Losec, Prilosec, Prilosec OTC, Zegerid
Therapeutic: antiulcer agents
Pharmacologic: proton-pump inhibitors
GERD/maintenance of healing in erosive esophagitis. Duodenal ulcers (with or without anti-infectives for Helicobacter pylori). Short-term treatment of active benign gastric ulcer. Pathologic hypersecretory conditions, including Zollinger-Ellison syndrome. Reduction of risk of GI bleeding in critically ill patients. OTC: Heartburn occurring ≥ twice/wk.
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: Diminished accumulation of acid in the gastric lumen with lessened gastroesophageal reflux. Healing of duodenal ulcers.
Adverse Reactions/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.
PHYSICAL THERAPY IMPLICATIONS
Examination and Evaluation
Monitor improvements in GI symptoms (gastritis, heartburn, and so forth) to help determine if drug therapy is successful.
Assess dizziness that might affect gait, balance, and other functional activities (See Appendix C). Report balance problems and functional limitations to the physician, and caution the patient and family/caregivers to guard against falls and trauma.
Monitor other CNS side effects (drowsiness, fatigue, weakness, headache), and report severe or prolonged effects.
Monitor any chest pain and attempt to determine if pain is drug induced or caused by cardiovascular dysfunction (e.g., angina that occurs during exercise).
In cases of NSAID-induced gastritis, implement appropriate manual therapy techniques, physical agents, and therapeutic exercises to reduce pain and decrease the need for aspirin and other NSAIDs.
Advise patient to avoid alcohol and foods that may cause an increase in GI irritation.
Instruct patient to report bothersome or prolonged side effects, including skin problems (itching, rash) or GI effects (nausea, diarrhea, vomiting, constipation, heartburn, flatulence, abdominal pain).
Absorption: Rapidly absorbed following oral administration; immediate release formulation contains bicarbonate to prevent acid degradation.
Distribution: Good distribution into gastric parietal cells.
Metabolism and Excretion: Extensively metabolized by the liver.
Half-life: 0.5–1 hr (increased in liver disease to 3 hr).
TIME/ACTION PROFILE (antisecretory effects)
|ROUTE ||ONSET ||PEAK ||DURATION |
within 1 hr
within 2 hr
Contraindicated in: Hypersensitivity; Metabolic alkalosis and hypocalcemia (Zegerid only).
Use Cautiously in: Liver disease (dose reduction may be necessary); Geri: Increased risk of hip fractures in patients using high-doses ...