Write a 1-page paper that addresses the following:

1. Explain your diagnosis for the patient, including your rationale for the diagnosis.
2. Describe an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed.
3. Justify why you would recommend this drug therapy plan for this patient. Be specific and provide examples.

Case study assigned: 

Patient LH 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

 

Case Scenario Week 4

Diagnosis and Rationale

When patient LH came in for a consultation, he described his symptoms as having diarrhea, nausea, and was frequently vomiting. Patient LH was a forty-year-old male who had brought himself into the Emergency Room and showed no critical case signs. During the patient's assessment, I asked if he had experienced a change in their diet or if they had traveled recently. This information would help me know if his body was reacting to new foods or changing the environment. Since he confirmed that he had not tried any new foods or traveled anywhere, the next step was to ascertain the patient's medical history. I found out that he has a history of drug abuse and possible Hepatitis C. In addition, the patient was using drugs such as prednisolone, nifedipine, and Synthroid. The second step of my assessment involved conducting light palpations on different areas of his abdomen to find out exactly where he was feeling the pain. I added deep percussions and carefully watched his face for any emotions that would indicate that the patient was going through pain.

All of this information helped me come up with my diagnosis, which I found to be gastroenteritis. My rationale was that using prednisone was the cause of nausea, vomiting, and diarrhea that the patient was experiencing. Prednisone is a drug used to improve a patient's immunity. However, since the drug is a type of corticosteroid, it is converted to prednisolone which affects the liver by increasing the liver enzymes (Hodgens& Sharman, 2020). This defect may compromise the patient's hepatic function, thereby increasing his Hepatitis C RNA levels. Eventually, the patient would start experiencing gastric issues, which would cause gastroenteritis. This disease shows itself through nausea, vomiting, and diarrhea.

The Drug Therapy Plan

The most appropriate drug therapy plan for patient LH would be to reduce the prednisolone dosage as its side effects were too extreme. It would be advisable to introduce gradual weaning off of the drug by tapering the dosage to reduce other side effects caused by abrupt stoppage. Tapering the medication involves a drug withdrawal process, which starts with the healthcare practitioner administering the total dosage during the first round. Then, the dosage is reduced by ten percent as the patient continues with the medication.

In addition, the patient should be treated with ondansetron, an antiemetic that would reduce vomiting and nausea (Griddine& Bush, 2018). Ondansetron is a better drug than others, such as promethazine, because it has fewer side effects. Since the patient was already suffering from side effects from the current prescription, ondansetron was the better option as it was less sedating. Ondansetron is an anti-nausea drug, meaning that its side effects would include headache, malaise, and fatigue, situations which can be easily controlled(Griddine& Bush, 2018). On the other hand, promethazine has severe side effects such as confusion, insomnia, blurred vision, dilated pupils, and in extreme cases, impotence. In addition, promethazine is an anti-histamine used after a patient has gone through surgery, making it unsuitable for patient LH.

Justification for the Recommended Drug Therapy Plan

Gastroenteritis is an inflammation that a patient experiences in the stomach and the digestive tract because of a bacterial infection or toxins from various drugs and medications. The main symptoms are nausea, vomiting, and diarrhea. Therefore, ondansetron would work to prevent serotonin, a chemical that initiates feelings of nausea and vomiting in the gut and the central nervous system. Since ondansetron has no adverse reactions when used with Synthroid and nifedipine, there would be no reason to discontinue them. Therefore, patient LH can continue using these medications together with ondansetron for optimum results.

Outline

Title: Case Scenario Week 4

Thesis: The case study assesses the signs and symptoms shown by the patient, recommends a drug therapy and justifies the recommended drug therapy.

1. Symptoms, Diagnosis and Rationale

1. Nausea, vomiting, and diarrhea indicate signs of liver damage
2. Current prescription causes the side effects of nausea, vomiting, and diarrhea
3. The diagnosis is gastroenteritis.
4.  My rationale was that using prednisone was the cause of nausea, vomiting, and diarrhea that the patient was experiencing

2. Description of an appropriate drug therapy

1. Drug tapering of prednisolone

1. Prednisolone causes nausea and vomiting

2. Ondansteron

1. An antimietic that will reduce the effects of nausea and vomiting

3. Justification of the chosen drug therapy

1. Does not interact with the current prescription