General Medicine Overview
1. Introduction to General Medicine
General Medicine encompasses a wide range of conditions affecting the body, requiring comprehensive diagnostic and therapeutic approaches. Physicians in this field manage acute and chronic illnesses, coordinate patient care, and provide preventive healthcare services.
2. Cardiovascular Diseases
Hypertension
Hypertension, or high blood pressure, is a common cardiovascular condition that significantly increases the risk of heart disease and stroke. Management includes lifestyle modifications and pharmacotherapy.
Antihypertensive Therapy
Antihypertensive medications, such as ACE inhibitors, beta-blockers, and diuretics, are used to control blood pressure and reduce the risk of cardiovascular events.
Clinical Case Example
A 50-year-old patient diagnosed with stage 1 hypertension may be prescribed an ACE inhibitor, with regular follow-up to monitor blood pressure and adjust therapy.
Table: Common Antihypertensive Medications
| Medication Class | Example | Mechanism of Action |
|---|---|---|
| ACE Inhibitors | Lisinopril | Inhibits the conversion of angiotensin I to angiotensin II |
| Beta-blockers | Metoprolol | Reduces heart rate and cardiac output |
3. Respiratory Diseases
Chronic Obstructive Pulmonary Disease (COPD)
COPD is a progressive respiratory condition characterized by airflow limitation. Management focuses on symptom control, improving quality of life, and preventing disease progression.
Bronchodilator Therapy
Bronchodilators, including beta-agonists and anticholinergics, are the mainstay of COPD management, helping to relieve symptoms and improve lung function.
Clinical Case Example
A 65-year-old patient with moderate COPD might be prescribed a combination of a long-acting beta-agonist (LABA) and an inhaled corticosteroid (ICS) to manage symptoms.
Table: Common Bronchodilators in COPD
| Medication Class | Example | Mechanism of Action |
|---|---|---|
| Beta-agonists | Salbutamol | Relaxes bronchial smooth muscle |
| Anticholinergics | Ipratropium | Inhibits acetylcholine-mediated bronchoconstriction |
4. Gastrointestinal Diseases
Peptic Ulcer Disease
Peptic Ulcer Disease (PUD) involves the development of sores in the stomach lining due to excessive gastric acid or H. pylori infection. Treatment includes acid-suppressive therapy and eradication of H. pylori.
Proton Pump Inhibitors
Proton pump inhibitors (PPIs) like omeprazole are commonly prescribed to reduce gastric acid production and promote ulcer healing.
Clinical Case Example
A patient with PUD might be started on a PPI and antibiotics if H. pylori is detected, with follow-up to ensure healing and prevent recurrence.
Table: Common Proton Pump Inhibitors
| Medication | Dosage | Indication |
|---|---|---|
| Omeprazole | 20 mg daily | PUD, GERD |
| Esomeprazole | 40 mg daily | PUD, GERD |
5. Special Considerations in General Medicine
Geriatric Medicine
The management of elderly patients requires special attention to polypharmacy, comorbidities, and physiological changes that affect drug metabolism and sensitivity.
Polypharmacy Management
Regular medication review is essential to minimize drug interactions and adverse effects, particularly in patients with multiple chronic conditions.
Clinical Case Example
An 80-year-old patient on multiple medications may need dose adjustments or discontinuation of non-essential drugs to reduce the risk of adverse effects.
Table: Common Geriatric Syndromes and Their Management
| Syndrome | Management Strategy |
|---|---|
| Falls | Fall prevention strategies, including home safety modifications and strength training exercises |
| Dementia | Cognitive stimulation, medication review, and caregiver support |
