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Mike 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 afterhe 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 he still has recurring epigastric pain. He has lost 6 lb since his last visit.His examination is unremarkable. His blood pressure (BP) is 118/72. Laboratory values are normal complete blood count (CBC) and a positive serum Helicobacter pylori test.What would you prescribe initially? How long would you prescribe these medications?I would treat Mike’s Helicobacter pylori by prescribing Aciphex 20 mg bid for 10-14 days along with clarithromycin 500 mg bid and Amoxicillin 1 g bid for 10-14 days. This is considered triple therapy (Woo, 2015). Until healing is complete, Proton Pump Inhibitor (PPI) will be continued for 8 to 12 weeks (Woo, 2015).What other possible meds could you prescribe to assist with the side effects from the medications prescribed?
esophageal erosive disease then they will be placed on H2RAs twice a day.List differential diagnosis that would help confirm GERD while ruling out other diagnosis. Which medication is the best medication for treatment of GERD and why? What labs or other diagnostic tests that are used to confirm GERD?Differential diagnosis that would help confirm GERD while ruling out other diagnosis would be cholelithiasis, peptic ulcer disease, angina and gastritis just to name a few (Buttaro et al., 2017). Endoscopy is used to help confirm GERD. There are many more that could be a differential diagnosis. The best medications for treatment of GERD would be Antacids, H2 receptor blockers (H2RA’s) and Proton pump inhibitors (PPI’s). Henricks (2016) states, “These medications are listed in increasing order of strength. H2-receptor blockers are better at reducing acid than antacids, and proton pump inhibitors arestronger than H2 receptor blockers”. H2RAs helps to limit gastric parietal cells acid secretion, PPI’s suppresses the gastric acid juices more than 90 percent (Woo, 2015). Depending on the symptoms of the patient, using the stepped approach, which consist of a step-up and step-down approach,may be beneficial for the patient (Woo, 2015). The step-up approach has three steps. The first step would be lifestyle