Ms. W. is a 55-year-old patient who consulted her physician because of recurrent epigastric pain and nausea and two recent episodes of vomiting, in which the emesis was dark-colored and granular in appearance. Her history includes heavy alcohol use, cigarette smoking, and persistent headaches. She has not followed all her physician's previous recommendations but has been controlling her headaches by taking two aspirins every few hours. Following tests, a bleeding gastric ulcer was diagnosed. Discuss the factors contributing to Ms. W.'s condition. Discuss synergism, antagonism, and potentiation as they apply to this case. Discuss the potential effects of increased bleeding from the ulcer. Discuss issues related to patient compliance.