Omeprazol 20mg/capsule, 2x a day P.O.

DRUG NAME

Generic Name: omeprazole Brand names: Prilosec, Prilosec OTC, Zegerid

MECHANISM OF ACTION Classifications:gastrointest inal agent; proton pump inhibitor; Antacids, Antireflux Agents & Antiulcerants

INDICATION

DRUG INTERACTIONS

Omeprazole suppresses gastric acid secretion by specific inhibition of the enzyme system hydrogen/potassium adenosine triphosphatase (H+/K+ ATPase) present on the secretory surface of the gastric parietal cell. Onset: Antisecretory: approx 1 hr; peak effect:0.5-3.5 hr. Duration: 72 hr. Absorption: Rapid but variable (oral); dosedependent. Bioavailability: Oral: approx 30-40%. Distribution: Proteinbinding: 95%. Metabolism: Extensively hepatic; converted to hydroxyomeprazole and omeprazole sulfone. Excretion: Via urine (77%) and bile. Elimination half-life: 0.53 hr.

Peptic ulcer NSAIDassociated duodenal or gastric ulcer and gastroduoden al erosions GERD ZollingerEllison syndrome Prophylaxis of acid aspiration during anaest hesia Acid-related dyspepsia Erosive oesop hagitis Reflux oesophagitis

Decreases absorption of itraconazole, ketoconaz ole, dasatinib, oral iron salts. Decreases levels of nelfinavir. Increases levels of benzodiazepines (e.g. diazepam, midazola m, triazolam), HMG-CoA reductase inhibitor, CYP2C19 substrates (e.g. citalopram, diazepam, methsuximide, phenytoin, propranolol, and sertraline), and CYP2C9 substrates (e.g. bosentan, dapsone, fluoxetine, glimepiride, glipizide, losartan, montelukast, nateglinide, paclitaxel, phenytoin, warfarin, and zafirlukast). Decreased levels/effects with CYP2C19 inducers (e.g. aminoglutethimide, carba mazepine, phenytoin, and rifampin). Decreases excretion of methotrexate. Enhances the adverse/toxic effect of cilostazol. May alter the concentrations/effects of clozapine.

ADVERSE REACTIONS Diarrhoea, nausea, fatigue, constipation, vomiting, flatulence, acid regurgitation, taste perversion, arthralgia, myalgia, urticaria, dry mouth, dizziness, headache, paraesthesia, abdominal pain, skin rashes, weakness, back pain, upper respiratory infection, cough. Potentially Fatal: Anaphylaxis.

OVERDOSAGE

Confusion, drowsiness, blurred vision, tachycardia, nausea, flushing, diaphoresis, headache, and dry mouth. Treatment is supportive; not dialysable.

NURSING RESPONSIBILITY > Special Precautions: Exclude malignancy, prolonged use, hepatic impairment. Pregnancy, lactation, children <1 yr. Elderly and Asians (increased bioavailability).

> Food Interaction: Absorption may be delayed. St John's wort decreases omeprazole levels. Avoid ethanol (may cause gastric mucosal irritation). Patient & Family Education Report any changes in urinary elimination such as pain or discomfort associated with urination, or blood in urine. Report severe diarrhea; drug may need to be discontinued. Do not breast feed while taking this drug.