Question

Ms. Mckelvey has been taking over-the-counter (OTC) famotidine for her indigestion for 2 weeks without significant relief. She decided to contact her healthcare provider because the symptoms continued to occur, particularly her heartburn symptoms. Now, however, the healthcare provider has added the room, Ms. McKelvey tells the nurse she is unhappy about a proton pump inhibitor. When the healthcare provider leaves this, because she has prided herself on keeping her "medical costs" down by using only home remedies and OTC drugs. "If they're both for ulcers," she says, "then what's the dif- Case Study ference? Why can't I just double my dose of the antacid? 1. What are the major differences between proton pump inhibitors and H2 receptor antagonists? 2. What should the nurse teach Ms. McKelvey regarding the use of home remedies and OTC drugs? 3. What strategies will you use to ensure that Ms. McKelvey adheres to her new prescription?

Answer 1

1. H2 receptor antagonist reduce the effects of acid in your stomach. ... Proton pump inhibitors (PPIs) reduce your body's production of acid. They work well for heartburn that isn't resolved byantacids or H2 blockers. It may take a little longer for a PPI to help your symptoms, but relief will last longer.

Both medications work by blocking and decreasing the production ofstomach acid, but PPIs are considered stronger and faster in reducing stomach acids. However, H2 receptor blockers specifically decrease the acid released in the evening, which is a common contributor to peptic ulcers

PPI are used for ulcers and GERD but H2 receptor antagonist are used for Mild heartburn

PPI retention time is 3 days while H2 receptor antagonist is 12 hrs

PPI inhibits the pump H2 receptor antagonist blocks H2 receptor

2. Nurse will teach that home remedies are effective only upto a certain time.But if symptoms are increasing and getting no relief from home remedies you should consult a physician because their can be any problem which cannot be treated by own. Certain medical interventions are required for treatment. She will also advice taking OTC medications without physician advise can leads to serious problems In future because of side effects.So always take medications by physician advise not by own will.And use those home remedies which are advised by the certified doctor in the past not to follow remedies by own.Nurse will also tell her that some ppi coming now a days are cost effective.

3. I will try to understand Mrs by my full efforts. I will say her I think their may be a problem of gastritis or GERD or may a initial stage ofpeptic ulcer disease that's why she is not getting relief from heartburn and indigestion. If H pylori gastritis is their she must need some antibiotics.

I tell her that PPi has longer duration of action, more complete inhibition of acid Secreation that maintains gastric PH above 4. I will tell her so many pros of ppi over H2 receptor antagonist.