Question

Pharmacotherapy Review the case study assigned by your Instructor for this Assignment 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. 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.

Answer

Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders

            Both gastrointestinal and hepatobiliary disorders affect the gastrointestinal (GI) tract. The patient in question exhibits various symptoms, including diarrhea, nausea, and vomiting. According to Naides (2019), these symptoms can result from various conditions, including gastrointestinal issues, ingestion of certain medications, and metabolic disorders. Medical history, therefore, plays a significant role in diagnosis. Patient HL’s medical history reveals drug and substance abuse trends, inferring that withdrawal from the substance could be the cause for the symptoms recorded. Another possible cause is the patient’s medication (Campbell & Norkus, 2018). Patient HL has been taking nifedipine, prednisone, and Synthroid, whose adverse effects include diarrhea, nausea, and vomiting (Bailie, 2021). Considering these factors, it may be challenging to establish the specific cause of the GI issues.

            Clinical studies have established that the first line of treatment for diarrhea, nausea, and vomiting is phenothiazine medications, particularly promethazine (Zikos et al., 2020). The ideal dosage for promethazine varies from 12.5 mg to 25 mg, based on the patient’s age and body weight. Sobin et al. (2017) highlight the drug’s adverse effects as agitation, blurred vision, dry mouth, and sedation. An alternative line of medication points to anticholinergics and antihistamines, preferably diphenhydramine. Willard (2019) recommends an ideal dosage within the range of 25 mg and 50 mg three times a day. Diphenhydramine has proven to elicit allergic reactions, among other contraindications. The side effects include confusion, drowsiness, and dry mouth.

            Patient HL’s medical history highlights his struggle with drug and substance abuse, which is a crucial aspect of the diagnosis and pharmacotherapy. The patient is also on medications that could be triggering diarrhea, nausea, and vomiting. Therefore, prescribing alternative medications would best fit Patient HL’s drug therapy (Campbell & Norkus, 2018). Also, the main goal for this hospital visit is to relieve the patient of the symptoms rather than act against the route cause, considering the various factors in play,