Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders

Pharmacotherapy in Gastroenteritis
Pharmacotherapy in Gastroenteritis
A patient comes to the clinic with symptoms of diarrhea, nausea, and vomiting. The
patient has a history of drug abuse and possible Hepatitis C. The patient is currently taking
Synthroid 100 mcg daily, Nifedipine 30mg daily and Prednisone 10 mg daily.
The patient has a possible gastroenteritis infection. Basing on the medical history, the
patient is on Prednisone which is a synthetic corticosteroid which has a possibility of reducing
the immune system and thereby predisposing the patient to gastrointestinal infection (Guarino,
Guandalini, & Vecchio, 2015). Gastroenteritis is the inflammation of the digestive tract
particularly the stomach and the intestines. The infection can result from a bacterial, viral or a
parasitic infection. Patients often present with loss of appetite, bloating, nausea and vomiting and
diarrhea. Treatment of gastrointestinal infection depends on the medical history, physical
examination, blood and stool tests. In most cases, the treatment depends on the cause.
Drug Therapy
According to Chow, Leung, & Hon (2014), the use of antiemetics helps in the treatment
of nausea and vomiting. The use of antiemetics is recommended since nausea and vomiting is
unpleasant and the distressing symptom increases the likelihood of dehydration and electrolyte
imbalance. Metoclopramide is a dopamine receptor antagonist approved for decreasing the
afferent impulses to the chemoreceptor trigger zone thereby reducing the gastric sphincter tone
and increasing the intestinal transit time.
Antimotility Agents (Antidiarrheal)
These agents are essential in the symptomatic treatment of mild to moderate diarrhea
which is non-bloody. As such, the drug helps in the prevention and the treatment of dehydration
associated with diarrhea. Agents in this category may include bismuth subsalicylate as well as
loperamide (Imodium) which is vital as an adjunct to rehydration as well as for symptomatic
relief. The most preferred drug is loperamide. The drug acts by altering the intestinal motility
and thereby giving time for the reabsorption of water in the intestines thus reducing the
frequency and volume of stools.
Flora Norm (Saccharomyces boulardii) is one of the agents that are used in the
management of acute diarrhea of various etiologies. The agent is live non-pathogenic yeast
which is recommended as a probiotic (Canziani et al., 2017). The drug alters the composition of
gut flora and inhibits the action of the pathogenic microorganisms. As such, it helps in the
maintenance of the healthy balance of intestinal flora through the production of lactic acid,
hydrogen peroxide, and acetic acid which in turn increases the acidity levels. Research indicates
that the drug as well produces bacteriocins which naturally kill undesirable microorganisms. The
drug is in the form of powder and is administered orally directly or mixed with water or
Oral Rehydration Salts
These are agents which are used for the treatment of dehydration. The ORS contains
sodium chloride, potassium chloride, sucrose and trisodium citrate dihydrate. The agent is
reconstituted with water and taken orally. The amount given is dependent on the frequency and
intensity of diarrhea.
Zinc Supplements
In gastroenteritis, patients present with diarrhea which is at times associated with severe
zinc deficiency. Research indicates that the use of zinc significantly reduces the complications
associated with diarrhea (Khan & Sellen, 2011). Zinc is an essential micronutrient used for cell
growth, immunity, protein synthesis as well as intestinal transport and water and electrolyte
transport. The recommended zinc salts used includes the zinc sulfate, zinc gluconate or zinc
Canziani, B. C., Uestuener, P., Fossali, E. F., Lava, S. A., Bianchetti, M. G., Agostoni, C., &
Milani, G. P. (2017). Clinical Practice: Nausea and vomiting in acute gastroenteritis:
physiopathology and management. European Journal of Pediatrics, 1-5.
Chow, C. M., Leung, A. K., & Hon, K. L. (2014). Acute gastroenteritis: from guidelines to real
life. Clinical and Experimental Gastroenterology, 3, 97.
Guarino, A., Guandalini, S., & Vecchio, A. L. (2015). Probiotics for prevention and treatment of
diarrhea. Journal of Clinical Gastroenterology, 49, S37-S45.
Khan, W. U., & Sellen, D. W. (2011). Zinc supplementation in the management of diarrhea.
Biological, behavioral and contextual rationale. Geneva, Switzerland: World Health

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