Right upper quadrant (of abdomen) pain

DC is a 46-year-old female who presents with a 24-hour history of right upper quadrant (of abdomen) pain.  She states the pain started about 1 hour after a large dinner she had with her family.  She has had nausea and on an instance of vomiting before the presentation.

PMH:                                                              Vitals: 

HTN                                                                Temp:              98.8^oF

Type II DM                                                     Wt:                  202 lbs

Gout                                                                Ht:                   5’8″

DVT – Caused by oral BCPs                          BP:                  136/82

HR:                 82 bpm

Current Medications:                                Notable Labs:

Lisinopril 10 mg daily                                   WBC:                          13,000/mm³

HCTZ 25 mg daily                                        Total bilirubin:           0.8 mg/dL

Allopurinol 100 mg daily                               Direct bilirubin:          0.6 mg/dL

Multivitamin daily                                          Alk Phos:                    100 U/L

                                                                     AST:                           45 U/L

                                                                      ALT:                           30 U/L

Allergies:

• Latex
• Codeine
• Amoxicillin

PE:

• Eyes: EOMI
• HENT: Normal
• GI: Nondistended, minimal tenderness
• Skin: Warm and dry
• Neuro: Alert and Oriented
• Psych: Appropriate mood

Questions

1. Explain your diagnosis for the patient, including your rationale for the diagnosis.

2. Describe an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed.

3. Justify why you would recommend this drug therapy plan for this patient. Be specific and provide examples.