NU702 <\/p>\n
Advanced
Pharmacotherapeutics <\/p>\n
Week #10
Case Study: GI system <\/p>\n
\u00a0 <\/p>\n
Complaint: \u201cMy heartburn has been
waking me up at night.\u201d <\/p>\n
\u00a0 <\/p>\n
History: Greg is a 47-year-old man
who presents at clinic with complaints of intermittent nocturnal
gastroesophageal reflux. History reveals that he awakens experiencing burning
pain substernally and in the back of his throat. This results in \u201cmy larynx
closing down\u201d and his being \u201calmost unable to breathe.\u201d As soon as he can
breathe effectively, he swallows \u201ca lot\u201d of antacid and flushes it down with
water. The entire episode is very frightening, and he is often afraid to go
back to sleep. Because he already has a problem with mild sleep apnea, he is
becoming increasingly tired and unable to function at work due to lack of
sleep. He now sleeps only in his recliner. He is also concerned about the
substernal pain because his father had a myocardial infarction at age 49 and
required coronary artery bypass surgery. He is 5 feet 9 inches tall and weighs
188 pounds (body mass index [BMI] is 27.8), with much of his excess weight
carried in his abdomen. He is not a smoker, \u201coccasionally\u201d has three or four
beers with friends, and \u201coften\u201d has pizza or submarine sandwiches for lunch
with a \u201cdiet cola.\u201d He takes no drugs other than the antacid after a reflux
episode. <\/p>\n
\u00a0 <\/p>\n
Assessment: A chest
x-ray and electrocardiogram are negative for cardiopulmonary disease, and Greg
is diagnosed by history with gastroesophageal reflux disease (GERD). <\/p>\n
\u00a0 <\/p>\n
What is
your diagnosis and initial management plan? Please include prescription as you
would write it in practice. <\/p>\n
\u00a0 <\/p>\n
Follow-Up Visit: At his
follow-up visit, Greg states that the number of episodes is much lower and they
are less severe, but he still has had two episodes. Careful history taking
reveals that both of these episodes were related to \u201clapses\u201d in following the
lifestyle modification. In both cases, he had friends visit, and they had consumed
\u201cthree or four\u201d beers each about 1 hour before he went to bed. He still sleeps
in his recliner because \u201cI do not want to have that feeling of not being able
to breathe again.\u201d He continues to report that he does not feel rested upon
awakening in the morning. He has lost 4 pounds. <\/p>\n
\u00a0 <\/p>\n
What
modifications would you make to Greg\u2019s treatment plan? <\/p>\n
\u00a0 <\/p>\n
Continuing Care: Four
weeks later, Greg is symptom-free. He is sleeping in his bed and feeling more
rested. <\/p>\n
\u00a0 <\/p>\n
His
treatment plan at this time is as follows\u2026? <\/p>\n
\u00a0 <\/p>\n","protected":false},"excerpt":{"rendered":"
NU702 Advanced Pharmacotherapeutics Week #10 Case Study: GI system \u00a0 Complaint: \u201cMy heartburn has been waking me up at night.\u201d \u00a0 History: Greg is a 47-year-old man who presents at clinic with complaints of intermittent nocturnal gastroesophageal reflux. History reveals that he awakens experiencing burning pain substernally and in the back of his throat. This […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[18],"class_list":["post-12045","post","type-post","status-publish","format-standard","hentry","category-research-paper-writing","tag-nursing"],"_links":{"self":[{"href":"https:\/\/papersspot.com\/blog\/wp-json\/wp\/v2\/posts\/12045","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/papersspot.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/papersspot.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/papersspot.com\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/papersspot.com\/blog\/wp-json\/wp\/v2\/comments?post=12045"}],"version-history":[{"count":0,"href":"https:\/\/papersspot.com\/blog\/wp-json\/wp\/v2\/posts\/12045\/revisions"}],"wp:attachment":[{"href":"https:\/\/papersspot.com\/blog\/wp-json\/wp\/v2\/media?parent=12045"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/papersspot.com\/blog\/wp-json\/wp\/v2\/categories?post=12045"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/papersspot.com\/blog\/wp-json\/wp\/v2\/tags?post=12045"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}