Nausea and vomiting can indicate the presence of gastrointestinal disorders (GI), metabolic disorders, neurological issues, or adverse reactions to drugs or substance abuse (Arcangelo & Peterson, 2013). Although the exact medical history of HL is unknown, based on the drugs used in the patient’s treatment, it is possible to assume that the patient suffers from hypertension, chest pain, breathing disorders, ulcerative colitis, or hormonal imbalances (Cerner Multum [CM], 2012; CM 2013a; CM 2013b).
Because diarrhea occurs simultaneously with vomiting and nausea, my diagnosis would be viral gastroenteritis, which should resolve spontaneously within five days (Arcangelo & Peterson, 2013). Medication related side-effects should also be considered when planning further treatment because the doses of current prescriptions might need adjustments. In both cases, the goal of drug therapy is to alleviate the symptoms and minimize the risks for complications of nausea, vomiting, and diarrhea (Arcangelo & Peterson, 2013).
The drug treatment plan needs to be changed because of the patient’s history and current condition. With a history of drug abuse and possible cirrhosis, nifedipine and prednisone may be harmful to the patient (CM 2012; CM 2013a). Both drugs are also associated with several side-effects, including nausea, vomiting, and diarrhea, which means they could be responsible for the patient’s symptoms, so the doses should be reduced after the patient’s assessment.
The best drugs for regulating nausea and vomiting in this case are antacids because prescription drugs commonly used for pharmacotherapy may cause several adverse events. For example, because the patient has predispositions to substance addiction and hepatic failure, lorazepam and cannabinoids should be avoided in this treatment (Arcangelo & Peterson, 2013).
In treating diarrhea, the best plan would be to skip the first line of therapy because antimotility agents may prolong symptoms by preventing the excretion of organisms responsible for viral gastroenteritis, and central nervous toxicity can also occur in patients with hepatic dysfunctions (Arcangelo & Peterson, 2013). Therefore, antisecretory agents used in second-line therapy, such as bismuth subsalicylate, are a better choice for regulating diarrhea.
References
Arcangelo, V. P., & Peterson, A. M. (Eds.). (2013). Pharmacotherapeutics for advanced practice: A practical approach (3rd ed.). Ambler, PA: Lippincott Williams & Wilkins.
Cerner Multum. (2012). Nifedipine. Retrieved from http://www.drugs.com/nifedipine.html
Cerner Multum. (2013a). Prednisone. Retrieved from http://www.drugs.com/prednisone.html
Cerner Multum. (2013b). Synthroid. Retrieved from http://www.drugs.com/synthroid.html
