Diagnosis and Rationale
The possible diagnosis for the patient includes Crohn disease, hepatitis C, irritable bowel disease or intestinal obstruction. These conditions are known to cause weight loss, fatigue, diarrhea, nausea, and anorexia in patients. However, the information on the patient history is limited hence; several tests need to be done to get a more accurate diagnosis. These tests should include the h.pylori test, stool test, liver function test, baseline test, and abdominal x-ray. It is also important to know whether the drug abuse by the patient involves alcohol and smoking.
Based on the medication the patient is using, the most likely diagnosis is acute gastroenteritis. Symptoms of gastroenteritis include fever, nausea, vomiting, abdominal cramps, and watery diarrhea. The disease transmission is through ingesting contaminated water and foods (Lawrence & Lidbury, 2015) Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders.
Drug Therapy Plan
The first line of intervention is improved self-hygiene. This is done alongside dosing on anti-diarrheal and anti-nausea medication. An appropriate drug would be 8mg ondansetron, administered three times a day. The dose will need to be adjusted based on the results of the liver function test Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders. This is because ondansetron is metabolized by the liver (Drugs, 2015). Additionally, the patient will need to take plenty of fluids to replace the lost amount. If diarrhea persists, the patient can be prescribed with loperamide. The patient will have to be discontinued on prednisone without tapering (EASL, 2018).
Justification of Drug Therapy Plan
There is a possibility of upsetting the GI following the discontinuation of prednisone. Prednisone is similar to the adrenal gland produced by cortisol hormone. When the dosage is reduced, the adrenal gland will have a significantly larger chance of resuming its normal function Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders. Lastly, with the possible hepatitis C diagnosis, the liver is at risk of damage by Synthroid. Thus, the patient should be monitored closely for any adverse effects. To avoid further damage to the liver, the dose should be appropriately adjusted.
References
Drugs.com. (2015). Ondansetron – FDA prescribing information, side effects and uses. Retrieved from http://www.drugs.com/pro/ondansetron.html
European Association for The Study of The Liver. (2018). EASL recommendations on treatment of hepatitis C 2018. Journal of hepatology, 69(2), 461-511.
Lawrence, Y., & Lidbury, J. (2015). Symptomatic management of primary acute gastroenteritis. Today’s Vet Pract, 2015, 46-52. Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders
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