Lansoprazole

At the Emergency Department, the attending physician, Dr. Vasiliou, obtains Mr. Mason's medication history. Dr. Vasiliou mentions to Mr. Mason that one of the medications he is taking, lansoprazole, could have contributed to his fracture risk. Mr. Mason asks why this has happened to him. Dr. Vasiliou explains that it is hard to tell but the extend of fractures with this drug seems to be associated with age. She also recommends that this is further investigated for osteoporosis since increased risk of fractures is normally associated with chronic use of PPIs. 

FURTHER DEVELOPMENTS 

Mr. Mason's abdominal pain has now fully resolved following his treatment with lansoprazole. 

However, over the next few weeks, Mr. Mason remains in a lot of pain due to his fracture. He manages to deal with the pain by taking high doses of ibuprofen three times a day.  

Emergency Department: Hemoptysis 

Later that night, Mr. Mason starts to feel nauseated and vomits. His vomit has a dark brown color. Mr. Mason is admitted to hospital and he is stabilized. Dr. Vasiliou informs Mr. Mason that his ibuprofen intake seems excessive and he probably could have prevented this unfortunate incident if he was taking a prostaglandin analogue together with ibuprofen. He also mentions that for patients with stomach problems, other analgesics may offer an advantage over ibuprofen. He advises Mr. Mason to discuss drug use with his physicians before taking any new drugs. 

Which gastroprotective drug is Dr. Vasiliou referring to? 


Aluminum hydroxide and Magnesium carbonate
Cimetidine
Celecoxib
Pantoprazole
Misoprostol

Map: Connor Mason_UNIC (1100)
Node: 20912
Score:

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OpenLabyrinth
OpenLabyrinth is an open source educational pathway system

Review your pathway

  • B
  • PPIs are weak bases that become activated by colonic bacteria
  • D
  • C
  • Ignore the emotional expression.
  • E
  • A
  • Respond bluntly: “That is common in diabetes.”
  • PPIs are weak acids activated by protonation in parietal cells
  • Blame the patient for non-adherence
  • PPIs are weak bases converted by CYP450 enzymes to the active form in parietal cells
  • Validate the emotion
  • Sequesters bile acids
  • PPIs are weak acids converted by CYP450 enzymes to the active form in parietal cells
  • Reschedule without offering alternative solutions
  • Antagonizes beta receptors
  • Tell the patient to change devices without giving proper guidance.
  • Reschedule with alternative (e.g., WhatsApp call) if needed
  • Insist on continuing with poor video quality
  • Reschedule without offering alternative solutions
  • Switch to audio + chat mode and promise a PDF summary afterward
  • PPIs are weak bases activated by protonation in parietal cells
  • Activates vasopressin receptors
  • Activates somatostatin receptors
  • Reschedule with alternative (e.g., WhatsApp call) if needed
  • Insist on continuing with poor video quality
  • Tell the patient to change devices without giving proper guidance.
  • Ramipril
  • Alters ammonia metabolism by colonic bacteria
  • Metolazone
  • The patient presentation is not due to paracetamol overdose
  • Bisoprolol
  • Cholestasis is the most likely diagnosis
  • There is a risk for a thromboembolic event
  • Amoxicillin
  • Ignore the emotional expression.
  • Validate the emotion
  • Paracetamol has been metabolized
  • Blame the patient for non-adherence
  • START
  • Respond bluntly: “That is common in diabetes.”
  • tactics
  • Lansoprazole

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