Naproxen 500 mg twice daily has been prescribed for TW. If TW were to experience dyspepsia during therapy, should she be given an antiulcer medication for prophylaxis against GI complications of NSAID...

Extracted text: Naproxen 500 mg twice daily has been prescribed for TW. If TW were to experience dyspepsia during therapy, should she be given an antiulcer medication for prophylaxis against GI complications of NSAID therapy or would a COX-2 selective NSAID be preferable?


Extracted text: that persists for several hours, fatigue, and generalized muscle and joint pain for the past 4 T.W, a previously health 42 year old, 60 kg woman, has been suffering from morning stiffness 37 CASE 1: months. In addition, she reports that her eves seem red most of the time and are unusualny dry. Her symptoms have been much more worse during the past month and a half, causing her to mit her physical activities somewhat. She also can no longer wear her wedding ring because of swelling of her hand. Physical examination reveals bilaterally symmetrical swelling, tenderness, and warmth of metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints of the hands. Relevant laboratory findings include the following: ESR: 52 mm/hour Hb: 10.6 g/dL RF- Positive Tests for antinuclear antibodies (ANA) and tuberculin sensitivity are negative. Her uric acid level is normal. X-ray findings show soft tissue swelling, narrowing of joint spaces, and marginal erosions in second and third MCP and PIP joints bilaterally with no evidence of calcification. Other routine laboratory data and physical findings are normal.