Classification: Gastric Antisecretory Drugs – Proton Pump Inhibitor
Action: Suppress gastric secretion by inhibiting hydrogen/potassium ATPase enzyme system in the gastric parietal cell: characterized as a gastric acid pump inhibitor, since it blocks the final step of acid production.
Indication: Short-term treatment of active duodenal ulcer, gastroesophageal reflux disease (GERD), including erosive esophagitis and symptomatic GERD; long term treatment of pathologic hypersecretory conditions (e.g. Zollinger-Ellison syndrome, multiple endocrine adenomas, systemic multiple endocrine adenomas, systemic mastocytosis); to maintain healing of erosive esophagitis; in combination with clarithromycin to eradicate H. pylori, use clarithromycin and amoxicillin in combination with omeprazole in patients with a 1-year history of duodenal ulcers or active duodenal ulcers to eradicate H. pylori; short-term treatment of active benign gastric ulcer.
Adverse Reactions: Angina, tachycardia, bradycardia; palpitation, headache, dizziness, rash, diarrhea, abdominal pain, acid regurgitation, nausea, vomiting, constipation, flatulence, cough, upper respiratory infection, asthenia, back pain.
- Assess other medications patient may be taking for effectiveness and interactions (especially those dependent on cytochrome P450 metabolism or those dependent on acid environment for absorption).
- Monitor therapeutic effectiveness and adverse reactions at beginning of therapy and periodically throughout therapy.
- Assess GI system: bowel sounds every 8hours, abdomen for pain and swelling, appetite loss.
- Monitor hepatic enzymes: AST, ALT, increased alkaline phosphatase during treatment.
- Assess knowledge/teach appropriate use of this medication, interventions to reduce side effects, and adverse symptoms to report.
- Pain, chronic (uses)
- Knowledge-deficit (teaching)
- Give before patient eats: patient should swallow capsule whole
- Do not open, chew, or crush: may give with antacids
- Take as directed, before eating
- Do not crush or chew capsules
- Delayed release capsule may be opened and contents be added to apple sauce
- Caution patient to avoid alcohol, salicylates, ibuprofen: may cause GI irritation
- Patient may experience anorexia; small frequent meals may help to maintain adequate nutrition
- Report severe headache, unresolved severe diarrhea, or changes in respiratory status. Inform physician if patient is or intends to become pregnant. Breast-feeding is not recommended.
- Absence of epigastric pain, swelling, fullness