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Clinical Outcomes of Antibiotics Penetrating The Bile And Gallbladder Essay

Clinical Outcomes of Antibiotics Penetrating The Bile And Gallbladder Essay

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Rationale for the Diagnosis

The patient’s presentation with right upper quadrant pain, which started after a large dinner, along with nausea and vomiting, is indicative of acute cholecystitis (Elfanagely et al., 2021). The onset of pain following a fatty meal suggests gallbladder involvement, and the nausea and vomiting may be related to gallbladder inflammation. The patient’s medical history, including hypertension, type II diabetes mellitus, and obesity, are risk factors for gallstone formation, which is a common cause of acute cholecystitis. The laboratory findings, including an increased white blood cell count (WBC) and increased alkaline phosphatase (Alk Phos), AST, and ALT), are consistent with the inflammatory process and potential gallbladder involvement. Clinical Outcomes of Antibiotics Penetrating The Bile And Gallbladder Essay

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Appropriate Drug Therapy Plan

NSAIDs (Nonsteroidal Anti-Inflammatory Drugs) such as ibuprofen for pain relief and to reduce inflammation. Moreover, Antiemetics like Ondansetron or metoclopramide are used to manage nausea and vomiting. For example, metronidazole covers gram-negative and anaerobic organisms commonly associated with biliary tract infections (Thabit, 2020). Lastly, urgent surgical consultation for cholecystectomy is indicated, especially if the patient’s symptoms persist or if there are signs of complications like perforation or gangrene.

Justification for Drug Therapy Plan

I would recommend NSAIDs because they help alleviate pain and reduce inflammation. However, caution should be exercised in patients with hypertension and diabetes, and alternative pain management strategies may need to be considered based on individual patient factors. Also, antiemetic (Ondansetron/Metoclopramide) medications can help control nausea and vomiting, improving the patient’s comfort and facilitating oral intake. Furthermore, antibiotics are essential in treating cholecystitis to cover potential infectious agents. The choice of antibiotics should consider local resistance patterns and individual patient factors, such as allergies. Surgical intervention is the definitive treatment for acute cholecystitis (Janssen et al., 2020). Consultation with a surgeon is crucial to assess the need for cholecystectomy and the timing of the procedure. Clinical Outcomes of Antibiotics Penetrating The Bile And Gallbladder Essay

 

 

References

Elfanagely, O., Iacono, S., Toussaint, A., & Johnson, R. R. W. (2021). 2021 Scientific Session of the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES), Las Vegas, Nevada, 31 August–3 September 2021: Posters. Surgical Endoscopy35, S104-S330. https://doi.org/10.1007/s00464-021-08748-9

Janssen, E. R., Hendriks, T., Natroshvili, T., & Bremers, A. J. (2020). Retrospective analysis of non-surgical treatment of acute cholecystitis. Surgical infections21(5), 428-432. https://doi.org/10.1089/sur.2019.261

Thabit, A. K. (2020). Antibiotics in the biliary tract: a review of the pharmacokinetics and clinical outcomes of antibiotics penetrating the bile and gallbladder wall. Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy40(7), 672-691.  Clinical Outcomes of Antibiotics Penetrating The Bile And Gallbladder Essay

DC is a 46-year-old female who presents with a 24-hour history of RUQ pain.  She states the pain started about 1 hour after a large dinner she had with her family.  She has had nausea and on instance of vomiting before presentation.

PMH: Vitals:
HTN Temp:  98.8oF
Type II DM Wt:       202 lbs
Gout Ht:        5’8”
DVT – Caused by oral BCPs Clinical Outcomes of Antibiotics Penetrating The Bile And Gallbladder Essay BP:       136/82
HR:       82 bpm

 

Current Medications: Notable Labs:
Lisinopril 10 mg daily WBC:                13,000/mm3
HCTZ 25 mg daily Total bilirubin:    0.8 mg/dL
Allopurinol 100 mg daily Direct bilirubin:  0.6 mg/dL
Multivitamin daily Alk Phos:           100 U/L
AST:                   45 U/L
ALT:                   30 U/L

Allergies:

  • Latex
  • Codeine
  • Amoxicillin

PE:

  • Eyes: EOMI
  • HENT: Normal
  • GI:bNondistended, minimal tenderness
  • Skin:bWarm and dry
  • Neuro: Alert and Oriented
  • Psych:bAppropriate mood Clinical Outcomes of Antibiotics Penetrating The Bile And Gallbladder Essay

To Prepare:

Review the case study assigned by your Instructor for this Assignment
Reflect on the patientâ€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 patientâ€s history, diagnosis, and drugs currently prescribed. Clinical Outcomes of Antibiotics Penetrating The Bile And Gallbladder Essay

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 patientâ€s history, diagnosis, and drugs currently prescribed.
Justify why you would recommend this drug therapy plan for this patient. Be specific and provide examples. Clinical Outcomes of Antibiotics Penetrating The Bile And Gallbladder Essay

 

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