and food allergies (Kim et al., 2019). The rationale for this diagnosis is that the patients possess some of the risk factors that can cause gastroenteritis; he is currently taking Prednisone 10 mg daily, a corticosteroid, increasing the risk of developing gastroenteritis. HL has a history of drug abuse which could include alcohol and tobacco use, suggesting the possibility of developing gastroenteritis. The patient also has a possible hepatitis C infection, which is likely to cause symptoms associated with gastroenteritis, and being a viral condition, it increases the risk and possibility of the patient suffering from gastroenteritis (Evon et al., 2018).
Describe an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed.
The goal of drug therapy among patients with gastroenteritis is to curb the symptoms and prevent complications. More laboratory tests have to be conducted to determine the actual cause, viral or bacterial cause to determine the best treatment therapy for this patient (Kim et al., 2019). Only supportive treatment can be provided in case of a viral cause, as the illness usually resolves itself with time. In case of bacterial causes, the prescription for this patient should include metronidazole 400mg, used to treat bacterial infections, or ciprofloxacin 500mg, which can control both bacterial growth and diarrhea symptom. Bismuth subsalicylate (Pepto-Bismol) 262mg oral tablets to manage vomiting and diarrhea (Schierenberg et al., 2019). The patient should continue with the current prescriptions Synthroid 100 mcg daily to manage hypothyroidism, Nifedipine 30 mg daily to manage hypertension, and Prednisone 10 mg daily to manage inflammation, including gastroenteritis.
Evon, D. M., Stewart, P. W., Amador, J., Serper, M., Lok, A. S., Sterling, R. K., … & Fried, M. W. (2018). A comprehensive assessment of patient reported symptom burden, medical comorbidities, and functional well being in patients initiating direct acting antiviral therapy for chronic hepatitis C: Results from a large US multi-center observational study. PloS one, 13(8), e0196908. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6070182/
Kim, Y. J., Park, K. H., Park, D. A., Park, J., Bang, B. W., Lee, S. S., … & Kim, Y. R. (2019). Guideline for the antibiotic use in acute gastroenteritis. Infection & chemotherapy, 51(2), 217-243. https://synapse.koreamed.org/articles/1128974
Schierenberg, A., Bruijning-Verhagen, P. C., van Delft, S., Bonten, M. J., & de Wit, N. J. (2019). Antibiotic treatment of gastroenteritis in primary care. Journal of Antimicrobial Chemotherapy, 74(1), 207-213. https://academic.oup.com/jac/article/74/1/207/5115421