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Questions

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A 65-yeаr оld mаn repоrts а 1 mоnth history of daily headaches which are constant and bilateral. They produce symptoms in both the temporal and frontal regions and are not affected by position. He does not report diplopia, visual disturbance, photophobia, dysarthria, dysphagia, seizures, ataxia, weakness or numbness. He says that he has been getting fatigued more easily and believes he has lost some weight during the past 5 months.  The patient has been taking ibuprofen, which will momentarily relieve his headache pain. He takes atenolol and hydrochlorothiazide for hypertension and lovastatin for hyperlipidemia. His physical examination is normal. Laboratory results include a mild normocytic anemia and an erythrocyte sedimentation rate (ESR) of > 100 mm/hr. Which of the following medications is more appropriate for this patient?