Question 1

Jim presents with complaints of “heartburn” that is minimally relieved with Tums (calcium carbonate) and is diagnosed with gastroesophageal reflux disease (GERD). An appropriate first-step therapy would be:

Omeprazole (Prilosec) twice a day
Ranitidine (Zantac) twice a day
Famotidine (Pepcid) once a day
Metoclopramide (Reglan) four times a day

Question 2

An elderly person has been prescribed lactulose for the treatment of chronic constipation. Monitoring with long-term treatment would include:

Electrolytes, including potassium and chloride
Bone mineral density for osteoporosis
Magnesium level
Liver function

Question 3

The next step in treatment when a patient has been on proton pump inhibitors twice daily for 12 weeks and not improving is:

Add a prokinetic (metoclopramide)