Introduction:
Gastrointestinal disease is a complicated problem that needs an in-depth approach. This paper gives an insight into two scenarios: Veronica, aged 29, who has developed epigastric pains, plus Neveah, aged 8, with constipation disorder.in compliance with evidence-based requirements and national guidelines while enforcing the appropriate medical standards, maximum management of the disease is easy.
Veronica’s Case
The 29-year-old black female by the name of Veronica George comes with a 2-month tormentious epigastric record. Her sleep is disrupted by the pain, which gets better after meals. V.G. records have been diagnosed with an untreated stomach infection six months prior, and she has been taking over-the-counter antacids and H2 receptor antagonists without success for the past two weeks. She is likewise on lithium for bipolar turmoil, a controlled condition. Her H. pylori infection will be treated with bismuth-based quadruple therapy.
Medication Choice and Rationale
According to The National Institute for Health and Care Exercises(2024) guidelines on the management of H.pylori, bismuth-based quadruple therapy is the choice as its content is intended to address H. pylori, including Bismuth Subsalicylate, Metronidazole, Antibiotic medication, and Esomeprazole. The instrument of activity is diverse, with bismuth’s antimicrobial properties and anti-toxin collaboration, as suggested by proof.
The National Institute of Health Care Drug Description Bismuth-Based Quadruple
Contents
- Bismuth Subsalicylate 300 mg
- Metronidazole 500 mg
- Tetracycline 500 mg
- Esomeprazole 20 mg
Education To the Patient
While avoiding the use of alcohol and cigarettes during treatment is key, it is also ethical to comply with a set of instructions on drug use by the physician. The endorsed plan is urgent. This is in accordance with Korean evidence-based guidelines on treatments of helicopter pylori disease (. Jung et al., 2020). Additionally, observing meal schedules and a balanced diet is recommended, and finally, side effects of the use of the drug include black feces.
The Major Adverse Reaction:
Two significant unfriendly responses requiring an adjustment of treatment incorporate serious, unfavorably susceptible responses and industrious, unbearable gastrointestinal secondary effects, as shown by Rothenstel et al. principles (2021). the two most severe reactions that prompt change treatment include adverse allergy reactions alongside persistent effects on gastrointestinal, in accordance to NICE:
Interactions With Drug
Lithium interaction
According to The Korean Journal of Medicine (2021), an evidence-based article, continuous use of prescribed drugs without proper monitoring may lead to their accumulation in the body. Therefore, lithium levels may go up for Veronica based on the Bismuth-based quadruple prescriptions; therefore, follow-up is required to avoid lithium toxicity.
Reduced efficacy with PPIs
NICE highlights the guidelines during the combination of drugs, including the use of safety garments like gloves; further, it recommends proper monitoring protocols’ It is therefore important to monitor potential changes while mixing bismuth-based quadruple for safety treatment effectiveness.
National Institute of Health And Care Exercises Safety Guidelines
- Where protected PPIs when dealing with drugs
- Report any accident case in the laboratory while taking first aid as the first step
Neveah: Patient Two
An 8-year-old young girl comes with painful bowel movements twice a week. The dad becomes worried about the size of her stools, requiring latrine plunging after every development. Polyethylene Glycol 3350 is the chosen medication.
Rome Iv Rules:
The Rome IV protocol for useful constipation in kids, inclusive of rare solid discharges and agonizing crap, goes hand in hand with Neveah’s case
Choice Of Medication and Rationale
Depending on the Patient-Focused Care Across the Life expectancy standards and rules, polyethylene Glycol is relevant since it makes the stool softer, which allows regular movement of the bowels, as pointed out in an evidence-based article (pawasauska et al.,2020). While effectiveness depends on eating the same thing every day, satisfactory liquid admission is pivotal. It is reasonable to anticipate gradual improvement rather than immediate results. Bloating and cramping in the abdomen are potential side effects; however, empowering normal latrine propensities is imperative.
American Gastroenterological Association-American constipation guidelines
- Health workers should engage in a decision-making process on the tastes of the sick.
- Patients should adhere to a well-balanced diet to boost the immunity of the body.
The drug prescription for constipation patient
Prescription for adults(above 18 years)-
Polyethylene Glycol(3350 )17 every day
Prescription for children(5-17 years)
Polyethylene Glycol(3350 )10g every day
Dose for infants(0-4)
Polyethylene Glycol(3350 )8g every day
Adverse Reactions:
A significant response that triggers treatment changes is a hypersensitive response, including rashes or trouble breathing.
The Drug Interactions
Likely associations with drugs influencing electrolyte balance, e.g., diuretics, could enhance performance effectiveness in healthcare. Also, alert with associative utilization of diuretics, possibly intensifying electrolyte awkward nature.
Conclusion:
Through the incorporation of evidence-based activities, complying with national standards and principles while taking into account patient-explicit variables, medical experts can tailor therapies to streamline results in gastrointestinal problems. The endorsed drugs and patient training methodologies illustrated above are lined up with current guidelines, cultivating a complete and viable way to deal with patient considerations. Clinicians are more likely to be able to provide the best possible care for their patients if they keep up with the most recent research as the healthcare landscape changes.
References
CME exam 1: American Gastroenterological Association clinical practice guidelines on the pharmacological management of irritable bowel syndrome with constipation (IBS-C) and American Gastroenterological Association clinical practice guidelines on the pharmacological management of irritable bowel syndrome with diarrhea (IBS-D). (2022). Gastroenterology, 163(1), e15-e17. https://doi.org/10.1053/j.gastro.2022.05.010
Poetry R.X.: How 50 inspiring poems can heal and bring joy to your life. (2021). G&D Media.
Jung, H., Kang, S. J., Lee, Y. C., Yang, H., Park, S., Shin, C. M., Kim, S. E., Lim, H. C., Kim, J., Nam, S. Y., Shin, W. G., Park, J. M., Choi, I. J., Kim, J. G., & Choi, M. (2021). Evidence-based guidelines for the treatment of Helicobacter pylori infection in Korea: 2020 revised edition. The Korean Journal of Medicine, 96(3), 160-189. https://doi.org/10.3904/kjm.2021.96.3.16
Pawasauskas, J. (2022). Opioid-induced constipation. Pain, 165-172. https://doi.org/10.1093/med/9780197542873.003.0020
Rosenthal, L. D., & Burchum, J. (2021). Lehne's pharmacotherapeutics for advanced
Practice nurses and physician assistants (2nd ed.). Elsevier.
Chapter 64: Drugs for Peptic Ulcer Disease
o Chapter 65: Laxatives
Chapter 66: Other Gastrointestinal Drugs
o Chapter 67: Vitamins
Chapter 69: Complementary and Alternative Therapy
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