Assignment: Pharmacotherapy for Hepatobiliary Disorders Assignment: Pharmacotherapy for Hepatobiliary Disorders Please respond to my teacher asking to my post if we should continue the three medication Synthroid 100 mcg daily Nifedipine 30 mg daily Prednisone 10 mg daily Assignment: Pharmacotherapy for Hepatobiliary Disorders Review of Case Study: Patient HL comes into the clinic with the following symptoms: nausea, vomiting, and diarrhea.?The patient has a history of drug abuse and possible Hepatitis C. HL is currently taking the following prescription drugs: Synthroid 100 mcg daily Nifedipine 30 mg daily Prednisone 10 mg daily History of Present Illness and Medical History Patient presents with symptoms of diarrhea, nausea and vomiting. Learning from HLs medical history, HL appears to have some possible chronic conditions based on his current medications; Synthroid 100 mg daily, Nifedipine 30mg daily, and prednisone 10mg daily. Also, the history states that HL has a history of drug abuse and possible Hepatitis C that could have possibly started years ago or more recently. Please respond to my teacher asking to my post if we should continue the three medication Synthroid 100 mcg daily Synthroid is a hormone replacement that is used to treat hypothyroidism, thyroid cancer and goiter (Drugs.com, 2017). Synthroid can have adverse effects if not taken properly or if misused. Diarrhea is a common side effect of Synthroid, but nausea and vomiting along with appetite changes are a severe/adverse side effe??. Nifedpine is a calcium channel blocker that is used to treat hypertension and chest pain (angina). The initial dose is 30-60mg orally once a day for the extended release and 10mg for the immediate release tablets. Vomiting, nausea and diarrhea are no???ll increase the level or effect of prednisone by affecting hepatic/intestinal enzyme CYP3A4 metabolism, and should be used with caution. ORDER INSTRUCTIONS-COMPLIANT NURSING PAPERS Assessment and Diagnostics A comprehensive history and physical examination is required to create a full picture of any under????..mine the cause of the symptoms. Primary Diagnosis: Hepatitis C Virus Hepatitis C is a serious liver infection caused by the hepatitis C virus that usually result from infected person-to-person contact of blood and bodily fluids, sexual intercourse or sharing of needles associated with illicit drug/substance use. It can be acute or c??.. Spontaneous Bacterial Peritonitis: is an acute bacterial infection of ascitic fluid, and is a complication in patients with liver cirrhosis. Symptoms include fever, chills, abdomina??..e it out. Gastroenteritis: is irritation/inflammation of the stomach and intestines caused by food contaminated with bacteria, viruses, parasites, or toxins. Symptoms may include cram???4 to 48 hours. Plan and Treatment Recommendations: Assignment: Pharmacotherapy for Hepatobiliary Disorders According to the American Association for the Study of Liver Diseases and the Infectious Diseases Society of America (2016), the following are the recommendations for treatment and management per HCV Guidelines: Regular laboratory monitoring is recommended in the setting of acut,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,etermine spontaneous clearance of HCV infection versus persistence of infection. If the practitioner and patient have decided that a delay in treatment initiation is acceptable, monitoring for spontaneous clearance is recommended for a minimum o????..ll under the genotype 1a (without cirrhosis). Combination of elbasvir (50 mg)/grazoprevir (100??..IU/mL Combination of paritaprevir (150 mg)/ritonavir (100 mg)/ombitasvir (25 mg) with dasabuvir (600 mg) daily fo,,,,,??.rin. Taking simeprevir (150 mg) with sofosbuvir (400 mg) daily for 12 weeks. Combination of sofosbuvir (400 mg)/velpatasvir (100 mg) daily for 12 weeks Taking daclatasvir (60 mg*) with s?????????ely. An alternative treatment, is the combination of elbasvir (50 mg)/grazoprevir (100 mg) with weight-based ribavirin; for patients who have baseline NS5A RASs? for elbasvir daily for 16 weeks. If a decision has been made to initiate treatment during the acute