Question

Ms. Leah Thompson is a 47-year-old patient who comes in today complaining of heartburn that is no longer responding to TUMS and Mylanta. She complains of heartburn especially after lunch and dinner. She recently lost her job as a bookkeeper for an auto parts store that went out of business. She is stressed, as she is a single parent to two “bright kids” who are “college material.” She does not know how she will afford college tuition, but she is determined to make it possible for them. She denies melena or bloody stools and nausea or vomiting. She has gained about 22 pounds in the past 2 years. She has been working overtime as much as possible and has found little time for exercising. She has no past medical history of heart disease, diabetes, or ulcerative colitis or Crohn’s disease. She has a normal complete blood count and has normal vital signs. You diagnose her with gastroesophageal reflux disease. 1. What is the appropriate medication to prescribe? 2. What education regarding the prescription does Ms. Thompson need?

Answer 1

1. H-2- receptor blockers ( ranitidine,famotidine,cimetidine) and proton pump inhibitors (omeprazole

    pantoprazole) are used to treat this condition.

2.Education about medication prescribed for GERD.

                      * Longer use of H 2 Receptor blockers result in vitamin B12 deficiency and bone fracture

                        so diet should include calcium and vitamin B12 contain foods.

                     * Side effects like nause,vomitting,diarrhea and vitamin deficiency are common so

                        consult physician if serious problem occur.

    * About one week of proper use needed for begin to get better result.