Question

J.C. 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 he was told by his doctor 6 months ago that he had an infection in his stomach. He never followed up and has been taking over-the-counter Zantac for 2 weeks without relief. 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 also takes Motrin twice a day for shoulder pain. He is allergic to penicillin.

1. List the specific goals for treatment for J.C.
2. What drug therapy would you prescribe for J.C.? Why?
3. What tests would you prescribe to determine the success of the therapy?
4. Discuss specific patient education based on the diagnosis and the prescribed therapy.
5. List one or two adverse reactions to the therapy that J.C. might have.
6. What would be the choice for second-line therapy?
7. What dietary and lifestyle changes should be commended for this patient?
8. Describe one or two drug-drug or drug-food interactions for the selected therapy.

Write your prescription for this patient

Answer 1

#.The specific goals for treatment for J.C :-

- Reduce the intermittent epigastric pain

- Rule out what is the cause behind the pain

- To start treatment for the disease

#. The drug therapy that would be prescribed for J.C. are :-

- Analgesics for pain management

- Antibiotics or antivirals as per the causative agent

#. The tests that would be prescribed to determine the success of the therapy are :-

- CBC in which leukocyte counts will indicate about the infection status

- Assessment of pain

- Ultrasound of abdomen to see the reduction in inflammation

#. Specific patient education :-

- Eat healthy diet

- Avoid too much spicy food

- Avoid junk foods

- Take plenty of fluids

- Don't take over the counter medications with out physician prescription

- Regular follow up with the physician

- Compliance to medications and healthy diet