NURS 6521 Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders

NURS 6521 Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders

Review the case study assigned by your Instructor for this Assignment

Reflect on the patient’s symptoms, medical history, and drugs currently prescribed.

Think about a possible diagnosis for the patient. Consider whether the patient has a disorder related to the gastrointestinal and hepatobiliary system or whether the symptoms are the result of a disorder from another system or other factors, such as pregnancy, drugs, or a psychological disorder.

Consider an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed.

By Day 7 of Week 4

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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.


For the Assignment this week, you will evaluate and determine a diagnosis for the case study patient who presents with symptoms of a possible GI/hepatobiliary disorder. You will then justify your diagnosis, including your rationale for the diagnosis. Based upon your diagnosis, you will then determine an appropriate treatment plan for the case patient. For full credit, please ensure that you provide the appropriate dose, route and frequency of administration of the medication(s) prescribed. Approach this as if you are writing a prescription for your patient – what drug, dose, route and frequency would you prescribe?


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When writing your Week 4 Assignment, consider the following scenario:

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 one instance of vomiting before presentation.




Type II DM


DVT – Caused by oral BCPs



Temp: 98.8°F

Wt: 202 lbs

Ht: 5’8”

BP: 136/82

HR: 82 bpm

Current Medications:

Lisinopril 10 mg daily

HCTZ 25 mg daily

Allopurinol 100 mg daily

Multivitamin daily


Notable Labs:

WBC: 13,000/mm3

Total bilirubin: 0.8 mg/dL

Direct bilirubin: 0.6 mg/dL

Alk Phos: 100 U/L

AST: 45 U/L

ALT: 30 U/L







Eyes: EOMI

HENT: Normal

GI: Nondistended, minimal tenderness

Skin: Warm and dry

Neuro: Alert and Oriented

Psych: Appropriate mood



Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders


Gastrointestinal and histobiliary illnesses are among the leading causes of disability globally. Correct diagnosis and treatment are critical in averting avoidable complications (Romano et al.,2018). The paper focuses on DC, a 46-year-old female patient who went to the clinic with a major complaint of RUQ discomfort that she claimed began around 1 hour after a meal she had with her family. She stated that she had nausea and vomiting prior to the presentation. She has a history of hypertension, DMT2, gout, and DVT. The paper discusses the patient’s diagnosis, treatment program, and present prescription predicated on the patient’s history, diagnosis, and current medication.


Based on the patient’s history of RUQ pain, vomiting, and diarrhea, acute pancreatitis is the most likely diagnosis. This is backed by a rise in bilirubin and liver functional tests such as AST and ALT. Gallstone disease, which is common in people with gout and high blood pressure, is a common cause of acute pancreatitis (Mederos et al.,2021). Furthermore, allopurinol, and lisinopril have been associated with a higher risk of gallstone disease (Sandhu et al.,2020). As demonstrated by the case scenario, the disease is also linked to deep venous thrombosis.

Treatment plan

Acute pancreatitis can be lethal. Common therapeutic aims include pain alleviation, improving appetite and nutrition, and avoiding additional inflammation (Gajanayake et al.,2019). I would continue DC on lisinopril 10 mg, Hydrochlorothiazide 25 mg to control her HTN, discontinue Allopurinol and add febuxostat as an option to combat the gout episode, add ibuprofen 500mg prn to manage pain, and anti-emetic to control vomiting and diarrhea.

I chose to include ibuprofen in the management of acute pancreatitis because of its efficacy in reducing pain and inflammation. Furthermore, patients tolerate it well. Allopurinol has to be discontinued due to its ability to elevate certain enzymes in the liver, potentially worsening liver function already compromised by this condition. It is also known to produce severe GIT adverse effects like as nausea and vomiting, warranting its discontinuation.



Romano, C., Dipasquale, V., Gottrand, F., & Sullivan, P. B. (2018). Gastrointestinal and nutritional issues in children with neurological disability. Developmental Medicine & Child Neurology, 60(9), 892-896.

Mederos, M. A., Reber, H. A., & Girgis, M. D. (2021). Acute pancreatitis: a review. Jama, 325(4), 382-390.

Sandhu, N., & Navarro, V. (2020). Drug‐induced liver injury in gi practice. Hepatology communications, 4(5), 631-645.

Gajanayake, I. (2019, April). Management of canine acute pancreatitis. In BSAVA Congress Proceedings 2019 (pp. 387-388). BSAVA Library.

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