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Questions 2-6

PN 105 Fundamentals of Nursing I Aspirin - Peptic Ulcer PO, a 72-year-old woman, has taken 650 mg of aspirin four times a day for 8 months to alleviate her symptoms of pain and inflammation associated with arthritis. Four weeks ago a peptic ulcer developed 1. Explain the process in which PQ could have a peptic ulcer. How could this have been prevented? 2. Compare the similarities and differences in the side effects of salicylates with those of acetic acid agents, propionic acid agents, COX-2 inhibitors, and phenylatic acid. 3. What patient teaching points should PQ receive before and during the time she takes the aspirin? 4. How would COX-2 prevent the development of a peptic ulcer? 5. Would DMARD's be more helpful in alleviating PQ's symptoms? Explain your answer. 6. Compare the differences in the various types of DMARD's Reviewed 9/10

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Answer 1

1. Aspirin belongs to class of NSAID's and anti platelets .
2. In this case PQ ,72 years old woman has been taking Aspirin intermediate dose of 650 mg four times a day for a long period of 8 months without any ppi/antacids/h2 blockers has led to peptic ulcer disease.
3. Aspirin inhibits enzymes (cox-1 and cox-2) that are responsible of producing protective mucosal layer in the gastrointestinal tract .so, blocking these enzymes leads to rupture of the protective mucosal layer leading to formations of ulcers(peptic ulcers and duodenal ulcers).
4. This could be prevented by taking a proton pump inhibitor(examples pantoprazole,esmoprazole,lansoprazole etc or selective H2 inhibitors( examples -ranitidine, famotidine ,cimetidine) which decrease the acid produced in the stomach.
5. she could have been warned about the side effects caused by aspirin at the time of prescribing it to her that might make her more aware and would have avoided spicy foods.