Omeprazole
Trade names:
Prilosec
Class: Proton Pump Inhibitors "
Ulcer-healing drugs Pregnancy: (Category C)
Action:
§ Binds to an enzyme on gastric parietal cells in the presence of
acidic gastric pH, preventing the final transport of hydrogen ions into the
gastric lumen.
§ Therapeutic Effects:
o
Diminished accumulation of
acid in the gastric lumen with lessened gastroesophageal reflux
o
Healing of duodenal ulcers.
Uses:
§ Management of GERD
§ Management
of duodenal ulcers (with or without anti-infective for H. pylori)
§ Treatment of pathologic hypersecretory conditions, including
Zollinger-Ellison syndrome.
Dose:
by mouth, prophylaxis against
stress ulcer 20 mg/12 hours,
NSAID-associated duodenal or gastric
ulcer and gastroduodenal erosions, 20 mg once daily for 4 weeks, followed by a
further 4 weeks if not fully healed; prophylaxis in patients with a history of
NSAID-associated duodenal or gastric ulcers, gastroduodenal lesions, or
dyspeptic symptoms who require continued NSAID treatment, 20 mg once daily
Gastric acid reduction during general
anaesthesia (prophylaxis of acid aspiration), 40 mg on the preceding evening
then 40 mg 2–6 hours before surgery
CHILD over 2 years, severe ulcerating reflux
oesophagitis, 0.7–1.4 mg/kg daily for 4–12
weeks; max. 40 mg daily (to be
initiated by hospital paediatrician) Contraindications:
§ Hypersensitivity.
Use Cautiously in:
§ Liver disease (dosage reduction may be necessary)
§ Pregnancy, lactation, or children (safety not established).
Side effects:
CNS: dizziness, drowsiness, fatigue,
headache, weakness.
CV: chest pain.
GI: abdominal
pain, acid regurgitation, constipation, diarrhea, flatulence, nausea,
vomiting. Derm: itching, rash.
Misc: allergic reactions.
Nursing
considerations:
Nurse should instruct the pt to take each dose
of Prilosec with a full glass (8 ounces) of water. Prilosec is usually taken before eating.
