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Gastrointestinal And Hepatobiliary Disorders Assignment Paper

Gastrointestinal And Hepatobiliary Disorders Assignment Paper

Gastrointestinal and Hepatobiliary Disorders

Cholelithiasis (K80) is formed in the gallbladder and consists of cholesterol, bilirubin, and bile. The prevalence of gallstones increases with age, and patients may be asymptomatic from months to years ul discovery (Tanaja et al., 2022). The risk factor associated with cholelithiasis includes the 5 Fs: female, fat, fair, forty and family history. Other related risk factors include; pregnancy (due to stasis caused by progesterone that decreases gallbladder contractility),  metabolic syndrome, bariatric surgery, and rapid weight loss. According to Jones et al. ( 2022), patients with cholelithiasis are sent with symptoms such as; RUQ pain after eating spicy or greasy food, nausea, and vomiting Gastrointestinal And Hepatobiliary Disorders Assignment Paper.

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Pharmacological agents include gallstone dissolution agents, which inhibit intestinal absorption of cholesterol and suppress hepatic cholesterol secretion. Ursodeoxycholic acid is an oral bile salt therapy which decreases the biliary cholesterol saturation significantly (Littlefield & Lenahan, 2019). It is prescribed at a dose of 8-10mg/kg in a divided dosage. Treatment requires 6-18 months. Pharmacological treatment is effective in patients with gallstones <1.5cm, the stone should have a high cholesterol content or mixed , the gallbladder should be functional, the common bile duct and cystic duct should be patent (Heuman, 2021). Desaturation of bile inhibits crystals from forming and may allow advanced extraction of cholesterol from existing stones.

In this case I would however recommend surgical intervention.According to Bloom (2022), the mainstay treatment therapy for symptomatic cholelithiasis is cholecystectomy .Removal of gallstones alone is not recommended due to the increased likelihood of recurrence after about one year.

References

Bloom, A. A. (2022, June 16). Cholecystitis: Practice Essentials, Background, Pathophysiology. Medscape.com; Medscape. https://emedicine.medscape.com/article/171886-overview

Heuman, D. M. (2021, October 17). Gallstones (Cholelithiasis): Practice Essentials, Background, Pathophysiology. Medscape.com; Medscape. https://emedicine.medscape.com/article/175667-overview

Jones, M. W., Weir, C. B., & Sassan Ghassemzadeh. (2022, April 13). Gallstones (Cholelithiasis). Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK459370/ Gastrointestinal And Hepatobiliary Disorders Assignment Paper

‌ Littlefield, A., & Lenahan, C. (2019). Cholelithiasis: Presentation and Management. Journal of Midwifery & Women’s Health, 64(3), 289–297. https://doi.org/10.1111/jmwh.12959

Tanaja, J., Lopez, R. A., & Meer, J. M. (2022, May). Cholelithiasis. Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK470440/

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Case study ..DC is a 46-year-old female who presents with a 24-hour history of RUQ pain.  She states the pain started about 1 hour after a large dinner she had with her family.  She has had nausea and one instance of vomiting before presentation.

 

PMH:                                                              Vitals: 

HTN                                                                Temp:              98.8oF

Type II DM                                                     Wt:                  202 lbs

Gout                                                                Ht:                   5’8”

DVT – Caused by oral BCPs                          BP:                  136/82

HR:                 82 bpm

 

Current Medications:                                

Notable Labs:

Lisinopril 10 mg daily                                   WBC:                          13,000/mm3

HCTZ 25 mg daily                                        Total bilirubin:           0.8 mg/dL

Allopurinol 100 mg daily                               Direct bilirubin:          0.6 mg/dL

Multivitamin daily                                          Alk Phos:                    100 U/L

                                                                           AST:                           45 U/L

ALT:                           30 U/L

Allergies:

  • Latex
  • Codeine
  • Amoxicillin

 

 

PE:

  • Eyes: EOMI
  • HENT: Normal
  • GI:Nondistended, minimal tenderness
  • Skin:Warm and dry
  • Neuro: Alert and Oriented
  • Psych:Appropriate mood

 

Instructions

 

To Prepare

  • 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

 

 

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

 

Please, be sure to add introduction with conclusion and 5 reference within 5 years.

Reading links

https://aasldpubs.onlinelibrary.wiley.com/doi/pdf/10.1002/hep.29367

Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.) St. Louis, MO: Elsevier.

  • Chapter 64, “Drugs for Peptic Ulcer Disease” (pp. 589–597)
  • Chapter 65, “Laxatives” (pp. 598–604)
  • Chapter 66, “Other Gastrointestinal Drugs” (pp. 605–616)
  • Chapter 80, “Antiviral Agents I: Drugs for Non-HIV Viral Infections” (pp. 723–743) Gastrointestinal And Hepatobiliary Disorders Assignment Paper