Author Question: A patient who has GERD with erosive esophagitis has been taking a PPI for 4 weeks and reports a ... (Read 48 times)

mpobi80 · **on:** Jul 24, 2018

A patient who has GERD with erosive esophagitis has been taking a PPI for 4 weeks and reports a decrease in symptoms. The patient asks the primary care NP if the medication may be discontinued. The NP should tell the patient that:

a. the dose may be decreased for long-term therapy.
b. antireflux surgery must be done before the PPI can be discontinued.
c. the condition may eventually be cured, but therapy must continue for years.
d. once the symptoms have cleared completely, the medication may be discontinued.

Question 2

A patient who has erectile dysfunction wants a medication to use as needed. The primary care NP should recommend:

a. tadalafil (Cialis).
b. sildenafil (Viagra).
c. avanafil (Stendra).
d. vardenafil (Levitra).

cdmart10 · **Reply #1 on:** Jul 24, 2018

Answer to Question 1

A
Once PPIs have proven clinically effective for treatment of patients with esophagitis, therapy should be continued long-term and titrated down to the lowest effective dose based on symptom control. PPI therapy is considered safer than surgery and should be tried first before surgery is performed. GERD is a lifelong syndrome and is not curable.

Answer to Question 2

C
Avanafil is the newest drug on the market and can be used on an as-needed basis because it has a shorter half-life and shorter onset of action. It may be taken 30 minutes before sexual activity. The other agents have an onset of action of several hours.