Question

A 20-year-old female college student presents due to a 7-day history of daily heartburn. She has never had this as bad as she does currently. The patient denies any other significant past medical history and is currently taking only a multivitamin daily. She recently admits to having increased episodes of headaches that she believes are due to stress. For this reason, she has been taking ibuprofen 600 mg every 8 hours. She states that she has been taking this consistently every 8 hours for the last 10 days; she hopes that after finals are over her headaches will subside. She also states she was given a 10 day course of amoxicillin 2 weeks ago for a middle ear infection, which resolved without any further intervention. She denies any difficulty swallowing, weight loss, night sweats, chest pain, black tarry stools, use of tobacco/alcohol, or coughing up blood. Physical examination is unremarkable for any abnormalities.

Which of the following medications would you suggest for the patient to begin for her headaches at this time?

1. Antibiotic
2. Anticholinergic
3. Proton pump inhibitor
4. H1-receptor antagonist
5. Acetaminophen

Answer 1

The suggested medication for the patient to begin for her headaches is acetaminophen, as ibuprofen can cause medication-overuse headache.

Step-by-step explanation:

Given the patient's history of daily heartburn and use of ibuprofen, it is likely that her headaches are caused by the frequent and prolonged use of ibuprofen. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that can cause a condition called medication-overuse headache (MOH) when used frequently and for a long duration. The recommended medication for the patient to begin for her headaches at this time would be acetaminophen, also known as paracetamol. Acetaminophen is a mild pain reliever that can help alleviate headache symptoms without the risk of medication-overuse headaches.