NURS 6521 PHARMACOTHERAPY FOR GASTROINTESTINAL AND HEPATOBILIARY DISORDERS 

Sample Answer for NURS 6521 PHARMACOTHERAPY FOR GASTROINTESTINAL AND HEPATOBILIARY DISORDERS  Included After Question

BY DAY 7 OF WEEK 4

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 Links to an external site.). All papers submitted must use this formatting.

A Sample Answer For the Assignment: NURS 6521 PHARMACOTHERAPY FOR GASTROINTESTINAL AND HEPATOBILIARY DISORDERS 

Title: NURS 6521 PHARMACOTHERAPY FOR GASTROINTESTINAL AND HEPATOBILIARY DISORDERS 

The patient in the case study presents with nausea, vomiting, and diarrhea. He has a drug abuse history and likely Hepatitis C. The current drug therapy includes Synthroid, Nifedipine, and Prednisone. The purpose of this assignment is to discuss the diagnosis and appropriate pharmacotherapy for the patient.

Diagnosis

Hepatitis C infection is the presumptive diagnosis. This is a liver inflammation caused by Hepatitis C virus (HCV). It is spread through sexual intercourse with infected persons, sharing personal items, and sharing drug-injection equipment (Ghany et al., 2020). Most infected persons are asymptomatic. Symptomatic cases present symptoms like fatigue, fever, reduced appetite, nausea, vomiting, abdominal discomfort, pale feces, dark urine, myalgia, and jaundice (Jin, 2020). Therefore, Hepatitis C is the primary diagnosis because of the positive symptoms of nausea, vomiting, and diarrhea and the client’s history of drug abuse and Hepatitis C infection.

Appropriate Drug Therapy

The recommended drug therapy will include a combination of Ombitasvir/paritaprevir/ritonavir (Technivie) for 12 weeks to treat Hepatitis C infection. Technivie is indicated for HCV infection in patients without cirrhosis. Ombitasvir inhibits HCV NS5A, which is needed for Hepatitis C viral replication. Paritaprevir inhibits NS3/4A serine protease required for proteolytic cleavage of the HCV-encoded polyprotein into mature forms (Wu et al., 2019). Ritonavir is a protease inhibitor that elevates paritaprevir serum levels. Nifedipine would be reduced to 10 mg and Prednisone to 5 mg since they are associated with GI side effects.

Conclusion

The patient’s nausea, vomiting, and diarrhea symptoms are consistent with Hepatitis C infection. Besides, the history of Hepatitis C and drug abuse make HCV infection the likely diagnosis. A combination of Ombitasvir/paritaprevir/ritonavir will be recommended to treat the HCV infection,

References

Ghany, M. G., Morgan, T. R., & AASLD‐IDSA hepatitis C guidance panel. (2020). Hepatitis C guidance 2019 update: American Association for the Study of Liver Diseases–Infectious Diseases Society of America recommendations for testing, managing, and treating hepatitis C virus infection. Hepatology71(2), 686–721. https://doi.org/10.1002/hep.31060

Jin, J. (2020). Screening for Hepatitis C Virus Infection. JAMA323(10), 1008-1008. doi:10.1001/jama.2020.1761

Wu, J., Huang, P., Fan, H., Tian, T., Xia, X., Fu, Z., … & Zhang, Y. (2019). Effectiveness of ombitasvir/paritaprevir/ritonavir, dasabuvir for HCV in HIV/HCV coinfected subjects: a comprehensive analysis. Virology journal16(1), 1–10.

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A Sample Answer 2 For the Assignment: NURS 6521 PHARMACOTHERAPY FOR GASTROINTESTINAL AND HEPATOBILIARY DISORDERS 

Title: NURS 6521 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).

