NURS 6521 Week 1 Assignment - Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders

Running Head: Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders Introduction In this case study I will be discussing pharmacotherapy for gastrointestinal (GI) and hepatobiliary disorders. The patient that is presented in a case study is HL that came in to the clinic due to nausea, vomiting and diarrhea which are related to possibility of GI infections and hepatobiliary disease Per patients history, it is evident patient has a history of drug use and possible hepatitis C. Patient appears to be taking Synthroid 100mcg daily, Nifedipine 30mg daily and Prednisone 10mg daily. I will be discussing the diagnosis and a proper drug therapy plan for this patient. Rationale for Diagnosis of the Patient With patients current symptoms presented, it is difficult to diagnose the patient right away. Hepatobiliary and gastrointestinal disorders can be very complicated to diagnose. It can be a potential diagnosis of simple food poisoning to stomach cancer with similar symptoms. It is important for me to as a practitioner to ask the patient additional questions in order to get a proper diagnosis. I would ask the patients questions that are pertaining to his medical history and current medication regimen in order to get a thorough assessment. These are the questions I would ask: • How long have you been using drugs in the past and if currently is using any drugs? • How long have you had hepatitis C for? • Why are you taking Prednisone? • Are there any other medical history that I should be aware of due to your treatment with Synthroid and nifedipine? • How long have you been experiencing current symptoms? • Do you struggle with constipation and how often you go to the bathroom? • Have you travelled anywhere recently? It will be important for me as practitioner to find out why is patient taking prednisone and for how long. Corticosteroids are frequently used in patients with autoimmune hepatitis and liver diseases, which showed great improvements in quality of life and extended longevity of patients (National Institute of Diabetes and Digestive and Kidney Diseases, 2014). Corticosteroids can be beneficial in controlling inflammation in patient with many different diseases and disorder. But, there can be many adverse side effects from taking corticosteroids such as; gastrointestinal bleeding, immunosuppression and peptic ulcers (Rosenthal & Burchum, 2021) By the presented symptoms of the patient and the current medication regiment it is possible that patient could have gastroenteritis. Patient could have contracted Helicobacter pylori (H.pylori) organism. It is evident that a big percentage of the world in infected with Hpylori and gastroenteritis and is common in USA (Chang et al., 2017). Hpylori is spread easily 3 Running Head: Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders by direct contact of stool, vomit, contaminated food/water or saliva and can cause peptic ulcers and gastritis ( Chang et al., 2017) The patient is taking prednisone medications with no knowledge of how long the medication has been taken, which caused immunosuppression and possibility of contracting Hpylori. Drug Therapy Plan and Recommendations 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 Conclusion It is very important to understand hepatobiliary and gastrointestinal disorders in order to treat patients efficiently. Hepatobiliary and gastrointestinal system plays a major role in the absorption and metabolism of the medication, an APRN must be knowledgeable in the pharmacodynamics and pharmacokinetics of the medications for such diagnosis. Gastrointestinal symptoms can be very tricky to diagnose, therefore a provider must be competent in understanding symptoms and proper drug therapy. With such knowledge and understanding a practitioner will provide efficient and effective treatment. References: 4 Running Head: Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders Chang, A. H.-M., Haggerty, T. D., de Martel, C., Leung, C. W.-M., & Parsonnet, J. (2017). Effect of Helicobacter pylori Infection on Symptoms of Gastroenteritis Due to Enteropathogenic Escherichia coli in Adults. Digestive Diseases and Sciences, 56(2), 457–464. National Institute of Diabetes and Digestive and Kidney Diseases. (2017). LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet]. Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.) St. Louis, MO: Elsevier.