Week 7 Discussion

Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders

Gastrointestinal (GI) and hepatobiliary disorders affect the structure and function of the GI tract. Many of these disorders often have similar symptoms such as abdominal pain, cramping, constipation, nausea, bloating, and fatigue. Since multiple disorders can be tied to the same symptoms, it is important for advanced practice nurses to carefully evaluate patients and prescribe treatment that targets the cause rather than the symptom. Once the underlying cause is identified, an appropriate drug therapy plan can be recommended based on medical history and individual patient factors. In this Discussion, you examine a case study of a patient who presents with symptoms of a possible GI/hepatobiliary disorder, and you design an appropriate drug therapy plan.

Consider the following case study:

Patient HL comes into the clinic with the following symptoms: nausea, vomiting, and diarrhea. The patient has a history of drug abuse and possible Hepatitis C. HL is currently taking the following prescription drugs:

Synthroid 100 mcg daily
Nifedipine 30 mg daily
Prednisone 10 mg daily

To prepare:
•Review this week’s media presentation on pharmacology for the gastrointestinal system.
•Review the provided case study. 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.

Post on or before Day 3 an explanation of your diagnosis for the patient including your rationale for the diagnosis. Then, describe an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed.
RESOURCES:

Required Resources

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Readings
•Arcangelo, V. P., & Peterson, A. M. (Eds.). (2013). Pharmacotherapeutics for advanced practice: A practical approach (3rd ed.). Ambler, PA: Lippincott Williams & Wilkins.
?Chapter 28, “Nausea and Vomiting” (pp. 392–409)

This chapter focuses on the etiology of nausea and vomiting, as well as body systems that impact or trigger nausea and vomiting. It also covers various drugs used to treat nausea and vomiting including the process of selecting, administering, and managing drug therapy for patients.
?Chapter 29, “Gastroesophageal Reflux Disease and Peptic Ulcer Disease” (pp. 410–423)

This chapter begins with an overview of risk factors, symptoms, and clinical stages of gastroesophageal reflux disease (GERD). It then examines drugs used to treat GERD and peptic ulcer disease (PUD), including proper dosages, possible adverse reactions, contraindications, and special considerations.
?Chapter 30, “Constipation, Diarrhea, and Irritable Bowel Syndrome” (pp. 424–453)

This chapter begins by exploring disorders associated with constipation and diarrhea, as well as drugs used in treatment. It also covers the pathophysiology of irritable bowel syndrome and related drug therapies.
? Chapter 31, “Inflammatory Bowel Disease” (pp. 454–471)

This chapter examines the causes, pathophysiology, and diagnostic criteria of inflammatory bowel disease (IBD), Crohn’s disease, and ulcerative colitis. It also identifies drugs used to treat IBD, including proper dosage, adverse reactions, and special considerations.

•Starr, S., & Raines, D. (2011). Cirrhosis: Diagnosis, management, and prevention. American Family Physician, 84(12), 1353–1359.
Retrieved from the Walden Library databases.

This article examines the clinical presentation, pathophysiology, diagnosis, management, and prevention of cirrhosis. It also provides methods for managing complications of cirrhosis.
•Drugs.com. (2012). Retrieved from https://www.drugs.com/

This website presents a comprehensive review of prescription and over-the-counter drugs including information on common uses and potential side effects. It also provides updates relating to new drugs on the market, support from health professionals, and a drug-drug interactions checker.

Media
•Laureate Education, Inc. (Executive Producer). (2012). Pharmacology for the gastrointestinal system. Baltimore, MD: Author.

This media presentation outlines drug treatment options for disorders of the gastrointestinal system.

Note: The approximate length of this media piece is 2 minutes.
Here is the reply from my professor on one of my discussions… just make sure that you address this.

Nice work. My only suggestion is to provide a more complete discussion of the medication classes. You should include how the medications work (MOA), why they work (i.e. relationship to pathophysiology/symptoms), side effects, and strategies to manage side effects. It may help to refer to the class announcements for a complete list of the elements that should be included in drug discussions. It serves as a great checklist to ensure that you have included all the expectations. Thanks for a great discussion this week.