B.F., age 28, presents with diarrhea and abdominal pain. He sayshe feels weak and feverish. His symptoms have persisted for 5 days.He tells you he has 8 to 10 bowel movements each day, although thevolume of stool is only about “half a cupful.” Each stool is wateryand contains bright-red blood. Before this episode, he had noticeda gradual increase in the frequency of his bowel movements, whichhe attributed to a new vitamin regimen. He has not traveledanywhere in the past 4 months and has taken no antibioticsrecently. His medical history is significant for UC; his mostrecent exacerbation was 2 years ago. He is taking no medicationsexcept vitamins.

Examination findings include a tender, slightly distendedabdomen. His BP is 122/84 sitting, 110/78 standing; HR 96 bpm; andtemperature of 100°F. Otherwise, physical findings areunremarkable. Laboratory study results reveal hemoglobin 12 g/dL;hematocrit 38%; white blood cell count 12,000/mm³;platelet count 242k; sodium 132; potassium 3.6. All other studyresults are within normal limits. The most recent colonoscopyfindings (4 years ago) revealed granular, edematous, friable mucosawith continuous ulcerations extending throughout the descendingcolon.

1. List the specific goals for treatment for B.F.
2. What drug therapy would you prescribe? Why?
3. What are the parameters for monitoring the success of thetherapy?
4. Discuss specific patient education based on the prescribedtherapy.
5. List one or two adverse reactions for the selected agent thatwould cause you to change therapy.
6. What would be the choice for second-line therapy?
7. What over-the-counter and/or alternative therapies might beappropriate for B.F.?
8. What lifestyle changes would you recommend for B.F.?
9. Describe one or two drug-drug or drug-food interactions for theselected agent

Write your prescription for this patient.