Posted: December 23rd, 2022
Pharmacotherapeutics for advanced practice.
please use peer review articles withinlast 5 years. Also use textbook Arcangelo, V. P., Peterson, A. M., Wilbur, V., & Reinhold, J. A. (Eds.). (2017). Pharmacotherapeutics for advanced practice: A practical approach (4th ed.). Ambler, PA: Lippincott Williams & Wilkins. Gastrointestinal (GI) and hepatobiliary disorders affect the structure and function of the GI tract.Pharmacotherapeutics for advanced practice. Many of these disorders often have similar symptoms such as abdominal pain, cramping, constipation, nausea, bloating, and fatigue.
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Since multiple disorders can be tied to the same symptoms, it is important for advanced practice nurses to carefully evaluate patients and prescribe 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 Discussion, 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.Pharmacotherapeutics for advanced practice. Consider the following 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 Prednisone 10 mg daily To prepare: Review this week’s media presentation on pharmacology for the gastrointestinal system. Review the provided case study. 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. With these thoughts in mind: Post an explanation of your diagnosis for the patient including your rationale for the diagnosis. Then, describe an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed.Pharmacotherapeutics for advanced practice.
The gastrointestinal tract is protected from pathogenic microorganisms by special defense mechanism located at each portion. GI tract disorders result from breaching of the epithelial walls by toxins or germs. These manifest in the form of wounds, ulcers, inflammations, bleeding, abdominal pain and, diarrhea among others.On the other hand, hepatobiliary disorders present a group of infections that affect the biliary system and the liver. They result from several factors including parasitic, bacterial and viral attacks, cardiac failure, drug abuse, metabolic disorders, poor nutrition and alcohol abuse among others(Canders et al., 2018). GI tract and hepatobiliary disorders alter the functioning and structure of the GI tract presenting related symptoms. The management of these illnesses demands appropriate diagnosis and formulation of accurate treatment plans to prevent misdiagnosis. This paper seeks to review a case study, reflect on the patient’s symptoms, medical history, and drugs currently prescribed and suggest the possible diagnosis. It will also propose an appropriate drug therapy plan for the patient.
The patient presented in the case study is called HL. Her symptoms include diarrhea, vomiting and nausea. She has a drug abuse history as well as Hepatitis C. she is currently on Prednisone 10 mg daily, Nifedipine 30 mg daily and Synthroid 100 mcg daily. Diarrhea, vomiting and nausea symptoms suggest the presence of several diseases and conditions including pregnancy, gastrointestinal tract infections and hepatobiliary among others. The time of onset of these signs indicate the cause. For instance, when vomiting occurs immediately after taking food, the likely cause could be gastritis, bulimia, ulcer and food poisoning. Delayed symptoms could result from attacks by particular food borne bacteria including salmonella.Viral gastroenteritis also causes nausea, vomiting and waterydiarrhea while other causes can include gallbladder disease, alcohol and toxin abuse anduse of medication.Pharmacotherapeutics for advanced practice.
Multiple health conditions present similar symptoms as those of the patient as described above. A differential diagnosis is thus essential for an accurate diagnosis and development of treatment plans. In this case, the medical and drug history as well as the patients symptoms will play and essential role in determining the diagnosis. Nausea, vomiting and diarrhea are likely to occur from stomach upsets, obstructions, infections and pregnancy. This means that the symptoms can overlap with those of other multiple illnesses and thus, further diagnosis is necessary.
The review of the medical history of the client demonstrates the use of drugs in the past. She is also taking medications whose likely side effects include vomiting and nausea. Drug abuse and particularly alcohol consumption is a risk factor in the contraction of gastrointestinal and hepatobiliary disorders. The digestion of alcohol takes a different approach in comparison to food. Depending on the amount of food present in the digestive system, 20% of alcohol is absorbed in the stomach while 80 percent is absorbed in the small intestine(Tabibian, et al, 2016).Pharmacotherapeutics for advanced practice.
Fatal impacts of drug abuse on the gastrointestinal tract include liver cirrhosis, whereby liver tissues are scared to the extent of disrupting blood flow. Moreover, it increases acidity and can destroy the beneficial intestinal bacteria(Tarnutzer, Mothersill&Imbach, 2018). Opiates also cause nausea, vomiting, bloating and constipation while tobacco disrupts liver functioning, causes heartburn, Crohn’s disease, ulcers and cancers. These and other drugs also cause nutritional deficiencies and lower the immunity of an individual causing gastrointestinal and hepatobiliary disorders.
From the patient’s history, a probable history of hepatitis C is reported. This condition is considered to be the cause of liver inflammations and other liver diseases. It is believed to increase the risk of hepatobiliary tumors. Research also shows that hepatitis is an hepatobiliary illness that aggravates the occurrence of biliary tree cancer which alters the liver-pancreas pathway disrupting their functions. This results in increased jaundice and vomiting. In this case, it is evident that hepatitis C and drug abuse contribute to the patient’s symptoms and thus, the diagnoses of the client with a gastrointestinal tract or hepatobiliary disorder aligns with their condition. Pregnancy is ruled out by the presence of diarrhea.
GI tract can be managed through drug prescriptions. However, the treatment is complicated by the increased resistance of antibiotics which has increased the development of new medicines and research to seek alternatives(Arcangelo et al., 2016). Passive immunization strategies and probiotic therapy have shown interesting preliminary results in the treatment of illnesses caused by Clostridium difficile colitis. Diarrhea can also be treated using a non-absorbed antimicrobial agent called rifaximin. Macrolides are also effective and safe in the treatment of multidrug-resistant Salmonella typhi. Hepatitis C is manageable through antiviral medications which aim at reducing the viral load to undetectable in at least three months after the completion of treatment. In order to prevent complications with hepatitis viruses, vaccinations for hepatitis A and B viruses can be administered to the client. Hepatobiliary disorders can be managed through the prescription of ursodeoxycholic acid, an oral bite salt therapy(Tarnutzer, Mothersill&Imbach, 2018). The above medications do not interact with the ones currently taken by the patient and thus they assure safety and tolerability of HL.
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