98%(129)127 out of 129 people found this document helpful
This preview shows page 1 - 3 out of 4 pages.
Week 6Discussion Question 1Mike is a 46-year-old who presents with a complaint of "heartburn" for 3 months. He describes the pain as burning and it is located in the epigastric area. The pain improves after he takes an antacid or drinks milk. He has been taking either over-the-counter (OTC) famotidine or ranitidine off and on for the past 2 months and hestill has recurring epigastric pain. He has lost 6 lb since his last visit.AssessmentHis examination is unremarkable. His blood pressure (BP) is 118/72. Laboratory values are normal complete blood count (CBC) and a positive serum Helicobacterpylori test.1.What would you prescribe initially?2.How long would you prescribe these medications?3.What other possible meds could you prescribe to assist with the side effects from the medications prescribed?4.How would the treatment vary if the patient has GERD instead?
I would treat Mike’s Helicobacter pylori by prescribing Aciphex 20 mg bid x 10-14 days along with clarithromycin500 mg bid and Amoxicillin 1 g bid x 10-14 days. This is considered triple therapy (Woo & Wynne, 2012). According to Woo & Wynne until healing is complete Proton Pump Inhibitor (PPI) will be continued for 8 to 12 weeks (2012). What other possible meds could you prescribe to assist with the side effects from themedications prescribed?Other medications that could be used if the patient is unable to tolerate the side effects of the regimen they are on are PPI with Clarithromycin and Metronidazole; Ranitidine with Metronidazole, Tetracycline and Bismuth subsalicylate; or PPI with Levofloxacin and Amoxicillin (Woo & Wynne, 2012).How would the treatment vary if the patient has GERD instead?The treatment for a patient with GERD would consist of lifestyle changes such as elevating the head of bed, avoiding spicy foods and acidic foods, avoid laying down after eating for at least 3 hours, limit caffeine intake, and other changes such as smoking cessation and weight loss. Medication would include antacids and histamine 2 receptor antagonists (H2RAs).