Assignment: Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders

Assignment: Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders

Assignment: Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders

Assignment: Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders

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 prescribed.

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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.

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	Excellent	Good	Fair	Poor
Explain your diagnosis for the patient, including your rationale for the diagnosis.	Points Range:23 (23.00%) – 25 (25.00%) The response accurately and clearly explains in detail the diagnosis for the patient, including an accurate and thorough rationale for the diagnosis that supports clinical judgment.	Points Range:20 (20.00%) – 22 (22.00%) The response provides a basic explanation of 1-2 diagnoses for the patient, including an accurate rationale for the diagnosis that may support clinical judgment.	Points Range:18 (18.00%) – 19 (19.00%) The response inaccurately or vaguely explains the diagnosis for the patient, including an inaccurate or vague rationale for the diagnosis that may or may not support clinical judgment.	Points Range:0 (0.00%) – 17 (17.00%) The response inaccurately and vaguely explains the diagnosis for the patient, including an inaccurate and vague rationale for the diagnosis that does not support clinical judgment, or is missing.
Describe an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed.	Points Range:27 (27.00%) – 30 (30.00%) The response accurately and completely describes in detail an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed.	Points Range:24 (24.00%) – 26 (26.00%) The response describes a basic explanation of the appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed.	Points Range:21 (21.00%) – 23 (23.00%) The response inaccurately or vaguely describes an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed.	Points Range:0 (0.00%) – 20 (20.00%) The response inaccurately and vaguely describes 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.	Points Range:27 (27.00%) – 30 (30.00%) The response provides an accurate, clear, and detailed justification for the recommended drug therapy plan for this patient. The response includes specific, accurate, and detailed examples that fully support the justification provided.	Points Range:24 (24.00%) – 26 (26.00%) The response provides a basic justification for the recommended drug therapy plan for this patient. The response includes only 1-2 examples that fully support the justification provided.	Points Range:21 (21.00%) – 23 (23.00%) The response provides an inaccurate or vague justification for the recommended drug therapy plan for this patient. The response may include examples, which may inaccurately or vaguely support the justification provided.	Points Range:0 (0.00%) – 20 (20.00%) The response provides an inaccurate and vague justification for the recommended drug therapy plan for this patient, or is missing. The response does not include examples that support the justification provided, or is missing.
Written Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance.	Points Range:5 (5.00%) – 5 (5.00%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity.	Points Range:4 (4.00%) – 4 (4.00%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.	Points Range:3.5 (3.50%) – 3.5 (3.50%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time.	Points Range:0 (0.00%) – 3 (3.00%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity less than 60% of the time.
Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation	Points Range:5 (5.00%) – 5 (5.00%) Uses correct grammar, spelling, and punctuation with no errors	Points Range:4 (4.00%) – 4 (4.00%) Contains a few (1–2) grammar, spelling, and punctuation errors	Points Range:3.5 (3.50%) – 3.5 (3.50%) Contains several (3–4) grammar, spelling, and punctuation errors	Points Range:0 (0.00%) – 3 (3.00%) Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding
Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list.	Points Range:5 (5.00%) – 5 (5.00%) Uses correct APA format with no errors	Points Range:4 (4.00%) – 4 (4.00%) Contains a few (1–2) APA format errors	Points Range:3.5 (3.50%) – 3.5 (3.50%) Contains several (3–4) APA format errors	Points Range:0 (0.00%) – 3 (3.00%) Contains many (≥ 5) APA format errors

A Sample Of This Assignment Written By One Of Our Top-rated Writers

Pharmacotherapy for Gastrointestinal and Hepatobiliary Diseases

 The patient in the case study is a 46 year-old who presents with right upper quadrant (RUQ) pain that she says has lasted for 24 hours. The subjective information is that the RUQ pain commenced after a heavy meal the previous day. She also had some nausea and a bout of vomiting before coming to the facility. The purpose of this paper is to come up with a diagnosis and treatment plan for her.

The Patient’s Diagnosis and Rationale

The patient’s history of RUQ pain in the last 24 hours that started after a heavy meal is instructive. This coupled with risk factors such as type II diabetes mellitus (insulin resistance and hyperglycemia), obesity (she has a BMI of 30.6 kg/m²), and hypertension suggest a diagnosis of nonalcoholic fatty liver disease or NAFLD (Chalasani et al., 2018; Hammer & McPhee, 2018; Jameson et al., 2018). The most distinguishing characteristic of NAFLD is discomfort or pain in the right upper quadrant of the abdomen. This patient then met all the other risk factors since she is obese, has a history of HTN and diabetes, and most probably has a high level of triglycerides in the blood since she is already obese.

Appropriate Drug Therapy and Justification

 Pharmacotherapy is usually offered to patents with NAFLD who have developed nonalcoholic steatohepatitis (NASH). It would be wise to then perform a biopsy on this patient before starting the medication recommended here. The aim is to confirm whether she has progressed to NASH yet. For this patient’s diagnosis of nonalcoholic fatty liver disease, the appropriate drug therapy would therefore be the thiazolidinedione pioglitazone together with vitamin E (Chalasani et al., 2018; Rosenthal & Burchum, 2018). The rationale is that the pioglitazone improves insulin sensitivity as well as reduces the levels of circulating free fatty acids. Vitamin E on the other hand improves liver histology and biochemistry (Chalasani et al., 2018).

Conclusion

 The clinical picture the patient in the case study presents with of RUQ pain and risk factors such as obesity, type II DM, and hypertension suggest strongly that she has a diagnosis of nonalcoholic fatty liver disease or NAFLD. To benefit from pharmacotherapy, the guidelines suggest that she should have progressed to nonalcoholic steatohepatitis or NASH. The drug therapy of choice therefore would be vitamin E and pioglitazone.

References

Chalasani, N., Younossi, Z., Lavine, J. E., Charlton, M., Cusi, K., Rinella, M., . . . Sanya, A. J. (2018). The diagnosis and management of nonalcoholic fatty liver disease: Practice guidance from the American Association for the Study of Liver Diseases. Hepatology, 67(1), 328–357. https://doi.org/10.1002/hep.29367

Hammer, D.G., & McPhee, S.J. (Eds). (2018). Pathophysiology of disease: An introduction to clinical medicine, 8^th ed. McGraw-Hill Education.

Jameson, J.L., Fauci, A.S., Kasper, D.L., Hauser, S.L., Longo, D.L., & Loscalzo, J. (Eds) (2018). Harrison’s principles of internal medicine, 20^th ed. McGraw-Hill Education.

Rosenthal, L.D., & Burchum, J.R. (2018). Lehne’s pharmacotherapeutics for advanced practice providers. Elsevier.