Case Study-46-Year-Old Female
Diagnosis and Diagnosis Rationale for the Patient
According to the information, DC is likely to suffer from acute pancreatitis. The history of the patient and presenting symptoms, including nausea, vomiting, and right upper quadrant pain, helped diagnose the disease. Investigations showed elevated bilirubin levels and pancreatic enzymes contributed to achieving the above diagnosis. In addition, the patient has a history of gout and use of allopurinol, which are risk factors for this disease. Acute pancreatitis is a disease that occurs due to inflammation of the pancreas (Mederos et al., 2021). Nausea, vomiting, and abdominal pain are the most common symptoms. Associating factors include increased levels of enzymes in the pancreas and bilirubin levels. Contributing factors include allopurinol use and previous history.
Appropriate Drug Therapy Plan
The patient’s current medications include multivitamins 100U/L daily, allopurinol 100mg daily, HCTZ 25mg daily, and lisinopril 10mg daily. According to the patient’s history, she has comorbidities like type 2 diabetes, hypertension, previous history of deep venous thrombosis and gout. The drug therapy plan for this patient includes continuing HCTZ and lisinopril for hypertension, analgesics such as ibuprofen to manage pain, and an antacid because of nausea and vomiting. If the patient does not have other gout episodes, she should continue taking allopurinol. However, the allopurinol dose could be increased, or another gout medication could be added if the patient gets another gout episode.
Why I Recommend the Drug Therapy Plan
Some lifestyle diseases, such as type 2 diabetes mellitus and hypertension, require lifetime management. Type 2 diabetes is a disease that occurs as a result of high sugar levels in the blood. The main aim of managing diabetes is to control sugar levels in the blood and prevent complications such as nephropathy and retinopathy resulting from uncontrolled sugar levels. Allopurinol is a drug of choice for controlling sugar levels and is also known to be effective (Thong et al., 2021). Its mechanism of action is that it decreases urinary albumin excretion rates and serum creatinine and increases the estimated glomerular Fluid rate, therefore reducing kidney damage in diabetic patients. It is also effective in the treatment of gout. It is a xanthine oxidase inhibitor that reduces uric acid production by stopping the purine catabolism pathway that causes its formation (Su et al., 2021). Gout is a condition that occurs due to inflammation and pain in the joints. The aim of the treatment is t control pain and reduce inflammation.
Hypertension is a condition that is characterized by elevated blood pressure than the normal. It can cause stroke, heart attack, and chronic kidney disease. Drugs that are used to control DC’s blood pressure are lisinopril and HCTZ. Lisinopril and HCTZ are angiotensin-converting enzyme inhibitors that initiate the conversion of angiotensin I to angiotensin II, which stimulates the adrenal cortex to release aldosterone which causes reabsorption of water and sodium and secretion of potassium and protons in the urine.
On the other hand, Deep Venous Thrombosis is caused by blood clots in the deep vein, especially in the legs. This condition is serious because the blood clots can dislodge and go to the lungs and stop blood flow in the pulmonary artery, leading to low oxygen levels and damage to other organs. It can easily lead to death. The treatment aims to reduce the risk of complications brought about by DVT and prevent the formation of blood clots. In order to control the formation of blood clots, aspirin can be administered. Aspirin causes an antithrombotic effect by inhibiting the activity of cyclooxygenase, an enzyme that causes the synthesis of prostaglandins that leads to clot formation.
References
Mederos, M. A., Reber, H. A., & Girgis, M. D. (2021).” Acute pancreatitis: a review “Jama, 325(4), 382-390.
Su, A., Yuan, X., Zhu, G., Jiang, X., Shu, R., Yang, W., … & Cui, L. (2022). Association Between Baseline Uric Acid and the Risk of Acute Pancreatitis: A Prospective Cohort Study. Pancreas, 51(8), 966-971.
Thong, V. D., Trinh, N. T. M., & Phat, H. T. (2021). Factors associated with the severity of hypertriglyceridemia-induced acute pancreatitis. Medicine, 100(21).
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Question 
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 the presentation.
Case Study-42-Year-Old Woman
PMH: Vitals:
HTN Temp: 98.8oF
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: 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
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.