NURS 6521 Assignment: Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders

Plan for Appropriate Drug Therapy

The therapy options suggested in this case study include weekly Hepatitis C pegylated interferon (IFN-). The patient is also placed on a daily dose of ribavirin for between 24 and 48 weeks. Particularly for HCV genotypes 2 and 3, the combination is efficient in eradicating infections. Food therapy should also be started for the patient. It is advised that eating a regular, balanced diet may avoid the disease’s accompanying nausea and vomiting. Cereals, whole grains, vegetables, and even fruits should be included in a balanced diet. A moderate to high protein diet should also be followed in order to heal the affected liver tissue (Venugopal et al., 2018). Additionally, the patient needs to stay away from medications like acetaminophen, sedatives, and aminoglycoside antibiotics, which are thought to be hepatotoxic in large dosages.

The correct application of the appropriate diagnostic techniques serves as the foundation for diagnosis, which determines the type of intervention to be used. HCV can be brought on by bacteria, viruses, or chemical substances. Ribavirin and pegylated interferon (IFN) can be used to treat the disorder.

GI and hepatobiliary disorders have an impact on the structure and function of the gastrointestinal system. Abdominal cramping, constipation, bloating, and exhaustion are common symptoms of several of these illnesses. Patients should be thoroughly evaluated by advanced practice nurses before they are prescribed medication, as various conditions can be linked to similar signs and symptoms.

After determining the underlying reason, a medication therapy plan might be given based on the patient’s medical history and personal characteristics. A case study of a patient with suspected GI/hepatobiliary illness is examined in this Assignment, and you construct an appropriate pharmacological therapy plan for the patient.

Also Read: Assignment: Asthma and Stepwise Management Essay

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. NURS 6521 Assignment: Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders

By Day 7 of Week 4

Gastrointestinal and Hepatobiliary Disorders

The scenario presents patient HL with the following symptoms: nausea, vomiting, and diarrhea due to Prednisone. The patient also has a history of drug abuse and possible signs of Hepatitis C. The history of drug abuse could also be the reason that is causing malfunction in the body, which leads to vomiting and nausea (Asrani et al., 2019). The paper determines the three differential diagnoses and explains the pharmacological way to treat them.

Diagnosis

Despite the absence of a physical and comprehensive examination, the available symptoms such as diarrhea, nausea, and vomiting can be used to diagnose the patient. Based on the presented symptom, the primary patient diagnosis is acute gastroenteritis. Acute gastroenteritis is caused by parasitic, direct viral, and bacterial (Amjad, 2020). In this case, the stomach and intestine suffer inflammation and irritation due to bacteria inflammation leading to food contamination (Amjad, 2020). Acute gastroenteritis can be spread by drinking contaminated beverages or foods (Amjad, 2020).

The patient history of drug abuse can help diagnose the patient to suffer from acute hepatitis C flare-up. Hepatitis C causes liver infection caused by a virus (Axley et al., 2018). Therefore, a patient history of drug abuse gives room for a high rate of contracting hepatitis C. The symptoms associated with a patient with Hepatitis C flare-up include nausea, vomiting, and diarrhea (Axley et al., 2018). The patient could also be diagnosed with a hepatobiliary disease caused by bacterial, virus, or alcohol consumption. The symptom is abdominal pain, nausea or vomiting, fatigue, and loss of appetite (Axley et al., 2018). However, HL suffered from Hepatitis C flare-up and acute gastroenteritis based on the symptom presented.

Drug Therapy and Treatment Plan

The primary aim is to overcome the patient’s symptoms and reduce complications. The patient should continue using Synthroid 100 mcg daily, which effectively restores thyroid hormone and helps treat Hepatitis C (Rosenthal & Burchum, 2020). Thyrotropin is released in hormone (TRH), leading to the anterior pituitary stimulation (Rosenthal & Burchum, 2020). The thyroid is secreted to 80% thyroxine (T4), while 20 % represents the L-triiodothyronine (Rosenthal & Burchum, 2020). The patient should also be prescribed promethazine 25mg daily to treat acute gastroenteritis (Amjad, 2020). The drug is also effective in the drug abuse history of HL. Promethazine 25mg daily does not produce any sedative effects, which is essentially dealing with the patient history of drug which causes an effect in the liver (Rosenthal & Burchum, 2020). The promethazine alienates the peripheral and central effects by using histamine receptors (Rosenthal & Burchum, 2020). The patient should reduce the intake of Nifedipine 30mg daily since it is used to treat hypertension (Ainuddin et al., 2019).

