Peptic Ulcer Disease and Maintenance Therapy

What would you prescribe initially?

Based on the examination and assessment, the patient under consideration suffers from peptic ulcer disease (PUD). The initial prescription for his case would be over-the-counter antacids and histamine 2 blockers, as well as lifestyle modifications (Woo, 2016). However, in case with PUD, many patients try some interventions prior to seeking health care. Mike has already resorted to famotidine and ranitidine, so it is necessary to move to the second step of the initial treatment. Such a decision is relevant to the patient’s case since it is particularly recommended for individuals with a positive H. pylori test (Woo, 2016).

Therefore, the initial prescription would include maintenance therapy with an antisecretory agent. Particularly, I would prescribe proton pump inhibitors (PPI), amoxicillin, and clarithromycin for this patient as the most common recommendation. An alternative triple-drug regimen would be metronidazole instead of amoxicillin (Fashner & Gitu, 2015). I would try this regimen in case Mike proved to be amoxicillin-resistant.

What concerns the major lifestyle modifications, they should include smoking cessation (in case Mike smokes), dietary changes, and stress management. Smoking is known not only to raise the risk for duodenal and gastric ulcers but also to slow down their healing (Woo, 2016). Therefore, if the patient smokes, this habit should be eradicated in order to promote the treatment process. Dietary adjustments are crucial for all patients with diseases of the gastrointestinal system. The major change concerns the amount of food and the frequency of intake.

Thus, I would recommend Mike to eat small portions of food several times a day rather than eat much only two or three times per day. Another dietary change would be the minimized consumption of alcohol, fruit juices, spices, and caffeine (Woo, 2016). The selection of dietary modification should depend on individual characteristics of the patient and upon the detailed analyses and tests that could indicate the most problem-causing types of food. Finally, controlling stress would be recommended to Mike since stressful situations are also known to deteriorate PUD.

How long would you prescribe these medications?

The most common duration of the first-line therapy aimed at the eradication of H. pylori is seven-ten days. The triple-drug regimen includes PPI, amoxicillin 1g, and clarithromycin 500mg twice a day (Fashner & Gitu, 2015). The latest research results indicate that there is a growing tendency of patients’ resistance to clarithromycin, which sometimes reaches up to 80% (Fashner & Gitu, 2015). Thus, such a regimen would not be advised in case Mike’s resistance to clarithromycin exceeded 15-20%. The alternative treatment with metronidazole instead of amoxicillin is also recommended for seven to ten days to assess the effects on the patient.

What other possible meds could you prescribe to assist with the side effects from the medications prescribed?

Although adverse effects of PUD treatment are not common, some still may occur in rare cases. The most typical side effects include diarrhea, constipation, nausea, and headache. To eliminate the development of adverse outcomes of treatment, adding probiotics to the triple therapy is recommended. In particular, Lactobacillus and Saccharomyces boulardii are reported to decrease the side effects in general by 14% and diarrhea in particular by 7% (Fashner & Gitu, 2015).

How would the treatment vary if the patient has GERD instead?

If the patient had gastroesophageal reflux (GERD), there would be some different approaches to treatment. First of all, lifestyle changes would play a much more crucial role in that case than in PUD (Woo, 2016). Apart from smoking cessation and dietary changes, such a lifestyle modification as antireflux maneuvers would be recommended to decrease back pressure on the lower esophageal sphincter from intra-abdominal contents (Woo, 2016). Another difference would be the duration of PPI therapy, which, in this case, would reach eight weeks.

References

Fashner, J., & Gitu, A. C. (2015). Diagnosis and treatment of peptic ulcer disease and H. pylori infection. American Family Physician, 91(4), 236-242.

Woo, T. M. (2016). Gastroesophageal reflux and peptic ulcer disease. In T. M. Woo & M. V. Robinson (Eds.), Pharmacotherapeutics for advanced practice nurse prescribers (4th ed.) (pp. 1021-1034). Philadelphia, PA: F. A. Davis Company.

Calculate the price
Make an order in advance and get the best price
Pages (550 words)
$0.00
*Price with a welcome 15% discount applied.
Pro tip: If you want to save more money and pay the lowest price, you need to set a more extended deadline.
We know how difficult it is to be a student these days. That's why our prices are one of the most affordable on the market, and there are no hidden fees.

Instead, we offer bonuses, discounts, and free services to make your experience outstanding.
How it works
Receive a 100% original paper that will pass Turnitin from a top essay writing service
step 1
Upload your instructions
Fill out the order form and provide paper details. You can even attach screenshots or add additional instructions later. If something is not clear or missing, the writer will contact you for clarification.
Pro service tips
How to get the most out of your experience with My Homework Geeks
One writer throughout the entire course
If you like the writer, you can hire them again. Just copy & paste their ID on the order form ("Preferred Writer's ID" field). This way, your vocabulary will be uniform, and the writer will be aware of your needs.
The same paper from different writers
You can order essay or any other work from two different writers to choose the best one or give another version to a friend. This can be done through the add-on "Same paper from another writer."
Copy of sources used by the writer
Our college essay writers work with ScienceDirect and other databases. They can send you articles or materials used in PDF or through screenshots. Just tick the "Copy of sources" field on the order form.
Testimonials
See why 20k+ students have chosen us as their sole writing assistance provider
Check out the latest reviews and opinions submitted by real customers worldwide and make an informed decision.
11,595
Customer reviews in total
96%
Current satisfaction rate
3 pages
Average paper length
37%
Customers referred by a friend
OUR GIFT TO YOU
15% OFF your first order
Use a coupon FIRST15 and enjoy expert help with any task at the most affordable price.
Claim my 15% OFF Order in Chat

escort

-
eskişehir escort

escort

-
eskişehir escort
Live ChatWhatsApp

escort

-
eskişehir escort