Advanced Pharmacology

Advanced Pharmacology

Name

Affiliations with Institutes

Advanced Pharmacology

Diagnosis

The patient is presented with symptoms of nausea, vomiting and diarrhea. HR appears to have some kind of chronic infection based on her medical history and current medication (Nifedipine 30mg daily, Synthroid 100mg daily and prednisone 10mg daily). The patient has also a history of hepatitis C and drug abuse.

Rationale for Diagnosis

Hepatitis C is an infection of the liver that is caused by the hepatitis C virus. It is usually transferred from infected person to person contact of bodily fluids and blood, sexual intercourse, and sharing of infected needles that are associated with illicit drug abuse ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"FnPqq7tp","properties":{"formattedCitation":"(Sullivan et al., 2018)","plainCitation":"(Sullivan et al., 2018)","noteIndex":0},"citationItems":[{"id":350,"uris":["http://zotero.org/users/local/qnvKw9vm/items/F97EESHQ"],"uri":["http://zotero.org/users/local/qnvKw9vm/items/F97EESHQ"],"itemData":{"id":350,"type":"article-journal","container-title":"JAMA psychiatry","issue":"5","page":"474-483","title":"The role of aging, drug dependence, and hepatitis C comorbidity in alcoholism cortical compromise","volume":"75","author":[{"family":"Sullivan","given":"Edith V."},{"family":"Zahr","given":"Natalie M."},{"family":"Sassoon","given":"Stephanie A."},{"family":"Thompson","given":"Wesley K."},{"family":"Kwon","given":"Dongjin"},{"family":"Pohl","given":"Kilian M."},{"family":"Pfefferbaum","given":"Adolf"}],"issued":{"date-parts":[["2018"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Sullivan et al., 2018). Synthroid 100 mcg is administered to the patient daily. This medicine has side effects if not taken properly or misused. The side effects associated with this drug include diarrhea, nausea, and vomiting. The patient is also taking prednisone which suppresses the immune system of individual. Therefore, the medical history and current medication shows that the patient is most likely to suffer from gastroenteritis.

Drug Therapy

Following the guidelines of the American Association for the Study of Liver Diseases, spontaneous and regular checkups and laboratory monitoring of infectious hepatitis C virus is recommended ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"pg3KaEfV","properties":{"formattedCitation":"(Sullivan et al., 2018)","plainCitation":"(Sullivan et al., 2018)","noteIndex":0},"citationItems":[{"id":350,"uris":["http://zotero.org/users/local/qnvKw9vm/items/F97EESHQ"],"uri":["http://zotero.org/users/local/qnvKw9vm/items/F97EESHQ"],"itemData":{"id":350,"type":"article-journal","container-title":"JAMA psychiatry","issue":"5","page":"474-483","title":"The role of aging, drug dependence, and hepatitis C comorbidity in alcoholism cortical compromise","volume":"75","author":[{"family":"Sullivan","given":"Edith V."},{"family":"Zahr","given":"Natalie M."},{"family":"Sassoon","given":"Stephanie A."},{"family":"Thompson","given":"Wesley K."},{"family":"Kwon","given":"Dongjin"},{"family":"Pohl","given":"Kilian M."},{"family":"Pfefferbaum","given":"Adolf"}],"issued":{"date-parts":[["2018"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Sullivan et al., 2018). It is important to clear persistent infection. Following the history and infection details, the drug therapy that is suggested to patient include a combination of Grazoprevir 100 IU/mL and Elbasvir 50 mg and a combination of Ritonavir (100mg) and Dasabuvir (600mg) daily. Counselling is also recommended for the patient on hydration, nutrition, and the use of hepatotoxic drugs.

