A 47-year old, Ms. Leah Thompson, suffers from Gastroesophageal Influx Disease (GERD). She comes to the hospital complaining of heartburn. However, she mentions that the heartburn condition is no longer responding to TUMs and Mylanta which are common medication for suppressing the symptoms, relieve the heartburn and pain, allow the esophagus to heal, and prevent further complications. Ms Thompson is a single mother who working extra hard to take care of her bright children. Consequently, she has no time to do some exercise. Ms Thompson has no history of heart disease, diabetes or ulcerative colitis or Crohn’s disease. Based on the mentioned conditions, the appropriate medication prescription for Ms Thompson would be antacids:
Some of the antacids that could be appropriate for the case of Ms Thompson are the H2 blockers (HR2As); for instance cimetidine and famotidine. This would be able to reduce the amount of acid in her stomach. However, in case the H2RAs are not able to solve the issue – commonly happens – then should use the Proton pump inhibitors (PPIs). Some of the PPIs that could be prescribed include lansoprzole and omeprazole ( Friedlander, Pallentino, Miller, & VanBeuge, 2010) .
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It is important that Ms. Thompson is educated regarding the prescriptions. Firstly Ms. Thompson needs to understand that sometimes the prescription might not be th solution. According to Chiba et al. (1997) – cited by Friedlander et al. (2007) – PPIs have about 84% chance of being effective while the H2RAs 52%. To mean that PPIs induced healing rate of EE is twice that of H2RAs. She must also understand that PPIs are mostly delayed-release formulations and therefore appropriate for healing and maintenance. PPI therapy can only be done once a day, however for those resistant to the treatment should seek help from a gastroenterologist ( Dossett, Mu, Davis, Bell, Lembo, Kaptchuk, & Yeh, 2015). If they are non-described; however, their use should not exceed 2 weeks because it could lead to gastrointestinal pathologies. DeVault and Castell (2005) explain that normally when prescribed PPIs can heal about 80% of patients within a period of 4 to 8 weeks. Ms. Thompson must also understand that in case both the H2RAs and the PPIs do not work, there is the possibility of the gastroenterologist recommending fundoplication surgery.
References
DeVault, K. R., & Castell, D. O. (2005). Updated guidelines for the diagnosis and treatment of gastroesophageal reflux disease. The American journal of Gastroenterology , 100 (1), 190.
Dossett, M. L., Mu, L., Davis, R. B., Bell, I. R., Lembo, A. J., Kaptchuk, T. J., & Yeh, G. Y. (2015). Patient-provider interactions affect symptoms in gastroesophageal reflux disease: a pilot randomized, double-blind, placebo-controlled trial. PloS one , 10 (9), e0136855.
Friedlander, E. A., Pallentino, J., Miller, S. K., & VanBeuge, S. S. (2010). The evolution of proton pump inhibitors for the treatment of gastroesophageal reflux disease. Journal of the American Association of Nurse Practitioners , 22 (12), 674-683.
