Pharmacologic Therapy
The patient’s subjective and objective data indicates she has inflammatory bowel disease (IBD). She presents with some IBD symptoms: diarrhea, abdominal pain, fever, fatigue, feeling weak, increased number of bowel movements and watery stool. Besides, the patient presents with IBD risk factors: health history of ulcerative colitis. She is currently on Benefiber prebiotic fiber, a significant risk factor for IBD. The lab tests indicate decreased sodium and potassium levels, caused by too much electrolytes’ loss due to diarrhea.
I would prescribe anti-inflammatory drugs to decrease the swelling in the colon. I would prescribe 400 mg delayed-release Mesalamine tablets to be taken four times a day. The patient will also require Azathioprine 3 mg/kg PO once daily. The Immune system suppressors will suppress the immune response that releases inflammation-inducing chemicals that damage the lining of the digestive tract (Pouillon et al., 2017). The patient will require an antibiotic prescription because the presence of fever presents an infection concern. She will need a twice-daily dose of Ciprofloxacin 100 mg to eradicate and prevent further infection (Chang & Hanauer, 2017).
Evaluation of Treatment Plan
The recommended pharmacologic therapy will be considered effective if it attains the intended treatment goals. The patient will be evaluated for the gradual elimination of diarrhea, abdominal pain, and fever and body weakness. The body’s sodium levels are expected to go back to between 135 and 145 milliequivalents per liter and the Potassium level 3.6 to 5.2 millimoles per liter. These are the normal levels in healthy adults.
Patient Education
The patient should be advised to take all the prescribed drugs as directed by the care provider. The drugs should be taken at the same time every day for better outcomes. The patient should be advised not to exceed the prescribed dose, dose frequency, and prescription duration ordered by the care provider. She should not stop any of the prescribed medicine without checking first with the care provider, even if symptoms improve. In case a dose is missed, it should be taken as soon as possible unless it is almost time for the next dose. In that case, she should skip the missed dose and resume the regular dosing schedule to o avoid double dosing.
The delayed-release Mesalamine tablets should be taken orally, with food, four times a day. The tablets should not be crushed or chewed because doing so reduces their efficiency and increase the risk of side effects. The patient should increase fluid intake to improve renal excretion of the drug and avoid toxicity.
The most common side effects of Mesalamine that the patient should watch out for include stomach upset, nausea, vomiting, constipation, headache, joint, and muscle pain. These side effects often go away after a few days without any clinical intervention. Some severe side effects that the patient should immediately report to the care provider include the presence of whole or partial tablets in the stool, indicating impaired absorption. The patient may also experience increased abdominal pain, bloody diarrhea, fever, change in the amount of urine, dark urine, yellowing eyes or skin, chest pain and shortness of breath, and allergic reactions.
Regarding the Azathioprine prescription, the drug should be taken with food to reduce the risk of gastrointestinal side effects. The common side effects that the patient should watch out for include fever, swollen glands, body aches, night sweats, easy bruising or bleeding, cold hands and feet, and shortness of breath, and increased frequency of infection (Broekman et al., 2017). These side effects can be fatal; therefore, the patient should contact the care provider if they become bothersome. Besides, these drugs are contraindicated in pregnant women as they can harm the unborn baby; therefore, the patient should use contraceptives efficiently to avoid pregnancy while on this prescription.
Regarding the ciprofloxacin prescription, the medication should be taken twice daily, at least 2 hours before or 6 hours after taking supplements and vitamins, because they impair its absorption and decrease its effectiveness. Besides, Calcium-rich foods, such as dairy products calcium-fortified juice, can also reduce the effect of this medication; therefore should not be co-administered. The patient should watch out for drug side effects such as nausea, diarrhea,
dizziness, lightheadedness, headache, or trouble sleeping (Wang & Hamlyn, 2020). These side effects are often mild and disappear without any inte
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