Pharmacotherapy for Gastrointestinal and Hepatobiliary
• 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
• 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.
Utilize the following case study:
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 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:
o Eyes: EOMI
o HENT: Normal
o GI:bNondistended, minimal tenderness
o Skin:bWarm and dry
o Neuro: Alert and Oriented
o Psych:bAppropriate mood
Sample Solution
In pharmacotherapy for gastrointestinal and hepatobiliary issues, it is necessary to first reflect on the patient’s symptoms, medical history, and the drugs currently prescribed. By doing so, it is possible to arrive at a diagnosis that takes into account any underlying disorder or condition related to the gastrointestinal and hepatic systems. It is also important to consider whether the symptoms can be attributed to another system such as pregnancy, drugs or psychological disorders (Schade et al., 2017). Once this analysis has been completed, an appropriate drug therapy plan can then be formulated based on these findings.
For example if a patient was presenting with chronic gastritis which was caused by Helicobacter Pylori infection then their drug therapy plan may include antibiotics such as amoxicillin and clarithromycin combined with an H2-blocker or proton pump inhibitor (PPI) such as omeprazole (Chen et al., 2020). This combination of drugs would help eradicate any bacteria present in addition to reducing acid production which could cause further damage or exacerbate existing symptoms. In cases where there are no underlying health conditions causing gastritis but rather lifestyle factors such as smoking or excessive alcohol consumption; then medications which reduce stomach acidity levels could still be prescribed since they provide relief from pain caused by ulcers due their anti-inflammatory properties (Hechtman & Sharma, 2019).
For hepatobiliary diseases meanwhile, nonsteroidal anti-inflammatory medications should generally be avoided in order reduce risk of liver injury through decreasing inflammation plus associated fibrosis progression. Alternatively other types of therapies including ursodeoxycholic acid treatments; immunosuppressant agents; dietary changes through avoiding certain foods rich in fats/proteins depending on severity of condition may also be recommended (Kiranmai & Srisailapathy , 2016). If none of these measures prove sufficient however then more aggressive approaches involving surgery coupled with antibiotics might need consideration.
Overall therefore, when prescribing medications for gastrointestinal and hepatobiliary ailments it is essential that patients consult with healthcare professionals who take into account all aspects surrounding their medical histories alongside current conditions before administering specific treatments.
