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 Advanced pharmacology
There are many causes of nausea and vomiting, most commonly these symptoms are caused by ingestion of substances or drugs, gastrointestinal disorders or metabolic disorders (Arcangelo, Peterson, Wilbur, & Reinhold, 2017). In this particular case study it is important to take into consideration the factors that could be contributing to the nausea, vomiting and diarrhea in patient HL. The patient has a history of drug abuse. With that being said, drug withdraw can be a factor in the cause of nausea, vomiting and diarrhea. Treatment for this type of cause would be dependent on what type of drug that patient was withdrawing from. The next factor would be medications the patient is currently taking. All three of these medications have nausea and vomiting as potential side effects. If this is the cause of the patient’s chief complaint, changing the medications could be an appropriate response. The last consideration would be the patient’s diagnosis of possible Hepatitis C. The most common symptoms of Hepatitis C include nausea, vomiting, and diarrhea (Franciscus, 2015). It would be hard to diagnosis the cause of this episode of nausea vomiting without other information such as aggravating and relieving factors, how long these symptoms have been occurring and if any other symptoms are associated with these. First line treatment of nausea and vomiting include phenothiazines such as promethazine. Promethazine can be given in 12.5-25mgs every four to six hours as needed. Contraindications include hypersensitivity, seizure disorders and Parkinson’s disease. Adverse effects include sedation, agitation, dry mouth and blurred vision (Arcangelo, Peterson, Wilbur, & Reinhold, 2017). Second line therapy would be to add an antihistamine or anticholinergic such as diphenhydramine. This medication is dosed from 25-50mg every six to eight hours as needed. Adverse effects include drowsiness, confusion and dry mouth. Contraindications include asthma, hypersensitivity and narrow-angle glaucoma (Arcangelo, Peterson, Wilbur, & Reinhold, 2017). If this persists the patient needs to reevaluate for other causes. Alternative therapies including herbal therapies such as vitamin b6 , ginger and even gum chewing are linked to the relief of nausea and vomiting (Darvall, Handscombe & Leslie, n.d.). Advanced pharmacology
Arcangelo, V. P., Peterson, A. M., Wilbur, V., & Reinhold, J. (2017). Pharmacotherapeutics for Advanced Practice (Vol. 4). Philadelphia: Wolters Kluwer.
Darvall, J. N., Handscombe, M., & Leslie, K. (n.d.). Chewing gum for the treatment of postoperative nausea and vomiting: a pilot randomized controlled trial. BRITISH JOURNAL OF ANAESTHESIA, 118(1), 83–89. https://doi-org.ezp.waldenulibrary.org/10.1093/bja/aew375
Franciscus, A. (2015). HCV Advcocate. Retrieved from HCSP Fact Sheet : http://hcvadvocate.org/hepatitis/factsheets_pdf/SEM_Nausea.pdf Advanced pharmacology
Week 4: Gastrointestinal and Hepatobiliary Disorders
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 require thoughtful and careful investigation. Similarly, hepatobiliary disorders may also mirror many of the signs and symptoms that patients present when suffering from GI disorders.
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?
This week, you examine GI and hepatobiliary disorders. You will review a patient case study and consider those factors in recommending and prescribing a drug therapy plan fo your patient. Advanced pharmacology
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. Advanced pharmacology
Utilize 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
· 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. Advanced pharmacology
· 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:
· 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 Advanced pharmacology
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