NURS 6521N-36 Advanced PharmacologyWeek 7 Discussion Post – Pharmacotherapy for Gastrointestinal & Hepatobiliary DisordersCynthia NwokochaJuly 10, 2017Pharmacotherapy for Hepatobiliary DisordersReview of 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 dailyNifedipine 30 mg dailyPrednisone 10 mg dailyHistory of Present Illness and Medical HistoryPatient presents with symptoms of diarrhea, nausea and vomiting. Learning from HL’smedical history, HL appears to have some possible chronic conditions based on his currentmedications; Synthroid 100 mg daily, Nifedipine 30mg daily, and prednisone 10mg daily. Also,the history states that HL has a history of drug abuse and possible Hepatitis C that could havepossibly started years ago or more recently. Synthroid is a hormone replacement that is used to treat hypothyroidism, thyroid cancerand goiter (Drugs.com, 2017). Synthroid can have adverse effects if not taken properly or ifmisused. Diarrhea is a common side effect of Synthroid, but nausea and vomiting along withappetite changes are a severe/adverse side effect of Synthroid, and should be reported the healthpractitioner immediately (Drugs.com, 2017). In a healthy adult age 50 years or less with a weightof 70kg or more; it is recommended that the initial dose of 100-125 mcg/day be taken for a fewmonths. In elderly patients, the starting dose should be 25-50mcg day and gradual increase ofdecrease of dose many be needed. Thyroid should be checked every 6-8 weeks (Drugs.com,2017). In addition, care should be taken if patient has any history of heart disease, coronaryartery disease or blood clots. Assuming this patient is under 50 years old, the current dosage isappropriate, however lab workup is needed to verify if the TSH levels are within normaltherapeutic levels.Nifedpine is a calcium channel blocker that is used to treat hypertension and chest pain(angina). The initial dose is 30-60mg orally once a day for the extended release and 10mg for theimmediate release tablets. Vomiting, nausea and diarrhea are not common side effects for thisdrug (Drugs.com, 2017). Nifedipine has also been linked to several instances of clinicallyapparent acute liver injury. Prednisone is a corticosteroid that prevents the release of substancesin the body that causes inflammation it also suppresses the immune system (Drugs.com.2017).
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