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 had nausea and one instance of vomiting before the presentation

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 had nausea and one instance of vomiting before the presentation

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 had nausea and one instance of vomiting before the presentation

Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders

The patient in the assigned case study presents with nausea and vomiting, RUQ pain, elevated bilirubin levels, elevated aspartate levels, and elevated white blood cells, which suggests a diagnosis of acute calculous cholecystitis (Pisano et al., 2020). Inflammation of the gallbladder due to infections is the main diagnostic feature of this condition, which is confirmed by elevated white blood cells, in addition to the symptoms displayed above. Previous evidence also reports that patients with acute cholecystitis usually present with URQ pain especially after a fatty large meal, just like the patient in the provided case study (Arockia Singh & Anish Kumar, 2019). An additional test to confirm this diagnosis includes abdominal ultrasound and CT, for identification of gall bladder stones.

ORDER A PLAGIARISM-FREE PAPER HERE ON;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 had nausea and one instance of vomiting before the presentation

Since acute calculous cholecystitis is caused by bacteria, antibiotic therapy is usually recommended by most clinical guidelines as the most effective treatment option. The choice of the antibiotic however depends on the causative microorganism which needs to be identified by a microbial culture of a sample of the patient’s bile (Fu et al., 2021). The patient also report allergic reactions to amoxicillin, which is the most common antibiotic normally used for the management of this condition. In such a situation, the use of third-generation cephalosporins like ceftriaxone is normally recommended in combination with metronidazole (Pisano et al., 2020). As such the patient’s prescription will include Ceftriaxone 1g administered intravenously for 5 days, and Metronidazole 1 g administered initially with a loading dose of 500 mg after every 8 hours. In the management of the patient’s nausea and vomiting, antiemetics like ondansetron are recommended. Tylenol on the other hand is effective in managing the associated pain. In case of worsening symptoms, surgical intervention may be considered.

References

Arockia Singh, M. D. S., & Anish Kumar, M. P. (2019). Diagnosis and management of acute acalculous cholecystitis in an outpatient: a case report. International Surgery Journal, 6(5), 1777. https://doi.org/10.18203/2349-2902.isj20191906

Fu, Y., Pang, L., Dai, W., Wu, S., & Kong, J. (2021). Advances in the study of acute acalculous cholecystitis: a comprehensive review. Digestive Diseases. DOI: 10.1159/000520025

‌Pisano, M., Allievi, N., Gurusamy, K., Borzellino, G., Cimbanassi, S., Boerna, D., … & Ansaloni, L. (2020). 2020 World Society of Emergency Surgery updated guidelines for the diagnosis and treatment of acute calculus cholecystitis. World journal of emergency surgery, 15(1), 1-26. https://doi.org/10.1186/s13017-020-00336-x

 

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.

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 on 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:
o Latex
o Codeine
o Amoxicillin
PE:
o Eyes: EOMI
o HENT: Normal
o GI:bNondistended, minimal tenderness
o Skin:bWarm and dry
o Neuro: Alert and Oriented
o Psych:bAppropriate mood