NURS 6521 PHARMACOTHERAPY FOR GASTROINTESTINAL AND HEPATOBILIARY DISORDERS 
NURS 6521 PHARMACOTHERAPY FOR GASTROINTESTINAL AND HEPATOBILIARY DISORDERS 

Appropriate Drug Therapy Plan

In this case study, the therapeutic options recommendable include Hepatitis C pegylated interferon-α (IFN-α), administered weekly. Additionally, the patient is put on a daily dose of ribavirin for about 24 to 48 weeks. The combination is effective in clearing the HCV genotypes, especially 2 and 3 infections. The patient should also be put on food therapy. It is recommended that eating a frequent balanced diet possibly prevents nausea and vomiting associated with the disease. The balanced diet should be composed of cereals, whole grains, vegetables, and even fruits. There should also be a moderate to high protein diet to heal the infected liver tissue (Venugopal et al., 2018). The patient should also avoid certain drugs like aminoglycoside antibiotics, sedatives, and acetaminophen, which are considered hepatotoxic in high doses.

Appropriate use of the proper diagnostic approaches forms the basis of diagnosis, which informs the kind of intervention to be taken. Viruses, bacteria, and chemical agents can cause HCV. The condition can be treated using pegylated interferon-α (IFN-α) and ribavirin.

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

A Sample Answer For the Assignment: NURS 6521 PHARMACOTHERAPY FOR GASTROINTESTINAL AND HEPATOBILIARY DISORDERS 

Title: NURS 6521 PHARMACOTHERAPY FOR GASTROINTESTINAL AND HEPATOBILIARY DISORDERS  

The case study concerns a 46-year-old female with reports of RUQ pain for the past 24 hours. The pain began an hour after having a large dinner. She also experienced nausea and one vomiting episode prior to the presentation. The purpose of this paper is to discuss the likely diagnosis and treatment plan.

Diagnosis

The likely diagnosis for this patient is Acute cholecystitis. This is a gallbladder inflammation that progresses over hours due to a gallstone obstructing the cystic duct. Gallaher & Charles (2022) explain that the classic presentation of Acute cholecystitis includes acute RUQ pain, fever, nausea, and vomiting associated with eating and physical exam findings of RUQ tenderness. Acute cholecystitis manifests with a high WBC count indicating inflammation (Bridges et al., 2018). In addition, serum levels of aspartate aminotransferase, alkaline phosphatase, and lactate dehydrogenase may be increased, pointing to abnormalities in liver function in persons with severe biliary obstruction (Doherty et al., 2022). Direct and indirect serum bilirubin levels are also increased. Acute cholecystitis is the selected diagnosis owing to postprandial RUQ pain, nausea, vomiting, mild abdominal tenderness, high WBC, and elevated Bilirubin levels.

Drug Therapy

Drug therapy will include antibiotics with IV Ceftriaxone 2 g once daily and IV metronidazole 500 mg every 8 hours. These antibiotics have adequate coverage against the most common pathogens (Gallaher & Charles, 2022). An antiemetic like Prochlorperazine IV 2.5 mg every 4 hours will be administered to alleviate nausea and prevent fluid and electrolyte disorders caused by vomiting. Oxycodone/acetaminophen 1 tablet orally every 6 hours will be prescribed for pain control.

Conclusion

Positive findings of postprandial RUQ pain, nausea, vomiting, mild abdominal tenderness, high WBC, and elevated Bilirubin levels indicate likely Acute cholecystitis. When a gallstone impacts the cystic duct and continuously obstructs it, it results in acute inflammation causing cholecystitis. Drug therapy will include antibiotics with Ceftriaxone and Metronidazole, antiemetic with Prochlorperazine, and Oxycodone/acetaminophen for pain relief.

References

Bridges, F., Gibbs, J., Melamed, J., Cussatti, E., & White, S. (2018). Clinically diagnosed cholecystitis: a case series. Journal of surgical case reports2018(2), rjy031. https://doi.org/10.1093/jscr/rjy031

Doherty, G., Manktelow, M., Skelly, B., Gillespie, P., Bjourson, A. J., & Watterson, S. (2022). The Need for Standardizing Diagnosis, Treatment and Clinical Care of Cholecystitis and Biliary Colic in Gallbladder Disease. Medicina58(3), 388. https://doi.org/10.3390/medicina58030388

Gallaher, J. R., & Charles, A. (2022). Acute Cholecystitis: A Review. JAMA327(10), 965–975. https://doi.org/10.1001/jama.2022.2350