Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders
Patient HL has nausea, vomiting, and diarrhea symptoms. However, before medication, it’s important for the care provider to understand HL’s medical history as the medication can impact on measures undertaken to improve their health. In this case, the patient has prescribed the following drug; Synthroid 100 mcg daily, Nifedipine 30 mg daily, Prednisone 10 mg daily. For instance, the prednisone prevents the production of discharge in the body which can cause inflammation. It can also suppress an individual’s immune system, and there is a necessity to comprehend why a patient needs this medication. The history showed the patient had Hepatitis C, which is a liver infection that can lead to acute inflammation of the liver. Long-term infection
with the hepatitis C causes high blood pressure, yellow discoloration of the skin and eyes and many others. Prescription of Nifedipine drug lowers patient blood pressure and makes it easier for heart to pump blood around the body. Watery diarrhea, Nausea, vomiting, and hepatitis C can be due to intestinal infection.
In this case, the patient HL is likely suffering from acute gastroenteritis which is the inflammation of the mucous membrane of the gastrointestinal tract and featured by vomiting. This disorder is common in children. In many cases, the gastrointestinal disease is caused by a virus which usually spreads from an individual to another or, through close contact with an infected individual, such as sharing food. For this reason, nurses and the child care have a high risk of viral gastroenteritis disease, especially if they do not clean their hands after coming contact with the infected person.
Diagnosis for the Patient and the Rationale for Diagnosis.
The diagnosis can be made clinically. In this situation, the doctor will assess the abdominal pain, abdominal cramping, and loose stools. These assessment results are commonly linked to diarrhea. If gastroenteritis encompasses the large intestine, the colon is not able to engross enough water, and the patient’s stool becomes watery. Evaluation of defecation is also very significant. Samples should be taken from the patient to identify the pathogen and establish the immediate treatment of the disease. Samples should be cultured for the bacteria and tested for the pathogen. Quick diagnosis allows for the isolation of the patient to prevent nosocomial contagion, which is often used as an indicator of the efficiency of precautions to control contact infection. Diagnosis can also be made by educating the patient concerning perianal care after every bowel movement. The rationale for this is that the anal part should be carefully cleaned in order to prevent the irritation of the skin and spread of disease-causing microorganism.
Drug Therapy Plan
Nasogastric Rehydration (NGTR): The patient takes 25ml/kg/hr for 4 hours.
For initial treatment of acute diarrhea infections like in the patient HL, rehydration should be included, which can be gained with oral electrolyte solutions. In this patient, antibiotic is required because the disorder is usually self-limiting (Rosenthal, & Burchum, 2018). Nasogastric Rehydration (NGTR) is a safe and actual way of rehydrating the patient; even after vomiting. It is recommended over the IV route. Any deliberation of antimicrobial therapy will be carefully considered against unintentional and potentially harmful outcomes. However, empirical and precise antimicrobial therapy can be considered in this situation. Moreover, treating gastroenteritis because of Shiga toxin creating Escherichia coli bacteria with antibiotics can upsurge the risk of hemolytic-uremic disorder.
Antiemetic Agents and Supplemental Zinc Therapy
Ondansetron wafer dose (drug dose)
Weight Ondansetron wafer dose
8 -15 kg 2mg
15-30 kg 4mg
> 30 kg 8 mg
The patient HL has a severe vomiting condition; therefore, there is a need to prevent further dehydration and to avoid the desire for IV therapy and frequent hospital admission. Ondansetron, a discerning serotonergic 5HT3 receptor adversary, has revealed to be a more effective antiemetic agent (Rosenthal, & Burchum, 2018). Also, the patient should be prescribed with Metoclopramide which has been confirmed to be more effective than the placebo. Zinc is an important micronutrient that usually guards the cells against oxidative injury. In this case, the patient has acute diarrhea; there is a substantial loss of zinc due to enlarged intestinal output. Giving the patient zinc supplements may increase the absorption of water.