infection period, monitoring HC???????..are recommended for acute infection. For patients in whom HCV infection spontaneously clears, treatment is Not Recommended. Counseling is recommended for patients with acute HCV infection on nutrition, hydration, avoiding hepatotoxic insults, including hepatotoxic drugs (e.g., aceta????s. Referral t?????????. Assignment: Pharmacotherapy for Hepatobiliary Disorders References American Association for the Study of Liver Diseases and the Infectious Diseases Society of America (2016). Management of Acute HCV Infection. Retrieved from http://www.hcvguidelines.org/unique-populations/acute-infection Centers for?Disease Control and Prevention?(2016).?Hepatitis C FAQs for the Public. Retrieved from https://www.cdc.gov/hepatitis/hcv/cfaq.htm Daley, M. (2015). Stool Symptoms of Hepatitis C. Retrieved from Drugs.com (2017). Drugs by Condition. Retrieved from http://www.drugs.com/ Dryden-Edwards, R. (2016). Drug Dependence and Abuse. Retrieved from http://www.emedicinehealth.com/drug_dependence_and_abuse/article_em.htm#drug_dependence__abuse_overview Green, T. (2016). Spontaneous Bacterial Peritonitis. Retrieved from Kemmer, N. & Sherman, K. (2010). Hepatitis C-related arthropathy: Diagnostic and treatment considerations. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3103264/ Medscape (2017). Drug Interaction Checker. Retrieved from WebMD (2015). Gastroenteritis. Retrieved from My Familys Disaster Plan APA formate Complete the Assignment Checklist. Check off items that you have in inventory. For items that are not applicable to you and your living situation, please write N/A (not applicable) in the space, otherwise it will be counted as incomplete. ?Remember to?protect personal information?by using pseudonyms, or by providing only partial information ?Ex: Sister: Britley *****, phone: 724-***-****, email: b********@yahoo.com Review the rubric for more information on how the assignment will be graded. Please note: You are?not?required to purchase any items on this list, however, take note of the items you are missing and consider how it could impact your safety and survival in a disaster. ?My Familys Disaster Plan Learn about the natural disasters that could occur in your community and how you can respond to them. Provide at least two references and sources of information. Use APA Style for your reference. Possible hazards in my area: 1.____________________? APA source reference: __________________________ 2. ____________________ APA source reference: __________________________ 3. ________________________________________________ 4. ________________________________________________ 5. ________________________________________________ 6. ________________________________________________ Emergency Phone Numbers (Program these into all phones and post in a common area in the home.) Police department: Fire department: Local emergency services: Healthcare provider(s): Local American Red Cross: Poison Help: 1-800-222-1212 Other local emergency personnel numbers: ___________________ ___________________ ___________________ Employers and School Officials Contacts I know the emergency response plans for employers and schools. _____ School: Address: Phone: Contact name: Child Day Care/School Phone # Employer: Address: Phone: Contact name: Employer: Address: Phone: Contact name: Family Communication Plan Prepare a family communication plan so that each member of the family can contact one another quickly. Everyone has a cell phone or calling card _____ Young children know how to call (numbers are saved) ______ Assignment: Pharmacotherapy for Hepatobiliary Disorders Name Contact Name Phone Email Identify two meeting places for your family in the event that you are separated. Near your home: Location: Address: Phone: Away from your home (in the event you cannot return home): Location: Address: Phone: Draw a floor plan of your home and attach it to your submission; mark two escape routes from each room.?