Prednisone 10mg is known to cause side effects such as vomiting, nausea, and diarrhea. Prednisone helps lower inflammation, which is achieved by decreasing the capillary permeability and the migration of the polymorphonuclear leukocytes (Rosenthal & Burchum, 2020). The drug therapy will involve taking the drug in three days and being encouraged to return to the clinic for further evaluation to determine the drugs’ effectiveness. The use of antiemetics will effectively deal with vomiting and nausea (Rosenthal & Burchum, 2020). However, the side effect of antiemetic use is that it increases electrolyte and dehydration imbalance (Rosenthal & Burchum, 2020).

Justifying the Recommendation Drug Therapy

The newer agent for curing hepatitis C infection is the antimotility agent, which effectively treats acute non-bloody diarrhea (Aksan et al., 2021). The agents in this category include loperamide (Imodium) and bismuth subsalicylate, which help rehydrate symptomatic relief (Aksan et al., 2021). The most reabsorption agent is loperamide, which helps alter intestinal motility by giving time for the reabsorption of water in the intestines, thus declining the volume of stools (Ayele et al., 2021). Oral Rehydration Salts are also effective in dealing with dehydration since they contain trisodium citrate, sucrose, and potassium chloride dehydrate. The amount given should depend on the intensity and frequency of diarrhea.

Conclusion

Zinc supplements effectively deal with gastroenteritis, which leads to diarrhea. Patients suffering from gastroenteritis face severe zinc deficiency (Hitch & Fleming, 2018). In this case, zinc will act as a micronutrient that helps the cell grow, boost immunity, and help intestinal transport. It is also essential in water and electrolyte transportation.

References

Ainuddin, J., Javed, F., & Kazi, S. (2019). Oral labetalol versus oral nifedipine for the management of postpartum hypertension a randomized control trial. Pakistan Journal of Medical Sciences, 35(5), 1428. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6717493/

Aksan, A., Farrag, K., Blumenstein, I., Schröder, O., Dignass, A. U., & Stein, J. (2021). Chronic intestinal failure and short bowel syndrome in Crohn’s disease. World Journal of Gastroenterology, 27(24), 3440. https://www.ncbi.nlm.nih.gov/pmc/articles/pmc8240052/

Amjad, M. (2020). An overview of the molecular methods in the diagnosis of gastrointestinal infectious diseases. International Journal of Microbiology, 2020. https://doi.org/10.1155/2020/8135724

Asrani, S. K., Devarbhavi, H., Eaton, J., & Kamath, P. S. (2019). Burden of liver diseases in the world. Journal of Hepatology, 70(1), 151-171. https://www.sciencedirect.com/science/article/pii/S0168827818323882

Axley, P., Ahmed, Z., Ravi, S., & Singal, A. K. (2018). Hepatitis C virus and hepatocellular carcinoma: a narrative review. Journal of Clinical and Translational Hepatology, 6(1), 79. https://doi.org/10.14218/JCTH.2017.00067

Ayele, T. M., Abebe, E. C., & Kassie, A. B. (2021). Investigation of Antibacterial and Anti-Diarrhoeal Activities of 80% Methanol Leaf and Fruit Extract of Leonotis ocymifolia (Burm. F) Iwarsson (Lamiaceae). Journal of Experimental Pharmacology, 13, 613. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8254535/

Hitch, G., & Fleming, N. (2018). Antibiotic resistance in travellers’ diarrhoeal disease, an external perspective. Journal of Travel Medicine, 25(Suppl_1), S27-S37. https://doi.org/10.1093/jtm/tay014

Rosenthal, L., & Burchum, J. (2020). Lehne’s Pharmacotherapeutics for Advanced Practice Nurses and Physician Assistants-E-Book. Elsevier Health Sciences.

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.

Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center offers an example of those required elements (available at http://writingcenter.waldenu.edu/57.htm). All papers submitted must use this formatting.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

• Please save your Assignment using the naming convention “WK4Assgn+last name+first initial.(extension)” as the name.
• Click the Week 4 Assignment Rubric to review the Grading Criteria for the Assignment.
• Click the Week 4 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
• Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK4Assgn+last name+first initial.(extension)” and click Open.
• If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
• Click on the Submit button to complete your submission. NURS 6521 Assignment: Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders

Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders

Abdominal infections could be associated with a wide range of clinical features, including abdominal pain, nausea, vomiting, and diarrhea. In that regard, therefore, it would be easy to confuse one diagnosis over the other. This essay considers a patient HL case study presented with nausea, vomiting, diarrhea, the diagnosis made, and the treatment options are taken.

Diagnosis

Hepatitis C is a possible diagnosis for HL. This condition would appear asymptomatic, but when symptoms occur, they could be mild or even severe. HL symptoms, including nausea, vomiting, and diarrhea, are prevalent with hepatitis C infection. This condition could be caused by viruses, bacteria, or parasitic infections. The infection can also be found in contaminated food or water, while chemical agents have also been shown to be causative. The diagnosis can be made using tests that include serologic assays, which measure the levels of antibodies that are generated, and the molecular assays which would detect the presence of HCV RNA (Chalasani et al., 2018).

References

Chalasani, N., Younossi, Z., Lavine, J. E., Charlton, M., Cusi, K., Rinella, M., … Sanyal, A. J. (2018). The diagnosis and management of nonalcoholic fatty liver disease: Practice guidance from the American Association for the Study of Liver Diseases. Hepatology, 67(1), 328–357. https://doi.org/10.1002/hep.29367

Venugopal, V., Padmanabhan, P., Raja, R., & Dixit, N. M. (2018). Modelling how responsiveness to interferon improves interferon-free treatment of hepatitis C virus infection. PLoS Computational Biology, 14(7), e1006335. https://doi.org/10.1371/journal.pcbi.1006335

Grading Criteria

To access your rubric:

Week 4 Assignment Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Week 4 Assignment draft and review the originality report.

Submit Your Assignment by Day 7 of Week 4

To participate in this Assignment:

Week 4 Assignment

Next Week

To go to the next week:

Module 4

Symptoms of various GI and hepatobiliary disorders frequently overlap, making diagnosis and treatment difficult. Symptoms such as vomiting, constipation, and bloating, for example, are non-specific and could be the result of an underlying medical condition or current prescription drug use. As an advanced practice nurse, you may be in charge of providing care to a patient who has non-specific symptoms related to the gastrointestinal and hepatobiliary systems.

How would you handle this patient’s care? Without knowing your current medical history or prescription drug use, what type of drug therapy would you recommend? Are there any drugs you should avoid in order to avoid a drug-drug interaction? These are the kinds of questions you might ask as an advanced practice nurse.

What’s Going on in This Module?

Module 3: Gastrointestinal and Hepatobiliary Systems is a one-week module that takes place during Week 4 of the course. In this module, you will look at diagnoses for patients who may have GI or hepatobiliary disorders. In addition, you create a drug therapy plan based on the patient’s history and diagnosis.

As an advanced practice nurse, you will almost certainly encounter patients who have gastrointestinal (GI) symptoms. It is worth noting that most GI tract symptoms are non-specific, so diagnosing the GI tract requires thoughtful and careful investigation. Similarly, hepatobiliary disorders may mimic many of the signs and symptoms seen in patients with GI disorders.

How can you distinguish the specific signs and symptoms of these potential disorders and body systems? What drug therapy plans will be most effective in treating these disorders in your patients?

This week, you will look at GI and hepatobiliary disorders. You will review a patient case study and take those factors into account when recommending and prescribing a drug therapy plan for your patient.

Learning Objectives

Students will:

• Evaluate diagnoses for patients with gastrointestinal and hepatobiliary disorders
• Justify drug therapy plans based on patient history and diagnosis

Learning Resources

Required Readings (click to expand/reduce)

Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2^nd 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 Diseases. 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.

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.

Learning Objectives

Students will:

• Evaluate diagnoses for patients with gastrointestinal and hepatobiliary disorders
• Justify drug therapy plans based on patient history and diagnosis

Learning Resources

Required Readings (click to expand/reduce)

Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2^nd 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 Diseases. 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.

Name: NURS_6521_Week4_Assignment_Rubric