Acute Gastroenteritis In Primary Care Essay Discussion
Advanced Pharmacology
Differential Diagnosis
Acute gastroenteritis is an infectious disease syndrome that mostly present with abdominal pain, nausea, vomiting and diarrhea. It usually last fewer than 14 days. Some of the infectious pathogens include; viruses, bacteria and parasitic infections(Schmutz et al., 2017). Amoebiasis is a parasitic enteral infection that is mainly caused by the Entamoeba histolytica. The symptoms range from watery diarrhea, mild abdominal cramps with the incubation period between two to four weeks(Hassam Zulfiqar et al., 2022). According to Patel & Shackelford, (2021)Irritable bowel syndrome is a disease that is characterized by altered bowel habits and abdominal pain in absence of an underlying pathology Acute Gastroenteritis In Primary Care Essay Discussion.
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Pharmacological treatment
In management of acute gastroenteritis correct dehydration by giving IV fluids or encouraging oral intake. Pharmacological intervention is dependent on the detected causative agent. Antibiotics are prescribed if bacteria are the cause whereas antiprotozoals are given for parasitic causes. The mainstay therapy for symptomatic Entamoeba Histolytica is hydration and use of tinidazole or metronidazole. IBS is referred to as a symptom-based disorder, thus the treatment plan is aimed at resolving the symptoms such as; diarrhea, abdominal pain, nausea and constipation.
From the objective data, patient was on treatment for hypothyroidism (synthyroid), hypertension (nifedipine) and an underlying inflammatory process. (prednisolone)
Synthyroid
Also known as levothyroxine which is an FDA approved drug that is mainly used in the treatment of primary, secondary and tertiary hypothyroidism. It is a synthetic version of the naturally produced thyroid hormone; T4 and therefore it can mimic the body’s endogenous production. Normally, TRH is secreted from the hypothalamus which then provokes the production of TSH from the anterior pituitary gland. TSH triggers the thyroid gland to produce L-triiodothyronine(T3) and thyroxine(T4(Bibinaz Eghtedari & Correa, 2021)). Thyroxine is then converted to the active metabolite T3Acute Gastroenteritis In Primary Care Essay Discussion.
Nifedipine
It is an anti-hypertensive and anti-anginal that belongs to the dihydropyridine subclass of the calcium channel blockers group of drugs. The depolarization stage of smooth muscle cells involves an influx of calcium ions via the voltage-gated channels. Nifedipine acts by inhibiting entry of calcium ions by blocking the voltage-dependent L-type calcium channels in the vascular smooth muscles and myocardial cells(Khan et al., 2022). This results in reduction of intracellular calcium which decreases peripheral arterial vascular resistance and dilatation of arteries resulting in a reduction in the systemic blood pressure and increased oxygen delivery to the myocardium.
Prednisone
An anti-inflammatory glucocorticoid that is manufactured from cortisone. It acts on the immune system to help relieve symptoms such as; itching, swelling, redness and allergic reactions. Also, it reduces the volume and activity of the immune system. Prednisone decreases inflammation by suppressing of the migration of polymorphonuclear leucocytes and reversal of the increased capillary permeability(Puckett et al., 2022). It also acts as an anti-emetic by interfering with the cerebral innervation of the emetic center through inhibition of prostaglandin.
Newer Agents of cure for hepatitis C
The goal of treatment of HCV is preventing disease progression and reduce the risk of hepatocellular carcinoma. According to (), treatment of hepatitis C can eradicate the disease permanently such that HCV RNA cannot be detected in the liver or blood with a decrease in antibody titers and improved liver function. The current therapy for HCV is oral direct acting antiviral (DAAS) tablets and an immense progress has been noted towards reducing the treatment of duration from 28 weeks to 12 weeks, increase in the cure rates, improving the adverse effects and eradicating the need for using injectables(Basit et al., 2022).The three class of DAAS comprises; NS5A inhibitors which hinders NS5A structural protein which target inhibition in the replication cycle of HCV. They include; ledipasvir and velpatasvir. Second generation protease inhibitors that hinders the NS3/4 serine proteases which inhibits HCV replication. Examples include enzyme responsible for transcription of the negative strand intermediate.
References
Basit, H., Tyagi, I., & Janak Koirala. (2022, May 2). Hepatitis C. Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK430897/
Bibinaz Eghtedari, & Correa, R. (2021, August 6). Levothyroxine. Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK539808/
Hassam Zulfiqar, Mathew, G., & Horrall, S. (2022, January 7). Amebiasis. Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK519535/
Khan, K. M., Patel, J. B., & Schaefer, T. J. (2022, May 8). Nifedipine. Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK537052/
Patel, N., & Shackelford, K. (2021, July 10). Irritable Bowel Syndrome. Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK534810/
Schmutz, C., Bless, P. J., Mäusezahl, D., Jost, M., & Mäusezahl-Feuz, M. (2017). Acute gastroenteritis in primary care: a longitudinal study in the Swiss Sentinel Surveillance Network, Sentinella. Infection, 45(6), 811–824. https://doi.org/10.1007/s15010-017-10495
Acute Gastroenteritis In Primary Care Essay Discussion
Hello students,
Here is your week 4 case study information: Please read some tips I have made below for getting a good score!
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 Acute Gastroenteritis In Primary Care Essay Discussion
Nifedipine 30 mg daily
Prednisone 10 mg daily
Instructor/Facilitator help:
1. One short paragraph on three differential diagnoses. Do not just say “symptoms are vague, no diagnoses possible, I will just do further assessment.”
Subjective & Objective information are intentionally provided vague (as a clinical case) so that you can develop a couple of pharmacological cases & discuss.
2. One short paragraph on how you will pharmacologically treat the three diagnoses you listed (Pharmacological Plan).
3. One short-short paragraph on Synthroid, Nifedipine, a peripheral calcium channel blocker & prednisone an antiinflammatory immunosuppressor (pharmacological information) and why patient was on these drugs, discussion based on your objective & assessment.
Briefly state the mechanism of action and therapeutic applications of these agents.
4. Long discussions/stories of no relevance to advanced practice pharmacology will carry no value with this project.
5. Include NEWER AGENTS of cure for hepatitis C infection. Discuss how these NEWER hepatitis C drugs of CURE work.
6. Include peer reviewed, scholarly articles of past 4 years as reference.
7. A conclusion with clinician level pharmacology in focus.
Best, Dr. P Acute Gastroenteritis In Primary Care Essay Discussion