Overview: Gastrointestinal Case Study
Joshua George is a 42-year-old white man presenting with a 2-month history of intermittent mid-epigastric pain. The pain sometimes wakes him up at night and seems to get better after he eats a meal. J.G. informs you that his doctor told him that he had an infection in his stomach 6 months ago. He never followed up and has been taking over-the-counter antacids and histamine receptor antagonists (H2Ras) for 2 weeks without relief. He takes no other medications. He is concerned because the pain is continuing. He has no other significant history except he is a 20 pack-year smoker and he drinks 5 cups of coffee a day. He eats late at night and goes to bed about 30 minutes after dinner. He is allergic to penicillin.
Diagnosis: Peptic Ulcer Disease
- List specific goals for treatment for J.G.
- What drug therapy would you prescribe for J.G.? Please provide your rationales.
- What are the parameters for monitoring success of the therapy?
- Discuss specific patient education based on the prescribed therapy.
- List one or two adverse reactions for the selected agent that would cause you to change therapy.
- What would be the choice for second-line therapy?
- What over-the-counter and/or alternative medications would be appropriate for J.G.?
- What lifestyle changes would you recommend to J.G.?
- Describe one or two drugâ€“drug or drugâ€“food interaction for the selected agent.