NURS 6521 Week 4 Assignment: Pharmacotherapy For Gastrointestinal And Hepatobiliary Disorders Example 2 Case Study: Gastroenteritis HL is a patient who presents with nausea, vomiting, and diarrhea with a history of drug abuse and possible Hepatitis C

NURS 6521 Week 4 Assignment: Pharmacotherapy For Gastrointestinal And Hepatobiliary Disorders Example 2

Case Study: Gastroenteritis

HL is a patient who presents with nausea, vomiting, and diarrhea with a history of drug abuse and possible Hepatitis C. This paper aims to highlight the differential diagnosis based on the patient’s presenting complaint, describe the recommended drug therapy, and justify its use for this patient.

Differential Diagnoses

The primary diagnosis is gastroenteritis. Differential diagnoses include food poisoning and bowel obstruction. Gastroenteritis is a viral, bacterial, or parasitic infection of the intestines that presents with the above presentation in addition to abdominal pain and is highly contagious (Maslennikov et al., 2021). The main causative agents are viruses, including noroviruses and rotavirus, transmitted through ingestion or coming into contact with contaminated food and water. Using prednisone, which suppresses the immune system, means an increased predisposition to infections. In addition to the patient’s presenting complaint, this means that gastroenteritis is the primary diagnosis.

Drug Therapy Plan

Gastroenteritis is often self-limiting, and the patient is encouraged to stay hydrated and rest. In this patient, I would recommend antiemetic drugs such as ondansetron (Riddle, 2018). In addition, I would recommend loperamide or bismuth subsalicylate. After finding out the reason for the use of prednisone, I would slowly taper off the drug and eventually discontinue it. The patient can continue using both Synthroid and nifedipine.

Justification For Drug Therapy

Antiemetics are critical in minimizing vomiting and consequent fluid loss. Ondansetron is my preferred drug of choice due to its limited sedative properties compared to other antiemetics, such as promethazine (Rosenthal & Burchum, 2021). Antidiarrheals such as loperamide and bismuth subsalicylate help address diarrhea, significantly contributing to fluid loss. Tapering off the prednisone and eventually discontinuing it is crucial in this patient. Corticosteroids such as prednisone, when used over long durations of time, significantly impact the liver. These drugs often increase the risk of developing or worsening nonalcoholic fatty liver disease. This is particularly risky in this patient with possible hepatitis C. Nifedipine and Synthroid have minimal to no impact on the liver and can be continued.

Conclusion

The patient’s presenting complaints paint a picture of gastroenteritis. Despite the condition being mostly self-limiting, prescribing antiemetics and antidiarrheals is important to minimize fluid loss. Discontinuing drugs such as prednisone, which have a significant impact on the liver in such a patient, is essential to minimize the risk of nonalcoholic fatty liver disease.

References

Maslennikov, R., Poluektova, E., Ivashkin, V., & Svistunov, A. (2021). Diarrhea in adults with coronavirus disease-beyond incidence and mortality: a systematic review and meta-analysis. Infectious Diseases (London, England), 53(5), 348–360. https://doi.org/10.1080/23744235.2021.1885733

Riddle M. S. (2018). Current management of acute diarrheal infections in adults. Polish Archives Of Internal Medicine, 128(11), 685–692. https://doi.org/10.20452/pamw.4363

Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.). St. Louis, MO: Elsevier.