Gastroesophageal Reflux Disease Case – Gastrointestinal System Example

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"Gastroesophageal Reflux Disease Case" is a decent example of a paper on the gastrointestinal system. Critical evaluation of Toby’ s symptoms points out that he is suffering from Gastroesophageal reflux disease (Chandrasoma & DeMeester, 2006). Question 1 The classes of medication chosen to aid Toby include Histamine (H2) blocking agent and proton pump inhibitors. They include ranitidine and omeprazole respectively. I chose these medications over the alternatives because they aid in diminishing the acidity of the gastric reflux, increases the lower esophageal sphincter pressure, prevent esophageal mucosal damage, and improves gastric emptying. The pharmacodynamics action of the chosen medication includes the following: ranitidine diminishes the production of stomach acid, making the stomach juices less acidic.

This makes the stomach juice entering the esophagus less irritating relieving the drastic symptoms and allowing the esophagus to heal. The pharmacodynamics action of Ranitidine involves the reduction of the amount of stomach acid. This aids in healing and preventing ulcers; thus improving the symptoms of heartburn and stomach pain (Wang et al. , 2009). Question 2 Points in educating the patient include tips on how to deal with the condition as mentioned below: Lifestyle modifications i. e.

avoiding foods known to worsen the condition, decrease of fat intake, sleeping with an elevated head so as to reduce nighttime reflux. Always take medications as failure to so will make the symptoms come back. The drug ought to be taken in the same period daily, and the dose must not be increased, nor should it be used more often than prescribed If the medication given does not work, the best option is consulting a doctor so that a different medicine can be prescribed. Question 3 Potential side effects for ranitidine include constipation, diarrhea, dizziness, headache, hives, nausea, and issues with urination.

As a medical practitioner, I would advise the patient that all drugs have side effects but they are minor, besides the side effects go away after medication is taken for sometimes. In case the side effects increase, the patient ought to consult a doctor. As a doctor, I would lower the dose and or change the medication. Worst-case scenarios include trouble breathing and swelling of the face, lips, throat, and tongue. If these happen, the patient should seek emergency services immediately and terminate the medication plan.

Potential side effects of omeprazole include headache, abdominal pain, fast/ slow heartbeat, seizures, persistent muscle spasms, and diarrhea. As a medical practitioner, I would advise the patient that these side effects are common by the time they will wear off. Worst-case scenarios include allergic reactions i. e. rash, swelling, severe dizziness, and trouble breathing. If the mentioned drastic symptoms develop, the patient is advised to seek medical help immediately. Question 4 Potential drug interactions for omeprazole include the increase of blood concentrations after taking valium, Coumadin, and Dilantin; this happens by diminishing the elimination of these drugs by the liver.

Potential drug interactions of ranitidine can occur if the medication is mixed with some products like procainamide or propantheline; causing serious side effects (Stargrove et al. , 2008). Question 5 I prescribed a generic name. Yes, there is a brand name version of these drugs. The brand name of ranitidine is Zantac; while the brand name of omeprazole is Prilosec. My rationale for prescribing a generic preparation is dependent on the cost and availability. Generic drugs are cheaper as compared to brand names, and they are readily available. Question 6 The cost of Prilosec is $0.63 / 20 mg caplet, while omeprazole is a $0.40 / 20 mg caplet.

This medication is on the $4 lists available at area stores. The cost of 60 tablets of ranitidine 150mg is $4, while Zantac 150mg Tablets 60 is $10.99. Generic ranitidine is on the $4 list available at area stores. Question 7 I will measure the efficiency of this medication after 8-12 weeks. Knowing if the medication has worked will depend on the responses given by the patient.

Moreover, tests have to be done. They include ambulatory acid (pH) probe tests, an x-ray of the upper digestive system, endoscopy, and manometry. I would know if the medication is efficacious if the symptoms have reduced i. e. the amount of acid produced in the stomach. Question 8 Should this option fail, an alternative treatment plan that is more invasive includes surgery i. e. Nissen fundoplication. This option has proven to be the best in eradicating GERD symptoms completely. Other alternative treatment plans include Magnet therapy and acupuncture (Plevris & Howden, 2011). Question 9 Omeprazole falls under pregnancy category C.

This medication should only be administered when the benefit outweighs risks. Ranitidine falls under pregnancy category B. This drug must only be used in pregnancy only when the benefit outweighs risks (Briggs et al. , 2011).

References

Briggs, G. G., Freeman, R. K., & Yaffe, S. J. (2011). Drugs in pregnancy and lactation: A reference guide to fetal and neonatal risk. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins

Chandrasoma, P., & DeMeester, T. R. (2006). GERD: Reflux to esophageal adenocarcinoma. Amsterdam: Elsevier / AP.

Plevris, J., & Howden, C. W. (2012). A problem-based approach to gastroenterology and hepatology. Chichester, West Sussex, UK: Wiley-Blackwell.

Stargrove, M. B., Treasure, J., & McKee, D. L. (2008). Herb, nutrient, and drug interactions: Clinical implications and therapeutic strategies. St. Louis, Mo: Mosby/Elsevier.

Wang Y, Pan T, Wang Q, Guo Z. Additional bedtime H2-receptor antagonist for the control of nocturnal gastric acid breakthrough. Cochrane Database of Systematic Reviews 2009, Issue 4. Art. No.: CD004275. DOI: 10.1002/14651858.CD004275.pub3.

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