Pharmacotherapy For Gastrointestinal and Hepatobiliary System essay
Pharmacotherapy For Gastrointestinal and Hepatobiliary System essay
Case Overview
DC is a 46 years old female with RUQ pain associated with nausea. She has hypertension, diabetes mellitus, gout, and DVT. She is currently on Lisinopril, HCTZ, Allopurinol, and multivitamin. She is allergic to amoxicillin, codeine, and latex. Her vital are the temperature at 98.8, weight 202Ibs, heart rate 82, and blood pressure at 136/82 mmHg. Her laboratory findings are WBC at 13000, total bilirubin 0.8mg/dl, direct bilirubin at 0.6mg/dl, alkaline phosphate at 100u/l, AST at 40u/l, and ALT 30u/l. on examination, Eyes: EOMI, HENT: Normal, GI: non-distended, minimal tenderness, Skin: warm and dry, Neuro: Alert and Oriented, and Psych: appropriate mood. Pharmacotherapy For Gastrointestinal and Hepatobiliary System essay
Diagnosis for the Patient
Amebic liver disease is an extra-intestinal manifestation of Entamoeba histolytica. The presenting signs and symptoms are abdominal pain of acute onset. The pain is usually constant, dull, and aching at the right upper quadrant. The pain may radiate to the right shoulder or scapular. The pain increases after eating, coughing, and walking. It is associated with fever, nausea, and vomiting. Upon examination, the patient is usually febrile, has jaundice, and has right upper quadrant abdominal tenderness (Prahraj & Anand, 2021). This is the patient’s diagnosis because she has pain at the RUQ of acute onset whose trigger is taking food. The pain is associated with fever, nausea, and vomiting. Upon examination, the patient has fever and tenderness at the RUQ. The WBC indicates the presence of an infection. In addition, the direct bilirubin is high. However, the liver enzymes are within the normal range. Pharmacotherapy For Gastrointestinal and Hepatobiliary System essay
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Appropriate Drug Therapy For This Patient
The patient has amoebic liver disease due to his clinical presentations and laboratory evaluation. In her plan of treatment, I will put into consideration other preexisting diseases; gout, DVT, hypertension, and diabetes mellitus.
- Metronidazole 400mg PO TDS for five days to treat amoebic liver disease
- Aspirin 81mg PO OD for gout pain, DVT, and fever
- Colchicine 0.6mg PO OD for gout
- Amlodipine 10mg PO OD for hypertension
- Healthy diet for diabetes mellitus
Reason For Recommending This Drug Therapy
The previous drug list had Lisinopril 10mg OD, HCTZ 50 OD, Allopurinol 10MG OD, and multivitamin. The patient’s blood pressure is well controlled. However, I changed lisinopril and HCTZ because they increase the risk of bradycardia. The recommended dose for lisinopril when co-administering with a diuretic is 5mg (Lysenko, 2021). HCTZ is not appropriate in diabetic patients because it inhibits insulin production, hence hyperglycemia. Therefore, amlodipine is the best drug for a hypertensive patient with diabetes mellitus. Allopurinol and lisinopril are not appropriate in liver disease. Colchicine is effective in treating gout and it is appropriate in liver disease. Metronidazole is an antiprotozoal and antibacterial agent recommended for tissue infections and liver abscess (Goel et al, 2021). Aspirin is an anticoagulant and NSAID that helps relieve fever, pain, and DVT.
References
Goel, V., Jain, A., Sharma, G., Jhajharia, A., Agarwal, V. K., Ashdhir, P., & Chauhan, V. (2021). Evaluating the efficacy of nitazoxanide in uncomplicated amebic liver abscess. Indian Journal of Gastroenterology, 40(3), 272-280.
Lysenko, V. A. (2021). Are there benefits of low doses of ACE inhibitors, MRAs, diuretics and statins in the treatment of heart failure?.
Prahraj, D., & Anand, A. C. (2021). Tropical liver diseases: an overview. Clinical Liver Disease, 18(3), 138.
