What is the most appropriate treatment choice for managing pain in a 76-year-old woman with osteoarthritis and a history of duodenal ulcer?

The most appropriate treatment choice for managing pain in a 76-year-old woman with osteoarthritis and a history of duodenal ulcer is oral acetaminophen. Acetaminophen is generally considered a first-line treatment for mild to moderate osteoarthritis pain. It is well-tolerated and poses a lower risk of gastrointestinal irritation compared to nonsteroidal anti-inflammatory drugs (NSAIDs) like naproxen, which can exacerbate or even lead to bleeding and ulcer complications in patients with a history of ulcers.

In this scenario, the emphasis is on managing the pain effectively while minimizing potential risks associated with other pain management strategies. Acetaminophen does not affect platelet function or cause gastrointestinal distress, making it a safer option, especially for older adults and those with prior gastrointestinal issues.

While hydrocodone and transdermal opioid patches can provide effective analgesia, they are typically reserved for more severe pain due to their potential for addiction and side effects, particularly in an older adult population. In summary, oral acetaminophen not only addresses the patient's pain control needs but also aligns with safety considerations, particularly in light of her duodenal ulcer history.