A patient is taking a low-dose PPI for long-term management of ...

[ts19998]

A patient is taking a low-dose PPI for long-term management of GERD and reports taking sodium bicarbonate (Alka-Seltzer) to help with occasional heartburn. The primary care NP should tell the patient to:
 
  a. change to aluminum hydroxide (Amphojel).
  b. use magnesium hydroxide (Milk of Magnesia) instead.
  c. continue using sodium bicarbonate (Alka-Seltzer) as needed.
  d. take calcium carbonate (Tums) instead of sodium bicarbonate (Alka-Seltzer).

Question 2

A patient who is newly diagnosed with schizophrenia is overweight and has a positive family history for type 2 diabetes mellitus. The primary care NP should consider initiating antipsychotic therapy with:
 
  a. ziprasidone (Geodon).
  b. olanzapine (Zyprexa).
  c. risperidone (Risperdal).
  d. chlorpromazine (Thorazine).

[whitcassie]

Answer to Question 1

D
Sodium bicarbonate is not suitable for long-term use because of side effects. Calcium carbonate requires monitoring when used long-term but has the highest acid-neutralizing capacity. Antacids containing aluminum and magnesium can cause electrolyte imbalances.

Answer to Question 2

A
Many antipsychotics increase the risk of metabolic syndrome in patients. Ziprasidone does not have effects on weight. The other agents all increase the risk of weight gain and metabolic syndrome.

[ts19998]

Thanks for the timely response, appreciate it

[marict]

Excellent