Justification for Drug Therapy

Hepatitis C is significantly important to be treated at initial stages to stop infection. Initiate treatment as early as possible. Complete regular monitoring is essentially important for acute infection of hepatitis C ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"WmohmBPO","properties":{"formattedCitation":"(Martin, Gonzalez, Vassileva, & Bechara, 2015)","plainCitation":"(Martin, Gonzalez, Vassileva, & Bechara, 2015)","noteIndex":0},"citationItems":[{"id":351,"uris":["http://zotero.org/users/local/qnvKw9vm/items/BDRMUIQ6"],"uri":["http://zotero.org/users/local/qnvKw9vm/items/BDRMUIQ6"],"itemData":{"id":351,"type":"article-journal","container-title":"Neuropsychology","issue":"6","page":"926","title":"Delay discounting is greater among drug users seropositive for hepatitis C but not HIV.","volume":"29","author":[{"family":"Martin","given":"Eileen"},{"family":"Gonzalez","given":"Raul"},{"family":"Vassileva","given":"Jasmin"},{"family":"Bechara","given":"Antoine"}],"issued":{"date-parts":[["2015"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Martin, Gonzalez, Vassileva, & Bechara, 2015). Spontaneous clearance of infection of hepatitis is not suggested in this case, therefore, these drugs are recommended ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"Wcq6Uisa","properties":{"formattedCitation":"(Talal, Thomas, Reynolds, & Khalsa, 2017)","plainCitation":"(Talal, Thomas, Reynolds, & Khalsa, 2017)","noteIndex":0},"citationItems":[{"id":349,"uris":["http://zotero.org/users/local/qnvKw9vm/items/TIE7KDPN"],"uri":["http://zotero.org/users/local/qnvKw9vm/items/TIE7KDPN"],"itemData":{"id":349,"type":"article-journal","container-title":"Annals of internal medicine","issue":"12","page":"897-898","title":"Toward optimal control of hepatitis C virus infection in persons with substance use disorders","volume":"166","author":[{"family":"Talal","given":"Andrew H."},{"family":"Thomas","given":"Dave L."},{"family":"Reynolds","given":"Jessica L."},{"family":"Khalsa","given":"Jag H."}],"issued":{"date-parts":[["2017"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Talal, Thomas, Reynolds, & Khalsa, 2017). Synthroid would be suggested as it is a hormone replacement therapy. The acute gastroenteritis would be treated by administering dimenhydrinate or cyclizine ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"KtTQIQxc","properties":{"formattedCitation":"(Alexandraki, Smetana, & Aronson, 2017)","plainCitation":"(Alexandraki, Smetana, & Aronson, 2017)","noteIndex":0},"citationItems":[{"id":348,"uris":["http://zotero.org/users/local/qnvKw9vm/items/NPNA7VDE"],"uri":["http://zotero.org/users/local/qnvKw9vm/items/NPNA7VDE"],"itemData":{"id":348,"type":"article-journal","container-title":"UpToDate. Retrieved from https: www. uptodate. com/contents/acute-viral-gastroenteritis-in-adults","title":"Acute viral gastroenteritis in adults","author":[{"family":"Alexandraki","given":"Irene"},{"family":"Smetana","given":"Gerald W."},{"family":"Aronson","given":"M. D."}],"issued":{"date-parts":[["2017"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Alexandraki, Smetana, & Aronson, 2017). An appropriate diet along with plenty of fluid intake would be recommended to treat acute gastroenteritis within 48 hours as this is caused by using drugs ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"uDQD3GzG","properties":{"formattedCitation":"(Szajewska et al., 2019)","plainCitation":"(Szajewska et al., 2019)","noteIndex":0},"citationItems":[{"id":347,"uris":["http://zotero.org/users/local/qnvKw9vm/items/QQTKX9PL"],"uri":["http://zotero.org/users/local/qnvKw9vm/items/QQTKX9PL"],"itemData":{"id":347,"type":"article-journal","container-title":"Alimentary pharmacology & therapeutics","issue":"11","page":"1376-1384","title":"Systematic review with meta‐analysis: Lactobacillus rhamnosus GG for treating acute gastroenteritis in children–a 2019 update","volume":"49","author":[{"family":"Szajewska","given":"Hania"},{"family":"Kołodziej","given":"Maciej"},{"family":"Gieruszczak‐Białek","given":"Dorota"},{"family":"Skórka","given":"Agata"},{"family":"Ruszczyński","given":"Marek"},{"family":"Shamir","given":"Raanan"}],"issued":{"date-parts":[["2019"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Szajewska et al., 2019). Utilizing these drugs would help the patient to recover from gastroenteritis and hepatitis C.

References

ADDIN ZOTERO_BIBL {"custom":[]} CSL_BIBLIOGRAPHY Alexandraki, I., Smetana, G. W., & Aronson, M. D. (2017). Acute viral gastroenteritis in adults. UpToDate. Retrieved from Https: Www. Update. Com/Contents/Acute-Viral-Gastroenteritis-in-Adults.

Martin, E., Gonzalez, R., Vassileva, J., & Bechara, A. (2015). Delay discounting is greater among drug users seropositive for hepatitis C but not HIV. Neuropsychology, 29(6), 926.

Sullivan, E. V., Zahr, N. M., Sassoon, S. A., Thompson, W. K., Kwon, D., Pohl, K. M., & Pfefferbaum, A. (2018). The role of aging, drug dependence, and hepatitis C comorbidity in alcoholism cortical compromise. JAMA Psychiatry, 75(5), 474–483.

Szajewska, H., Kołodziej, M., Gieruszczak‐Białek, D., Skórka, A., Ruszczyński, M., & Shamir, R. (2019). Systematic review with meta‐analysis: Lactobacillus rhamnosus GG for treating acute gastroenteritis in children–a 2019 update. Alimentary Pharmacology & Therapeutics, 49(11), 1376–1384.

Talal, A. H., Thomas, D. L., Reynolds, J. L., & Khalsa, J. H. (2017). Toward optimal control of hepatitis C virus infection in persons with substance use disorders. Annals of Internal Medicine, 166(12), 897–898.