WARNING: Read only if you are super bored otherwise you will be wasting your time. Wikipedia might be helpful in some cases.
Name: Mrs JP
Age: 52 years old
Weight: 75kg
Presenting complaint:
Mrs JP comes into your pharmacy and complaining about heartburn, abdominal pain and bloating, and she wakes up quite frequently at night due to gastric pain. She says she normally manages her pain with antacids and Nurofen (ibuprofen), sometimes eating would also ease her pain. She was not worried about it until she experienced persistent vomiting and occasionally vomitting out some blood for the past one week. She also mentions that her stools appear to be a darker colour than usual. She reported an unexplained weight loss of 12kg over the past 3 weeks.
Past Medical History and Medications:
Diclofenac 50mg bd for arthritic pain
Aspirin 100mg bd
Ramipril 10mg d
Verapamil 80mg d
Glyceryl trinitrate for occasional angina
Simvastatin 40mg d for high cholesterol
Metformin 1000mg d for type 2 diabetes
Fluoxetine 20mg d for depression
Allergic to penicillin
Family and Social History:
Divorced, living with 2 children
Works at a coffee joint where she gets free flow of coffee and tea everyday. She gets her coffee fix of 3-4 cups a day.
Social drinker, enjoys 2-3 glasses of wine after dinner, sometimes inviting some friends over during the weekend for dinner and some wine
Loves Indian food - enjoys it spicy and fried
Dad passed away due to stomach cancer
Mum alive, survived from a heart attack 2 years ago
After visiting the GP, she was found to have low haemoglobin levels, positive urea breath test, positive faecal blood occult test, and tested positive for H. pylori.
*yawn*
Questions.
What are the alarm symptoms of peptic ulcer disease? Outline the alarm symptoms that Mrs JP may be experiencing.
Identify the conditions that predispose patients to peptic ulcer disease when taking an NSAID.
What is the first line treatment for eradication of H. pylori in Mrs JP's case?
What options would be considered if the first line treatment fails?
As a pharmacist, what counselling information would you provide for Mrs JP?
Diclofenac 50mg bd for arthritic pain
Aspirin 100mg bd
Ramipril 10mg d
Verapamil 80mg d
Glyceryl trinitrate for occasional angina
Simvastatin 40mg d for high cholesterol
Metformin 1000mg d for type 2 diabetes
Fluoxetine 20mg d for depression
Allergic to penicillin
Family and Social History:
Divorced, living with 2 children
Works at a coffee joint where she gets free flow of coffee and tea everyday. She gets her coffee fix of 3-4 cups a day.
Social drinker, enjoys 2-3 glasses of wine after dinner, sometimes inviting some friends over during the weekend for dinner and some wine
Loves Indian food - enjoys it spicy and fried
Dad passed away due to stomach cancer
Mum alive, survived from a heart attack 2 years ago
After visiting the GP, she was found to have low haemoglobin levels, positive urea breath test, positive faecal blood occult test, and tested positive for H. pylori.
*yawn*
Questions.
What are the alarm symptoms of peptic ulcer disease? Outline the alarm symptoms that Mrs JP may be experiencing.
Identify the conditions that predispose patients to peptic ulcer disease when taking an NSAID.
What is the first line treatment for eradication of H. pylori in Mrs JP's case?
What options would be considered if the first line treatment fails?
As a pharmacist, what counselling information would you provide for Mrs JP?