______ Pick a friend or relative who lives out of the area for household members to call/email to say they are okay. Name: Phone: Email: Everyone in the house knows how and when to shut off utilities. ______ Utility Name Number Shut-Off Location/Main Controls Electric Water Gas Evacuation Plan and Transportation Extra gallon of gas ______ Local government resource ______ Contact person/agency: Address: Phone: Certifications Stay current and up to date (e.g., CPR, ACLS, PALS, TNCC). Certification #1: Date of Completion/renewal: Certification #2: Date of Completion/renewal: Certification #3: Date of Completion/renewal: Property, Health, and Financial Well-being Review property insurance policies for disaster policies. ______ Current ______ Appropriate to needs ______ Review life-insurance policies.? ______ Current ______ Appropriate to needs ______ Review health insurance policies.? ______ Current ______ Appropriate to needs ______ Review financial documents. ______ Emergency savings?? $______ Easily accessible, small cash savings $ ______ Important Documents and Items Secured Make sure you have copies of important documents and items that can be stored in a fireproof watertight container. Assignment: Pharmacotherapy for Hepatobiliary Disorders ??Important Items Check off Photocopied Items That are Safely Stored Personal identification Cash and coins Credit card(s) Extra set of house keys and car keys Birth certificate Marriage certificate Drivers license Social Security card Passport/visa Wills Deeds Inventory of household goods (with photos & serial numbers) Insurance papers Immunization records AllergiesMedications Bank and credit card numbers Stock/bonds Emergency contact list (phone/address/email) Local map and emergency shelter locations Pet information Additional: Consider ways to help neighbors who may need special assistance (ESL/medical/living alone). Name Special Help Needed Address Phone Pet Arrangements As per local and state health and safety regulations, pets are not permitted in some shelters such as American Red Cross shelters. Service animals are permitted. Name of shelter vet: Address: Phone: Names of pet friendly hotels/motels or friends/family out of the area: Name: Address: Phone: Name: Address: Phone: Name: Address: Phone: Special Needs Assistance Special needs assistance organization in community. Name: Address: Phone: Register with local office of emergency services or fire department. Name: Address: Phone: Create a network of neighbors, friends, relatives, coworkers to aid you in an emergency _____ Mobility escape chair in place _____ High-rise/apartment arrangements for emergency evacuation _____ Extra wheelchair batteries, oxygen, catheters, medications, food for service animals _____ Caregiver identification information _____ Medical bracelet, etc. _____ Assignment: Pharmacotherapy for Hepatobiliary Disorders Disaster Supply Kit ?Go Bag? You and your family may need to survive on your own for 3 days or more. Consider having additional supplies for up to two weeks confinement or shelter. You should prepare emergency supplies for the following situations: Go Bags Home: Make sure all family members know where the go bags are and have access them. _____ Specific go bags: Pet go bag _____ Child go bag with special items for feeling safe and staying occupied _____ Car: 3-day supplies included with emergency roadside equipment _____ Work go bag _____ ORDER INSTRUCTIONS-COMPLIANT NURSING PAPERS Water Supplies Stocking water supplies should be a top priority. Drinking water in emergency situations should not be rationed. It is critical to store adequate amounts of water for your household. Check off the supplies you have on hand and indicate the date the supply needs to be refreshed. Two quarts of water daily for drinking for each person in household. _____ Extra two quarts of water daily for children, nursing mothers, and those who are ill and need more. _____ One gallon/week supply of water stored for sanitary and cooking needs for household. _____ Change water every 6 months. Update water supplies _____________ (date) Safety Tip: Water Storage and Collection in an Emergency Do not store in glass containers or other containers that can break. Do not rely on untested devices for decontaminating water. If you have a well or public water, follow treatment