Lisandra Ponce de Leon
List specific goals for treatment for J.G. What drug therapy would you prescribe for J.G.? Why?
After a meal, the patient receives relief from the pain through gastritis since gastritis occurs on an empty stomach. Treatment for gastritis relies upon the specific reason. Intense gastritis brought about by nonsteroidal mitigating medications or liquor can be eased by keeping away from these substances. However, H. pylori disease or inflammation requires different treatment.
Medication to treat H. pylori in your digestive tract is a combination of antibiotics, such as clarithromycin and amoxicillin or metronidazole, to kill the bacterium.
Medication used to treat gastritis is antacids. The reason behind this is that these antacids will help in the reduction of acid reflux. Take an antacid 1 hour after a meal or when you have heartburn. If you take them at night for symptoms, don’t take them with food.
Antacids Other medicines you are taking can change the way your body absorbs them. Any other medication can be taken1 one hour before or 4 hours after taking antacids (Knott; 2020).
Discuss specific patient education based on the prescribed therapy.
Proton Pump Inhibitor or PPIs are generally protected and very much endured; however, uncommon aftereffects incorporate headaches, loose bowels, and nausea. PPI treatment is related to an increased risk of osteoporotic fractures.
List one or two adverse reactions for the selected agent that would cause you to change therapy.
The two adverse effects are:
What would be the choice for second-line therapy?
The second line treatment would be Pepto-Bismol. Bismuth subsalicylate is the fundamental part of Pepto-Bismol. This medication is utilized for indigestion and heartburn, acid reflux, looseness of the bowels, and nausea (feeling like heaving).
It works by ensuring your stomach and the lower part of your throat from stomach corrosive. It’s likewise a gentle acid neutralizer that lessens overabundance stomach corrosive and soothes uneasiness (Johnson; 2019).
What lifestyle changes would you recommend to J.G.?
The recommended lifestyle change would be:
Smoking makes the discomfort worse; thus, smoking cessation is recommended.
Drinking coffee can increase stomach acid production; thus, minimizing/stopping coffee consumption is recommended.
The patient should prevent eating late at night, and it is recommended to wait at least 3 hours after eating before sleeping.
Avoid foods that can trigger acid reflux: regular exercise and a healthy diet.
Knott L. (2020). Antacids. Available at: https://patient.info/digestive-health/indigestion-medication/antacids
Johnson, J. (2019). What to know about Pepto Bismol? Medical News Today. https://www.medicalnewstoday.com/articles/326605
Epigastric Pain Treatment
1. List specific goals for treatment for J.G.
Some of the specific goals for treating J.G are providing relief to the illness’s symptoms like dyspepsia, promoting faster healing of the ulcers, and preventing the reoccurrence of ulcers and other complications.
1. What drug therapy would you prescribe for J.G.? Why?
Considering the patient is allergic to penicillin, the most recommended treatment will be clarithromycin triple therapy. The therapy will be administered for 14 days. The patient will be given omeprazole 20mg BID, clarithromycin 500mg BID, and amoxicillin 1g BID for the triple therapy. I suggest this treatment therapy because a combination of two antibiotics with an H2 blocker or a compound with bismuth has proven to be successful in treating mid-epigastric pain. Also, an acid suppressor is needed to help provide symptoms relief and promote the eradication of a bacterial infection or growth.
1. Discuss specific patient education based on the prescribed therapy.
Generally, PPIs are considered safe and more tolerable to patients under the medication. Although it is modest, there are side effects to it, though uncommon. Headaches, diarrhea, and nausea are the most reported side effects. The patient will have to be educated on the increased risk of osteoporotic fractures following the use of the medication. It has also been reported that PPI increases the risk of both community-acquired and hospital-acquired pneumonia upon continuous exposure to therapy.
1. List one or two adverse reactions for the selected agent that would cause you to change therapy.
It is very common that the use of amoxicillin in therapy increases the occurrence of pseudomembranous colitis, although all antibiotics have a characteristic of causing pseudomembranous colitis (Mayo clinic, 2020, Para. 6). Additionally, Amoxil causes antibiotics-associated diarrhea, nausea, and vomiting.\
1. What would be the choice for second-line therapy?
For the second therapy, I would recommend quadruple bismuth therapy that will last for 14 days. The following drugs will be taken during this period, Omeprazole 20mg BID, Bismuth subsalicylate 300 mg QID, Tetracycline 500mg QID, and Metronidazole 500mg QID.
1. What lifestyle changes would you recommend to J.G.?
According to Hopkins (2021, para. 2-3), smoking affects the digestive system in several ways, causing peptic ulcers and heartburn. J.G will have to reduce his smoking habits to manage the pain. Stomach ulcers are also contributed by coffee, and therefore the patient will have to stop taking coffee or reduce the amount consumed. Regular workouts will be helpful, and finally, the patient should consider eating at least three hours before bedtime.
ReHopkins (2021). Smoking and the Digestive System. Johns Hopkins Medicine. Retrieved from: https://www.hopkinsmedicine.org/health/conditions-and-diseases/smoking-and-the-digestive-system
MayoClinic (2020). Pseudomembranous colitis . Retrieved from: https://www.mayoclinic.org/diseases-conditions/pseudomembranous-colitis/symptoms-causes/syc-20351434