Gastrointestinal and Hepatobiliary Disorders

Gastrointestinal and Hepatobiliary Disorders

Gastrointestinal and Hepatobiliary Disorders

The patient has a positive diagnosis of cholecystitis. The patient presented with right upper quadrant pain. The history of the presenting complaint revealed that the RUQ pain started 24 hours before the visitation, an hour after a large meal. Additionally, notable lab work revealed an elevated WBC of 13,000/mm3 (normal 4500-11,000). Cholecystitis is a common cause in the right upper quadrant. Acute cholecystitis may be potentiated by the ingestion of a heavy meal. In this condition, WBCs are usually slightly elevated due to the presence of an inflammatory process. Cholecystitis also presents with nausea and vomiting (Gallaher & Charles, 2022). The symptoms observed in this patient were consistent with classic symptoms of cholecystitis and informed my diagnosis. Hire our assignment writing services in case your assignment is devastating you. We offer assignment help with high professionalism.

The drug therapy plan for this patient will focus on pain relief, antibiotics to treat the infection, and other non-pharmacological strategies to offset the inflammatory process. The patient will thus be initiated on Flurbiprofen 100 mg every 8 hours (Fraquelli et al., 2018) and ciprofloxacin 500mg every 12 hours (Buckman & Mazuski, 2019). These drugs were selected due to their less propensity to interact with the medications the patient is already using. Rehydration with IV fluids and periodic fasting to rest the gall bladder are some non-pharmacological interventions for the patient. Cholecystectomy can also be considered when all these interventions fail.

My drug therapy plan consisted of flurbiprofen and ciprofloxacin. I selected flurbiprofen because of its effectiveness in relieving mild to moderate pain and its little likelihood of interacting with other medications. Opioid analgesics such as meperidine maintain high effectiveness in relieving pain associated with cholecystitis (Rosenthal & Burchum, 2022). However, they were excluded due to potential cross-reactivity since the patient was allergic to codeine. A broad-spectrum antibiotic was also necessary to treat apparent infections (Rosenthal & Burchum, 2022). Penicillin antibiotics remain effective in this regard but were excluded because of the potential cross-reactivity since the patient was allergic to amoxicillin.

References

Buckman, S., & Mazuski, J. (2019). Review of the Tokyo Guidelines 2018: Antimicrobial Therapy for Acute Cholangitis and Cholecystitis. JAMA Surgery, 154(9), 873. https://doi.org/10.1001/jamasurg.2019.2169

Fraquelli, M., Casazza, G., Conte, D., & Colli, A. (2018). Non-steroid anti-inflammatory drugs for biliary colic. Cochrane Database of Systematic Reviews, 2016(9). https://doi.org/10.1002/14651858.cd006390.pub2

Gallaher, J., & Charles, A. (2022). Acute Cholecystitis. JAMA, 327(10), 965. https://doi.org/10.1001/jama.2022.2350

Rosenthal, L., & Burchum, J. (2022). Lehn’s Pharmacotherapeutics for Advanced Practice Nurses and Physician Assistants (2nd ed.). Elsevier.

ORDER A PLAGIARISM-FREE PAPER HERE

We’ll write everything from scratch

We are starting week 4 and will be going over medications in the GI and Hepatobiliary system.

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.

Gastrointestinal and Hepatobiliary Disorders

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 plan.

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.

Case:
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 had nausea and one instance of vomiting before the presentation.

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:bNondistended, minimal tenderness
Skin:bWarm and dry
Neuro: Alert and Oriented
Psych:bAppropriate mood