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Pharmacotherapy For Gastrointestinal And Hepatobiliary Disorders Essay

Pharmacotherapy For Gastrointestinal And Hepatobiliary Disorders Essay

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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. Pharmacotherapy For Gastrointestinal And Hepatobiliary Disorders Essay

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INSTUCTIONS:

 

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.

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. Pharmacotherapy For Gastrointestinal And Hepatobiliary Disorders Essay

 

Work with information provided; statements such as I’m unable to treat the patient until lab results are provided  are “unacceptable.

You may use as many pages as you need.

Case Study:

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 had nausea and one instance of vomiting before the presentation.


PMH:                                                              Vitals: 


HTN                                                                Temp:              98.8F


Type II DM                                                     Wt:                  202 lbs


Gout                                                                Ht: 5’8″


DVT – Caused by oral BCPs                          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:      Pharmacotherapy For Gastrointestinal And Hepatobiliary Disorders Essay                      30 U/L


Allergies:

Latex
Codeine
Amoxicillin


PE:

Eyes: EOMI
HENT: Normal
GI: Nondistended, minimal tenderness
Skin:  Warm and dry
Neuro: Alert and Oriented
Psych:  Appropriate mood

 

 Feedback:

The case studies are provided for you to treat the patient as an NP; this is your chance to prescribe medications. Please refrain from making statements like I will consult the experts or the medicines should be changed;  document what you would prescribe for the patient and why.

Many of you should observe the patient’s lab results, vitals, and symptoms.

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REQUIRED READING:

  • Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants(2nd ed.) St. Louis, MO: Elsevier.
    • Chapter 64, “Drugs for Peptic Ulcer Disease” (pp. 589–597)
    • Chapter 65, “Laxatives” (pp. 598–604)
    • Chapter 66, “Other Gastrointestinal Drugs” (pp. 605–616)
    • Chapter 80, “Antiviral Agents I: Drugs for Non-HIV Viral Infections” (pp. 723–743)
  • Chalasani, N., Younossi, Z., Lavine, J. E., Charlton, M., Cusi, K., Rinella, M., . . . Sanya, A. J. (2018). The diagnosis and management of nonalcoholic fatty liver disease: Practice guidance from the American Association for the Study of Liver DiseasesLinks to an external site.. Hepatology, 67(1), 328–357. Retrieved from https://aasldpubs.onlinelibrary.wiley.com/doi/pdf/10.1002/hep.29367

This article details the diagnosis and management of nonalcoholic fatty liver disease. Review this article to gain an understanding of the underlying pathophysiology as well as the suggested pharmacotherapeutics that might be recommended to treat this disorder. Pharmacotherapy For Gastrointestinal And Hepatobiliary Disorders Essay

Case Overview

D.C a 46 year old female presents with RUQ pain for the last 24 hours which started one hour after dinner. She reports of having nausea and one episode of vomiting. She is a known diabetic, hypertensive, gout patient and has a positive history of DVT.

Diagnosis

Cholelithiasis is the probable diagnosis. Cholelithiasis also known as gallstones are hardened deposits of digestive juices that are formed in the gall bladder. Gallstones are mainly formed from over secretion of cholesterol by the liver cells, impaired emptying or hypo motility of the gall bladder (Jones et al., 2021). D.C has some of the risk factors associated with the disease that include female gender, obese, has a history of use of oral contraceptives, she is in her 40’s and is diabetic. The patient also presents with some of the classical symptoms of cholelithiasis. According to Littlefield & Lenahan, (2019), the symptoms include right upper quadrant pain after feeding, nausea and vomiting. Pharmacotherapy For Gastrointestinal And Hepatobiliary Disorders Essay

Appropriate Drug Therapy

Treatment is only indicated only in the presence of symptoms. Ursodeoxycholicacid and chenodeoxycholic acid are litholytic drugs that is used in the dissolution of the gallstones (Shenoy et al., 2022). Treatment of acute biliary colic mainly involves pain control using NSAID’s or narcotic pain relievers. Antispasmodics agents such as scopolamine are thought to relieve and relax spasms of the gallbladder.

Drug Recommendation Justification

Litholytic therapy is recommended for gallstones must have high cholesterol content and be <1cm. litholytic drugs promote dissolution of gallstones and cholesterol crystals, causes formation of unsaturated bile and reduces hepatic secretion of biliary cholesterol (Biesterveld et al., 2020).  Pain management is important to improve the patient’s quality of life. Pharmacotherapy For Gastrointestinal And Hepatobiliary Disorders Essay

References

Biesterveld, B. E., Alam, H. B., Kronick, S. L., Pomerantz, B., Repaskey, W. T., & Rice, M. D. (2020). Evaluation and Management of Gallstone-Related Diseases in Non-Pregnant Adults. In PubMed. Michigan Medicine University of Michigan. https://www.ncbi.nlm.nih.gov/books/NBK569245/

Jones, M. W., Weir, C. B., & Ghassemzadeh, S. (2021). Gallstones (Cholelithiasis). PubMed; StatPearls Publishing. https://pubmed.ncbi.nlm.nih.gov/29083691/

Littlefield, A., & Lenahan, C. (2019). Cholelithiasis: Presentation and Management. Journal of Midwifery & Women’s Health, 64(3), 289–297. https://doi.org/10.1111/jmwh.12959

Shenoy, R., Kirkland, P., Hadaya, J. E., Tranfield, M. W., DeVirgilio, M., Russell, M. M., & Maggard-Gibbons, M. (2022). Management of symptomatic cholelithiasis: a systematic review. Systematic Reviews, 11(1). https://doi.org/10.1186/s13643-022-02135-8 Pharmacotherapy For Gastrointestinal And Hepatobiliary Disorders Essay

 

 

 

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