methods provided by your public health service or water provider. Store water in a cool, dark place. Food: Preparing and Emergency Supply Food, unlike water may be rationed except for children and pregnant women. No special food needed. Keep canned foods and dry mixes stocked. Replenish food supplies every 6 months. Use and replace. Store newer items in the back, older items in front. Assignment: Pharmacotherapy for Hepatobiliary Disorders Stock high energy protein foods in go bags: Peanut butter ______ Trail mix ______ Granola bars ______ Peanuts ______ Hard candy ______ Boxed juices ______ Powdered milk ______ Dry fruits______ Keep infant foods and special diet foods in supply. ______ First Aid Supplies Assemble a first aid kit for your home?and?each vehicle. ______ Check off all of the basic items you have and list additional specialty items you have on hand: First aid manual ______ Sterile adhesive bandages, assorted sizes ______ Safety pins assorted sizes ______ Cleansing agents ______ Antibiotic ointment ______ Latex gloves (2 pair) ______ Petroleum jelly or other lubricant ______ 2-inch and 4-inch sterile gauze pads (4 to 6 of each) ______ Triangular bandages (3) ______ Sunscreen______ Scissors______ 2-inch and 3-inch sterile roller bandages (3 rolls each) ______ Tweezers ______ Needle______ Moistened towelettes ______ Antiseptic ______ Thermometer ______ Tongue depressor blades (2) ______ Prescription medication list (ask your pharmacist about storing prescription medications) ______ Extra pair or prescription eye glasses or contacts______ Nonprescription drugs: Aspirin and non?aspirin pain relievers ______ Antidiarrheal medication ______ Antacid______ Laxative______ Vitamins______ Syrup of ipecac ______ Tools and Emergency Supplies Assemble these items in a disaster supply kit in case you need to leave quickly. Check off all of the basic items you have and list additional specialty items you have on hand. Tools Portable, battery-powered radio, TV, alarm clock ______ Flashlight and extra batteries ______ Signal flare ______ Matches in a waterproof container ______ Shut-off wrench, pliers, shovel, hammer, screwdriver, and other tools ______ Duct tape and scissors ______ Plastic sheeting ______ Whistle ______ A-B-C fire extinguisher ______ Tube tent ______ Compass ______ Work gloves ______ Paper, pen, pencils ______ Needles and thread ______ Sanitation and Hygiene Washcloth and towel ______ Towelletes, soap, hand sanitizer, liquid detergent ______ Toiletries ______ Heavy-duty plastic garbage bags ______ Medium?sized plastic bucket with tight lid and small shovel for digging a latrine ______ Disinfectant and household chlorine bleach ______ Assignment: Pharmacotherapy for Hepatobiliary Disorders Kitchen Items Manual can opener ______ Mess kits or paper cups, plates, plastic utensils ______ All-purpose knife ______ A dropper (eye dropper) with measurements ______ Liquid bleach to treat water ______ Only use regular, unscented chlorine bleach products that are suitable for disinfection and sanitization as indicated on the label. The label may say that the active ingredient contains 6 or 8.25% of sodium hypochlorite. Do not use scented, color safe, or bleaches with added cleaners. If water is cloudy, let it settle and filter it through a clean cloth, paper towel, or coffee filter. Sugar, salt, pepper ______ Aluminum foil, plastic wrap ______ Resealing plastic bags ______ If food must be cooked, a small camping stove and can of cooking fuel ______ Clothes and Bedding One complete change of clothes and footwear for each member of household. Shoes should be sturdy work shoes or boots. ______ Rain gear, hats and gloves, extra socks and underwear, thermal underwear, sunglasses. ______ Blankets or sleeping bag and pillows for each member. ______ Specialty Items as Needed For: The baby ______ The elderly ______ Pets ______ Other Items Add a list of additional items to include here. Review other disaster preparedness websites for items not included here. Check off items that you have and list items you need to acquire. ??Item ??Included Assignment: Pharmacotherapy for Hepatobiliary Disorders Order Now

