Dyspepsia and Peptic ulcer Chanon Suebsan 58 010720011 Pharmacist : Good morning. I'm pharmacist on duty. How can I help you? Patient : Good morning. Today I want to buy some medicine for relieving stomachache. Pharmacist: For yourself? Patient : Yes. Pharmacist: Can you tell me about your symptoms? Patient : I had a stomachache and when I ate something. Pharmacist : Do you have other symptoms along with your stomachache? Patient : Yes, I have. I always felt nausea and vomiting. Pharmacist : Do you vomit blood? Patient : Yes, it occurred 2 days ago. Pharmacist : Have your stool had a darker color? Patient : No, it hasn’t. It looks the same as normal Pharmacist : Have you ever had this symptom before? Patient : No. I don’t have symptom before. Pharmacist : How strong is the pain? Let's say in a 1 to 10 scale, how would you describe the intensity of the pain? Patient : Between 4-5 Pharmacist : Is the pain continuous or does it come and go? Patient : It comes and goes. Pharmacist : Do you usually have your meal on time? Patient : I rarely had breakfast because I was too hurried to go to work. Pharmacist : Oh! really it is not good. When you eat something, your symptoms will get better? Patient : No, on the other hand, I feel worsened. Pharmacist : How long have you had this symptom? Patient : Oh! last week. Pharmacist : Have you drunk alcohol coffee or soft drink and smoke in regularly? Patient : I have just drink coffee every day. Pharmacist : Are you allergic to any medicine? Patient : Nothing that I know. Pharmacist: Do you have any other health problems? Patient : Yes, I had osteoarthritis for a long time. Pharmacist: What kind of medication are you currently taking? Patient : I always take Indomethacin for it. Pharmacist: Could you tell me how to take this medication (indomethacin)? Patient : I take this two tabs per day Pharmacist: From your information that you told me, I think you have dyspepsia because you use indomethacin for a long time, so this drug can lead to bleeding in stomach. You always miss meal, so this make your symptoms worse. Today I will dispense an antacid and omeprazole for relieving symptom. They will make you feel better. Take antacid 2 teaspoons between meals and before bedtime, Take omeprazole 2 capsules 30 minutes before meal two times a day in the morning and evening for 8 weeks. If your symptoms were not relieved, I recommend you see the doctor as soon as possible. Patient : How about the side effect? Pharmacist : These two medications have the same side effect but it’s not quite known widely but it will make you are headache or stomach upset a little bit but don’t worry Pharmacist : Do you have any question? Patient : No. Pharmacist : Can you recall how to take the medicine? Patient : Yes. Take antacid 2 teaspoons between meals and before bedtime, Take omeprazole 2 capsules 30 minutes before meal two times a day in the morning and evening for 8 weeks. Pharmacist : Finally, do not forget to take this medication because it is very important. And you should drink a lot of water after take indomethacin. You should have your meal in the right time. And avoid drinking coffee because it can make your symptom worse. I hope you will get better soon. Patient : Thank you very much for your help. Pharmacist : It’s my pleasure.