Question

B.F., age 28, presents with diarrhea and abdominal pain. He says he feels weak and feverish. His symptoms have persisted for 5 days. He tells you he has 8 to 10 bowel movements each day, although the volume of stool is only about “half a cupful.” Each stool is watery and contains bright-red blood. Before this episode, he had noticed a gradual increase in the frequency of his bowel movements, which he attributed to a new vitamin regimen. He has not traveled anywhere in the past 4 months and has taken no antibiotics recently. His medical history is significant for UC; his most recent exacerbation was 2 years ago. He is taking no medications except vitamins.

Examination findings include a tender, slightly distended abdomen. His BP is 122/84 sitting, 110/78 standing; HR 96 bpm; and temperature of 100°F. Otherwise, physical findings are unremarkable. Laboratory study results reveal hemoglobin 12 g/dL; hematocrit 38%; white blood cell count 12,000/mm³; platelet count 242k; sodium 132; potassium 3.6. All other study results are within normal limits. The most recent colonoscopy findings (4 years ago) revealed granular, edematous, friable mucosa with continuous ulcerations extending throughout the descending colon.

1. List the specific goals for treatment for B.F.
2. What drug therapy would you prescribe? Why?
3. What are the parameters for monitoring the success of the therapy?
4. Discuss specific patient education based on the prescribed therapy.
5. List one or two adverse reactions for the selected agent that would cause you to change therapy.
6. What would be the choice for second-line therapy?
7. What over-the-counter and/or alternative therapies might be appropriate for B.F.?
8. What lifestyle changes would you recommend for B.F.?
9. Describe one or two drug-drug or drug-food interactions for the selected agent

Write your prescription for this patient.

Answer 1

• List the specific goals for treatment for B.F.

Specific goals of treatment of B.F involves treating the symtoms and let the decending colon to heal. Preventing additional flare-ups.

• What drug therapy would you prescribe? Why?

The prescribed drug would be aminosalicylates or 5-ASAs. It inhibits te inflammatory processes by blocking the function of cyclooxygenase and lipoxygenase and subsequent production of prostaglandins which then reduces the inflammation in the colon and the symptoms associated with ulcerative colitis.

• What are the parameters for monitoring the success of the therapy?

Control in the signs and symptoms reveal the sucsess rate of therapy. Sigmoidoscopy is an endoscopic evaluation of decendinng colon also used to analysis the efficacy of the drug.

• Discuss specific patient education based on the prescribed therapy.

Therapeutic Patient Education abbreviated as TPE help patients to manage their illness and to get benefits in both health and financial terms.