T.H., a 57-year-old stockbroker, has come to the
gastroenterologist for treatment of recurrent mild to severe
cramping in his abdomen and blood-streaked stool. You are the
registered nurse doing his initial workup. Your findings include a
mildly obese man who demonstrates moderate guarding of his abdomen
with both direct and rebound tenderness, especially in the left
lower quadrant (LLQ). His vital signs are 168/98, 110, 24, 100.4° F
(38° C); he is slightly diaphoretic. T.H. reports that he has
periodic constipation. He has had previous episodes of abdominal
cramping, but this time the pain is getting worse. Past medical
history reveals that T.H. has a "sedentary job with lots of
emotional moments," he has smoked a pack of cigarettes a day for 30
years, and he had "two or three mixed drinks in the evening" until
2 months ago. He states, "I haven't had anything to drink in 2
months." He denies having regular exercise: "just no time." His
diet consists mostly of "white bread, meat, potatoes, and ice cream
with fruit and nuts over it." He denies having a history of cardiac
or pulmonary problems and has no personal history of cancer,
although his father and older brother died of colon cancer. He
takes no medications and denies the use of any other drugs or
T.H. is being sent home with prescriptions for metronidazole (Flagyl) 500mg PO q6h, ciprofloxacin (Cipro) 500mg PO q12h, and dicyclomine (Bentyl) 20mg 4 tomes per day for 5 days.
The prescription of metronidazole is an antimicrobial (antibiotic )which can fight against and kill the disease causing microorganisms including the GUT causing infection resulted in diarrhoea .
Ciprofloxacin belongs to a group of antibiotic which can treat abdominal infection caused due to bacterial infection. As a result the fever can settle down .
Dicyclomine is specially used to treat cramps of the intestine .As a result it relaxes the intestinal muscles and reducing the GUT movements and hence diarrhoea is under control .
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