4.1 Gastrointestinal Case Study

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4.1 Gastrointestinal Case Study

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

  1. List specific goals for treatment for J.G.
  2. What drug therapy would you prescribe for J.G.? Please provide your rationales.
  3. What are the parameters for monitoring success of the therapy?
  4. Discuss specific patient education based on the prescribed therapy.
  5. List one or two adverse reactions for the selected agent that would cause you to change therapy.
  6. What would be the choice for second-line therapy?
  7. What over-the-counter and/or alternative medications would be appropriate for J.G.?
  8. What lifestyle changes would you recommend to J.G.?
  9. Describe one or two drug–drug or drug–food interaction for the selected agent.