Previous order # 236577: I would like to request for the writer for this previous order #236577 to please write this assignment. Thank you. This week your assignment will deal with the Hepatobiliary and GI system. You will write a paper that needs to include the following: 1. Explain your diagnosis for the patient, including your rationale for the diagnosis. 2. Describe an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed. 3. Justify why you would recommend this drug therapy plan for this patient. Be specific and provide examples. Please use the following case for this assignment: DC is a 46-year-old female who presents with a 24-hour history of RUQ pain. She states the pain started about 1 hour after a large dinner she had with her family. She has had nausea and on instance of vomiting before presentation. PMH: Vitals: HTN Temp: 98.8oF Type II DM Wt: 202 lbs Gout Ht: 5’8” DVT – Caused by oral BCPs BP: 136/82 HR: 82 bpm Current Medications: Notable Labs: Lisinopril 10 mg daily WBC: 13,000/mm3 HCTZ 25 mg daily Total bilirubin: 0.8 mg/dL Allopurinol 100 mg daily Direct bilirubin: 0.6 mg/dL Multivitamin daily Alk Phos: 100 U/L AST: 45 U/L ALT: 30 U/L Allergies: Latex Codeine Amoxicillin PE: Eyes: EOMI HENT: Normal Pharmacotherapy For Gastrointestinal and Hepatobiliary System essay GI:bNondistended, minimal tenderness Skin:bWarm and dry Neuro: Alert and Oriented Psych:bAppropriate mood Assignment: Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders 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. To Prepare 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. Write a 1-page paper that addresses the following: 1. Explain your diagnosis for the patient, including your rationale for the diagnosis. 2. Describe an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed. 3. Justify why you would recommend this drug therapy plan for this patient. Be specific and provide examples. Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center offers an example of those required elements (available at http://writingcenter.waldenu.edu/57.htm). All papers submitted must use this formatting. Resources: Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.) St. Louis, MO: Elsevier. Chapter 64, “Drugs for Peptic Ulcer Disease” (pp. 589–597) Chapter 65, “Laxatives” (pp. 598–604) Chapter 66, “Other Gastrointestinal Drugs” (pp. 605–616) Chapter 80, “Antiviral Agents I: Drugs for Non-HIV Viral Infections” (pp. 723–743) Chalasani, N., Younossi, Z., Lavine, J. E., Charlton, M., Cusi, K., Rinella, M., . . . Sanya, A. J. (2018). The diagnosis and management of nonalcoholic fatty liver disease: Practice guidance from the American Association for the Study of Liver Diseases. Hepatology, 67(1), 328–357. Retrieved from https://aasldpubs.onlinelibrary.wiley.com/doi/pdf/10.1002/hep.29367 This article details the diagnosis and management of nonalcoholic fatty liver disease. Review this article to gain an understanding of the underlying pathophysiology as well as the suggested pharmacotherapeutics that might be recommended to treat this disorder. Rubrics: NURS_6521_Week4_Assignment_Rubric Grid View List View Excellent Good Fair Poor Explain your diagnosis for the patient, including your rationale for the diagnosis. 23 (23%) – 25 (25%) 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. 20 (20%) – 22 (22%) The response provides a basic explanation of 1-2 diagnoses for the patient, including an accurate rationale for the diagnosis that may support clinical judgment. 18 (18%) – 19 (19%) The response inaccurately or vaguely explains the diagnosis for the patient, including an inaccurate or vague rationale for the diagnosis that may or may not support clinical judgment. 0 (0%) – 17 (17%) The response inaccurately and vaguely explains the diagnosis for the patient, including an inaccurate and vague rationale for the diagnosis that does not support clinical judgment, or is missing. Pharmacotherapy For Gastrointestinal and Hepatobiliary System essay
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Describe an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed. 27 (27%) – 30 (30%) The response accurately and completely describes in detail an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed. 24 (24%) – 26 (26%) The response describes a basic explanation of the appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed. 21 (21%) – 23 (23%) The response inaccurately or vaguely describes an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed. 0 (0%) – 20 (20%) The response inaccurately and vaguely describes 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. 27 (27%) – 30 (30%) 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. 24 (24%) – 26 (26%) The response provides a basic justification for the recommended drug therapy plan for this patient. The response includes only 1-2 examples that fully support the justification provided. 21 (21%) – 23 (23%) The response provides an inaccurate or vague justification for the recommended drug therapy plan for this patient. The response may include examples, which may inaccurately or vaguely support the justification provided. 0 (0%) – 20 (20%) The response provides an inaccurate and vague justification for the recommended drug therapy plan for this patient, or is missing. The response does not include examples that support the justification provided, or is missing. 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 rambling nor short and lacking substance. 5 (5%) – 5 (5%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity. 4 (4%) – 4 (4%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. 3.5 (3.5%) – 3.5 (3.5%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time. 0 (0%) – 3 (3%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity less than 60% of the time. Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation 5 (5%) – 5 (5%) Uses correct grammar, spelling, and punctuation with no errors 4 (4%) – 4 (4%) Contains a few (1–2) grammar, spelling, and punctuation errors 3.5 (3.5%) – 3.5 (3.5%) Contains several (3–4) grammar, spelling, and punctuation errors 0 (0%) – 3 (3%) Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list. 5 (5%) – 5 (5%) Uses correct APA format with no errors 4 (4%) – 4 (4%) Contains a few (1–2) APA format errors 3.5 (3.5%) – 3.5 (3.5%) Contains several (3–4) APA format errors 0 (0%) – 3 (3%) Contains many (≥ 5) APA format errors Total Points: 100 Pharmacotherapy For Gastrointestinal and Hepatobiliary System essay
