Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders Essay Assignment

Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders

Introduction

Pharmacotherapy involves the use of medication to treat various diseases and disorders. Before making the appropriate drug therapy plan, it is imperative to review the patients’ symptoms, medical history, and current medications. In the case, Patient HL exhibits symptoms of nausea, vomiting, and diarrhea. The patient also has a history of drug abuse and possible hepatitis C infection. Further, Patient HL’s current prescriptions include Synthroid, Nifedipine, and Prednisone. Patient HL needs a new treatment plan that will mitigate nausea, vomiting, and diarrhea. The symptoms presented by HL may be indicative of several conditions . The purpose of this paper is to review the patient HL’s medical history, current medications, and current symptoms to make a diagnosis and drug therapy plan to mitigate the gastrointestinal and hepatobiliary symptoms.

Differential Diagnosis

Based on Patient HL history, the symptoms of nausea, vomiting, and diarrhea might be caused by gastrointestinal disorders, drug withdrawal syndromes, and the currently prescribed medication. The patient might have also been infected by a gastrointestinal disorder known as gastroenteritis. Gastroenteritis refers to the inflammation of the stomach and small intestines caused by a virus infection. Gastroenteritis is usually spread through contact with the infected persona of contaminated food and water. Some of the common gastroenteritis symptoms include watery diarrhea, nausea, and vomiting (Banyai et al., 2018). These symptoms appear with 24 to 48 hours of infection.

Drug withdrawal syndrome refers to the symptoms that occur when an individual stop taking medication or abusing a drug abruptly. Drug withdrawal syndrome is caused by individual addiction and dependence on the drug. Patient HL might experience withdrawal symptoms of nausea, vomiting, and diarrhea by abruptly stopping the intake of alcohol or opioids, such as heroin (Bluthenthal et al., 2020). The possibility of drug withdrawal syndromes is based on the Patient’s HL history of drug abuse.

The patient might also be experiencing nausea because of consuming the currently prescribed medication. According to Drugs.com, Synthroid, Nifedipine, and Prednisone have side effects of nausea, vomiting, and diarrhea (Drugs.com, 2019). These medications might have been prescribed to mitigate the effects of hepatitis C. Hepatitis C is usually spread by the sharing of needles by intravenous drug users (Joy et al., 2016). In the past, it was spread through blood transfusion and organ transplants, but these modes of infection have reduced due to exhaustive screening for pathogens. In this case, the patient might be taking prednisone to prevent liver inflammation caused by the hepatitis c virus (Drugs.com, 2019). Patient HL might also be taking Synthroid to treat hypothyroidism caused by Prednisone (Drugs.com, 2020). Hypothyroidism also causes hypertension, making Patient HL to be prescribed with Nifedipine (Drugs.com, 2018).

Diagnosis and Rationale for Diagnosis

Based on Patient HL’s previous diagnosis of hepatitis C infection and drug abuse, my diagnosis would be that the patient might be suffering from drug withdrawal symptoms of intravenous drugs such as heroin, opioids, and other prescription drugs. Withdrawal from drugs causes significant physiological symptoms including gastrointestinal symptoms such as nausea, vomiting, diarrhea, and stomach cramps (Addictions and recovery, 2020).

Drug therapy plan

Patient HL should take a dosage 20mg of methadone daily, 0.2 mg of clonidine every 6 hours for seven days, and 16mg buprenorphine daily (Martínez & Pintado, 2020). These medications should be taken orally while monitoring patient HL symptoms in the hospital setting. The administration of methadone, clonidine, and buprenorphine will mitigate the withdrawal syndrome symptoms, which include nausea, vomiting, and diarrhea. Loperamide may also be used to manage the diarrhea (Rosenthal & Burchum, 2018). Loperamide will help by decreasing bowel motility and the secretion of fluids in the intestines thus stopping the diarrhea (Rosenthal & Burchum, 2018). IV and Oral fluids must be increased to prevent dehydration.

Conclusion

Patient HL symptoms, history of drug abuse, and current medication suggest that he might be suffering from gastroenteritis, drug withdrawal symptoms of alcohol and opioids, or the prescribed medicine. Patient HL had earlier been diagnosed with hepatitis C, spread through the sharing of needles used in intravenous drugs, and might also be taking the medication to suppress liver inflammation. The analysis suggests that he might be suffering from drug withdrawal symptoms of substances such as opioids and heroin injected into the vein. The symptoms might, therefore, be mitigated by the administration of methadone, clonidine, and buprenorphine.

 

 

References

Addictions and recovery (2020). Drug and Alcohol Withdrawal. Retrieved from https://www.addictionsandrecovery.org/withdrawal.htm

Bányai, K., Estes, M. K., Martella, V., & Parashar, U. D. (2018). Viral gastroenteritis. The Lancet392(10142), 175-186.

Bluthenthal, R. N., Simpson, K., Ceasar, R. C., Zhao, J., Wenger, L., & Kral, A. H. (2020). Opioid withdrawal symptoms, frequency, and pain characteristics as correlates of health risk among people who inject drugs: drug and Alcohol Dependence, 107932.

Drugs.com (2018). Nifedipine Uses, Dosage & Side Effects. Retrieved from https://www.drugs.com/nifedipine.html

Drugs.com (2019). Prednisone Uses, Dosage, Side Effects, Warnings. Retrieved from https://www.drugs.com/prednisone.html

Drugs.com (2020). Synthroid Uses, Dosage & Side Effects. Retrieved from https://www.drugs.com/synthroid.html

Joy, J. B., McCloskey, R. M., Nguyen, T., Liang, R. H., Khudyakov, Y., Olmstead, A., & Poon, A. F. (2016). The spread of hepatitis C virus genotype 1a in North America: a retrospective phylogenetic study. The Lancet Infectious Diseases16(6), 698-702. Martínez, N., & Pintado,

  1. C. (2020). Substance Withdrawal in ICU Environment. Oncologic Critical Care, 1913-1933.

Rosenthal, L. D., & Burchum, J. (2018). Lehne’s pharmacotherapeutics for advanced practice providers. St Louis, MO: Elsevier.

 

Assignment: Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders

Photo Credit: Getty Images/iStockphoto

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.
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.

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.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

  • Please save your Assignment using the naming convention “WK4Assgn+last name+first initial.(extension)” as the name.
  • Click the Week 4 Assignment Rubric to review the Grading Criteria for the Assignment.
  • Click the Week 4 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
  • Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK4Assgn+last name+first initial.(extension)” and click Open.
  • If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
  • Click on the Submit button to complete your submission.

 

 

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