Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders

Week 7

INITIAL POST

Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders

It is important to complete a thorough health history and examination before diagnosing HL. There are several necessary questions related to HL’s medication list that should ask:

· What is the prednisone prescribed for?

· When were the last time drugs used or needles shared?

· How long have the symptoms been present?

· Describe the stools/emesis.

Hepatitis C

Hepatitis C is an infection of the liver. This infection causes few symptoms, so the individuals are not aware and do not seek treatment (WebMD, 2017). However, you may experience stomach pain, loss of appetite, nausea, fatigue, and jaundice (WebMD, 2017). Hepatitis can be ruled out with testing.

Other Diagnosis

After additional testing and further examination, the appropriate diagnosis related HL’s symptoms and medication regime would be gastroenteritis. According to the research, gastroenteritis is defined as “an inflammation of the intestine that causes diarrhea, abdominal cramps, nausea, loss of appetite, and other symptoms of digestive upset” (Drugs.com, 2017). A person usually develops gastroenteritis by contact with someone who has diarrhea, an area where sanitation is poor, recent travel to an underdeveloped country, or has eaten food left out at room temperature for extended periods of time (Drugs.com, 2017). These factors are indicative of viral gastroenteritis.

The current medication regimen does not contribute to the associated symptoms. For HL, the symptoms should reside in one to seven days. As the practitioner, I would encourage hydration if tolerable. Once nausea resides it would be important to resume a normal diet. HL can start with clear liquids and advance as tolerated. For the diarrhea, first line therapy would include the use of over-the-counter anti-diarrhea medication. Rest would also be included in these instructions. Moreover, before changing or tapering the prednisone dose I would encourage HL to take prednisone dose with food “to minimize GI irritation and complications” (p. 401). According to the text, prednisone combined with other agents is often used in “highly emetogenic regimens” (p. 401). If the nausea does not subside, I would prescribe Zofran, a serotonin antagonist. Zofran works by “antagonizing the type 3 (5HT3) serotonin receptors centrally in the chemoreceptor trigger zone (CTZ) and also peripherally at the vagal and splanchnic afferent fibers from the enterochromaffin cells in the upper GI tract” (Arcangelo & Peterson, 2013).

References

Arcangelo, V. P., & Peterson, A. M. (Eds.). (2013). Pharmacotherapeutics for advanced practice: A practical approach (3rd ed.). Ambler, PA: Lippincott Williams & Wilkins.