Reference no: EM133396212

Question: A 31-year-old Hispanic woman presents to the emergency department of her local hospital. She is complaining of abdominal pain, vomiting, and general malaise over the past 24 hours. She admits to having taken a "handful" of Lorcet and drinking "3 or 4 rum & cokes" the night before she started vomiting. She has no medical history of any other significant underlying physiologic disease states. There is also no history of recent surgeries. In addition to the Lorcet, she takes birth control pills daily and is also taking 10 mg Lexapro once daily for depression.You order as series of bloodwork panels, including a liver panel. You receive the following results:Alkaline phosphatase (ALP): 302 U/L (standard range: 41-133 U/L)Alanine aminotransferase (ALT): 351 (standard range: 7-56 U/L)Aspartate aminotransferase (AST): 1045 (standard range: 5-40 U/L)Total bilirubin: 3.33 mg/dL (standard range: 0.1-1.2 mg/dL)Pregnancy test: neg1. Based on this information, what is the initial diagnosis for this patient? What further information would you like to know to confirm your diagnosis?2. What do we need to know about the toxicokinetics and biotransformation of Lorcet and alcohol that may be important for determining the appropriate course of treatment?3. Might her ethnic and/or genetic background account for differences in toxicokinetics of these xenobiotics?4. What do you think is the mechanism of toxicity involved in her clinical symptoms?5. What would be your recommended treatment for this patient and why?