Pharmacotherapy For Gastrointestinal And Hepatobiliary Disea ✓ Solved

Pharmacotherapy for Gastrointestinal and Hepatobiliary Dis

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.

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: Synthroid 100 mcg daily, Nifedipine 30 mg daily, and Prednisone 10 mg daily.

As an advanced practice nurse, you will likely encounter patients who will present with symptoms affecting the gastrointestinal (GI) tract. Of special note, is the consideration that most symptoms concerning the GI tract are non-specific and therefore, diagnosing diagnoses of the GI tract requires thoughtful and careful investigation. Similarly, hepatobiliary disorders may also mirror many of the signs and symptoms that patients present when suffering from GI disorders.

Rationale considerations: How might you tease out the specific signs and symptoms between these potential disorders and body systems? What drug therapy plans will best address these disorders for your patients?

Write a 1.5 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.

Paper For Above Instructions

In this paper, I will outline the diagnosis and drug therapy plan for Patient HL, who presents with nausea, vomiting, and diarrhea, compounded by a history of drug abuse and possible Hepatitis C. The symptoms exhibited provide essential insight into the underlying biological and physiological mechanisms at play and guide the formulation of an effective pharmacotherapeutic strategy.

Diagnosis

Considering the symptoms and medical history of Patient HL, it is reasonable to suspect acute viral hepatitis, given the concurrent consumption of substances and the history of Hepatitis C infection. Acute hepatitis presents with non-specific symptoms, including nausea, vomiting, and diarrhea, which can be attributed to elevated liver enzymes and subsequent metabolic dysfunction (Tavakkoli et al., 2021). The patient’s previous drug abuse further complicates the presentation, as it can exacerbate liver dysfunction if an underlying hepatitis infection is active. Additionally, the possibility of acute gastroenteritis cannot be overlooked, especially if recent dietary indiscretion or exposure to pathogens exists. However, given the patient's history, the likelihood of an exacerbation of Hepatitis C is greater.

Drug Therapy Plan

For Patient HL, a comprehensive drug therapy plan should encompass antiviral treatment aimed at managing Hepatitis C if the diagnosis is confirmed. Direct-acting antivirals (DAAs) such as Sofosbuvir/Velpatasvir (Epclusa) would be a primary choice, as this combination is effective in treating various genotypes of Hepatitis C, with high cure rates and favorable safety profiles (AASLD, 2022). The patient should also be monitored for any signs of liver function deterioration, as certain medications can further stress an already compromised liver.

In conjunction with antiviral therapy, symptomatic management is essential. Antiemetic medications, like Ondansetron, may be recommended to alleviate nausea and optimize hydration and nutritional intake. Furthermore, close monitoring of electrolyte levels and the provision of intravenous fluids may be warranted if diarrhea persists or worsens, as dehydration can complicate recovery. The chronic nature of Prednisone (10 mg daily) and Nifedipine (30 mg daily) use in this patient should also be reassessed; potential interactions with new medications should be identified, and alternative therapies may be considered.

Justification of the Drug Therapy Plan

The rationale behind the chosen drug therapy regimen for Patient HL is the necessity to address the underlying viral infection influencing the patient’s symptoms while simultaneously managing the presenting symptoms. DAAs represent a well-tolerated and highly effective treatment method for Hepatitis C, providing the optimal approach towards minimizing the risks associated with the liver's inflammatory processes (Chiriboga et al., 2022).

The combination of Ondansetron allows for the mitigation of severe nausea, a common concern in both hepatitis and gastroenteritis, which is crucial for maintaining oral nutritional intake and preventing dehydration (Vo & Choi, 2020). With regard to monitoring, regular follow-up appointments could help identify any fluctuating liver function tests that necessitate adjustments to the treatment plan, ensuring the pharmacotherapy remains safely aligned with the patient's health context.

In summary, the interlocking complexity of GI and hepatobiliary disorders challenges diagnosis and treatment but underscores the pivotal role of tailored pharmacotherapeutic interventions. The drug therapy plan for Patient HL focuses on addressing both causative factors and symptomatic relief, aiming for optimal health outcomes through coordinated care.

References

• AASLD. (2022). AASLD Guidance on Treatment of Hepatitis C.
• Chiriboga, L., et al. (2022). Treatment Strategies for Hepatitis C. Journal of Liver Research, 18(3), 50-65.
• Tavakkoli, H., et al. (2021). Symptoms of Acute Hepatitis: A Comprehensive Overview. American Journal of Gastroenterology, 116(1), 178-189.
• Vo, A., & Choi, J. (2020). The Role of Ondansetron in Preventing Nausea and Vomiting in Viral Illnesses. Clinical Therapeutics, 42(3), 456-463.
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