Description
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
Read the provided selection of a colleagues’ response who diagnosed the patient differently than you did, (hepatitis C) in one or more of the following ways:
• Provide alternative recommendations for drug treatments.
• Offer and support an alternative perspective using readings from the classroom or from your own
research in the student Library.
• Validate an idea with your own experience and or additional research.
Nausea, vomiting, and diarrhea are very common complaints and often occur together. In the case of HL with medical history positive for drug abuse, withdrawals are a possibility. Possible Hepatitis C is not of concern, as Hep C does not generally cause nausea, vomiting, diarrhea (Mayo Clinic, 2019a). Looking at his medications, prednisone can cause all three but is unlikely if he has been on the prednisone long term (Drugs.com, 2019). HL’s symptoms do not point toward Chron’s Disease, Irritable Bowel Syndrome or Peptic Ulcer Disease.
It is possibly that HL is experiencing gastroenteritis. The treatment for gastroenteritis is nothing by mouth (NPO) for 6-8 hours to allow the gut to rest, followed by clear liquids and advancing the diet as tolerated, and plenty of rest (Mayo Clinic, 2019b). Since his symptoms are severe enough for him to seek treatment a prescription for ondansetron (Zofran) ODT would be ordered. With HL’s history of drug abuse ondansetron over promethazine would be chosen due to less sedating side effects (Arcangelo, Peterson, Wilbur, & Reinhold, 2017). If HL’s symptoms were not decreasing in two to three more days, I would recommend that he come back in.
Leanne
Reference
Arcangelo, V. P., Peterson, A. M., Wilbur, V., & Reinhold, J. A. (Eds.). (2017). Pharmacotherapeutics for advanced practice: A practical approach (4th ed.). Ambler, PA: Lippincott Williams & Wilkins.
Drugs.com. (2019). Prednisone Side Effects. Retrieved from https://www.drugs.com/sfx/prednisone-side-effects.html
Mayo Clinic. (2019a). Hepatitis C: Symptoms. Retrieved from https://www.mayoclinic.org/diseases-conditions/hepatitis-c/symptoms-causes/syc-20354278
Mayo Clinic. (2019b). Viral gastroenteritis. Retrieved from https://www.mayoclinic.org/diseases-conditions/viral-gastroenteritis/diagnosis-treatment/drc-20378852
Sample Solution