ADDITIONAL DETAILS 

Pharmacotherapy for Hepatobiliary Disorders

Introduction

Hepatobiliary disorders are conditions that affect the liver and biliary tract. They include gallstones, cholelithiasis, choledocholithiasis and cholestatic jaundice. These diseases can be life-threatening if not diagnosed and treated early on.

Overview

Hepatobiliary disease, also known as liver and bile duct diseases, is a broad term that covers a variety of conditions in which the liver and bile ducts become damaged or diseased. Liver disease may result from environmental factors such as alcohol use or high fat diets; some types of liver cancer; viral hepatitis; autoimmune responses (such as lupus); and inherited defects in the workings of your body’s immune system.

The symptoms of hepatobiliary disease are often vague but may include jaundice (yellowing of skin), fatigue/lethargy, nausea/vomiting, abdominal pain/cramps, fever with chills—and sometimes no symptoms at all until later on when they become more severe or persistently recurring over time due to damage caused by inflammation or scarring around affected areas within your body’s digestive tract (colon).

Biliary Tract Diseases

Biliary tract diseases are a group of disorders that affect the biliary tree, which includes the gallbladder, common bile duct and pancreatic duct. The liver secretes bile into these tubes to aid in digestion. If there is abnormal emptying or obstruction in any part of this system, it can cause severe health problems for your body.

Gallstones

Gallstones are solid concretions that form in the gallbladder. They’re usually made of cholesterol, bile salts and other organic material.

Gallstones can be as small as a grain of sand or as large as a golf ball.

Cholelithiasis Etiology and Pathophysiology

Cholelithiasis is a common condition in which cholesterol-rich bile (cholesterol gallstones) develop in the gallbladder. The most common cause of cholelithiasis is an inherited mutation in the ABCB1 gene, which causes an increased rate of cholesterol absorption. Other causes include:

• Obesity

• Alcohol abuse or excess alcohol consumption (ethanol)

Cholelithiasis Treatment

There are a number of non-surgical treatments for cholelithiasis. Some of these include dietary changes, medications and avoiding alcohol.

Lifestyle changes are also important in the treatment of cholelithiasis. Weight loss can help reduce the size of gallstones while physical activity may help promote good liver function and decrease blood pressure levels. Healthy diet with increased intake of fiber, low fat intake/low calorie diet and adequate water intake should be adopted by individuals suffering from this condition so as to improve their quality life expectancy as well as prevent any complications associated with its management or treatment options

Acute Cholecystitis

Acute cholecystitis is a condition in which the gallbladder becomes inflamed. Symptoms include abdominal pain, fever and nausea.

Cholecystitis can be caused by gallstones or alcohol use. Treatment includes antibiotics and pain medication if necessary.

Chronic Cholecystitis Treatment

• Surgical removal of the gallbladder (cholecystectomy). In most cases, a cholecystectomy is performed to remove the gallbladder. The procedure is usually performed under general anesthesia or sedation. It may also be done as an outpatient procedure under local anesthesia and if there are no complications, recovery time can be as short as 24 hours after surgery.

• Percutaneous transhepatic cholangiography (PTC). This test uses a thin needle inserted into your bile duct through one end of your small intestine called jejunum, which connects directly with your liver’s common hepatic ducts that lead directly into its bile canaliculi system located in each lobe region of livers’ ducts where bile comes from inside them back into bloodstream again with help from other body processes such as liver functions like production/secretion rate etc…

Hepatic and Biliary Disease Diagnosis and Management

• Diagnosis of Hepatitis

Hepatitis is a systemic disease caused by the hepatitis A virus, hepatitis B virus (HBV), and hepatitis C virus (HCV). The three types of hepatitis can be differentiated by their clinical presentations, viral serologic tests, and viral markers. Patients with acute or chronic HCV infection are at risk for developing cirrhosis; however, most patients with chronic HBV have no symptoms or signs related to the disease.

• Diagnosis of Cirrhosis

Cirrhosis refers to liver injury that occurs as a result of excessive alcohol consumption over time in someone with impaired liver function. The stage of cirrhosis is determined based on clinical findings such as ascites and/or variceal bleeding along with elevated serum bilirubin levels (>15 mg/dL) or low platelets (<50 000/uL). Patients who have been diagnosed with advanced stages may experience portal hypertension due to increased pressure in their abdomen causing other organs such as pancreas and kidney failure if not treated properly.

Takeaway:

The takeaway is the most important part of any article. It’s where you can summarize what you learned and convey your recommendations, so that your readers get the most out of reading the article.

Takeaway: The takeaways should be brief summaries of what was covered in your article, with a call-to-action at the end (e.g., “Learn more about this topic by reading my blog post.”).

Conclusion

The most common biliary tract disease is gallstones, which are a result of excess cholesterol. This condition usually occurs in people who are older than 40 years of age or have had a previous gallbladder surgery.

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