Background
The case study is about Mrs. Z who is a 34yo female. She visits the clinic with a chief complaint of diarrhea and abdominal pain. The client reports that these symptoms started 4 days ago. She further reports a suspected fever but denies taking a temperature. The client also reports feeling weak. The client reports an increase in the number of bowels in the last few months.
She reports having an average of about 10 small-volume watery stools. Her daily stool contains varying amounts of blood. The client denies recent use of antibiotics or travel. Her medical history is positive for ulcerative colitis. The client denies being under any medications for the last few years. Mrs. Z has also not been symptomatic in the recent past. She reports being on an oral contraceptive. The client takes slippery elm capsules for some years. In the last few days, the client has been taking Benefiber prebiotic fiber, 2 to 3 doses. The client’s blood pressure was 116/70 and 100/66 while sitting and standing. Her oxygenation saturation was 92 and her temperature was 100.1. Her physical examination results indicated active bowel sounds in all 4 quadrants of her abdomen. Mild tenderness was also noted with palpation. The client’s lab results indicated a WBC of 14,000; Hct 35.7; Hgb 11.9; 133 sodium, and 3.3 potassium. This paper focuses on pharmacological therapy that would be recommended for Mrs. Z; strategies for evaluating the effectiveness of the prescribed therapy; recommended patient education related to the prescribed pharmacologic agent; pharmacogenetic to be considered regarding prescribed pharmacology agents; helpful alternative therapies or over-the-counter agents; and recommended lifestyle changes.
Pharmacological Therapy that would be recommended for Mrs. Z
Inflammatory bowel disease (IBD) is a common diagnosis in various patient populations worldwide. IBD is categorized into two major forms, including ulcerative colitis and Crohn’s disease. Individuals diagnosed with this condition mainly report chronic inflammation of the gastrointestinal (GI) tract. The client has a positive history of ulcerative colitis, which is characterized by various symptoms, including diarrhea often accompanied by pus or blood, rectal bleeding, abdominal cramping, and pain, the urgency to defecate, rectal pain, inability to defecate, weight loss, and fatigue or weakness (Sehgal et al., 2018). The client reports diarrhea and abdominal pain during the clinical interview. The client reports an increase in the number of bowels in the last few months with an average of about 10 small-volume watery stools. Her daily stool contains varying amounts of blood and reports feeling weak, qualifying for an ulcerative colitis diagnosis. Additionally, ulcerative colitis is attributed to some physical exams findings such as skin rashes, abdominal tenderness without mass, joint swelling and pain, and abdominal pain (Buck et al., 2020). The client’s physical examination indicated mild tenderness with palpation and evidence of abdominal pain. Therefore, the client qualifies for ulcerative colitis diagnosis.
The client would be prescribed Dipentum 500 mg twice daily. This drug is preferred since it’s an aminosalicylate with anti-inflammatory action. According to Le Berre et al. (2020), aminosalicylates are recommended as the first-line treatment and maintenance therapy in adults with ulcerative colitis. These drugs are recommended due to their efficacy in inducing and maintaining remission in individuals diagnosed with mild to moderate ulcerative colitis. Thus, Dipentum 500 mg twice daily would effectively manage presented symptoms, including diarrhea and abdominal pain, and prevent remission.
Strategies for Evaluating the Effectiveness of the Prescribed Medication
A healthcare provider evaluates a treatment regimen to determine its efficacy in treating an individual patient. In this case, the client’s drug therapy will be evaluated after two weeks based on clinical manifestations reported during the initial visit. A decline in the number of bowel movements, the volume of watery stool, and blood in the stool will indicate the efficacy of the prescribed medication, Dipentum 500 mg twice daily as treatment and maintenance therapy. Additionally, the decline in abdominal pain after taking the medication for two weeks will indicate its effectiveness in managing the client’s condition. The client will be advised to continue with the current drug and dosage and return to the clinic after two weeks for review. On the contrary, the current medication and dosage will be considered ineffective if the client does not report improvement in initial clinical manifestations after taking the medication for two weeks. In this case, the client’s dosage should be titrated upwards to Dipentum 2 g/day. A
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