Omeprazole dosing

VORICONAZOLE OMEPRAZOLE Possible t efficacy and adverse effects of both drugs 1. Inhibition of voriconazole metabolism via CYP2C19 and CYP3A4 2. Inhibition of metabolism of omeprazole 1. No dose adjustment of voriconazole is recommended 2. Halve the omeprazole dose... 

The clinical relevance of the CYP2C19 polymorphism, primarily present in Asian populations (4), has been studied by a number of investigators who have shown that the cure rate for Helicobacter -pylori infection is greater in patients who are genetic poor metabolizers (5). When given omeprazole doses of 20 mg/day for 4 weeks, these individuals have plasma areas under... 

A. While on cefotetan, MN will have to increase his omeprazole dose. 

The interaction between voriconazole and omeprazole is established but no adjustment to the dose of voriconazole is required. The clinical importance of the marked rise in serum omeprazole levels caused by voriconazole is not established, but the manufacturers recommend that the omeprazole dose be halved, although the US manufacturers restrict this to patients taking omeprazole 40 mg or more. The increase in levels of esomeprazole by voriconazole does not routinely require a dose adjustment of esomeprazole However, patients taking esomeprazole in doses of more than 240 mg daily (e.g. for Zollinger-Ellison syndrome) may require a dose adjustment. ... 

Fluconazole is not aftected by omeprazole, and is unlikely to be aftected by other proton pump inhibitors. However, fluconazole markedly increases omeprazole levels. The clinical relevance of these changes is uncertain, but not likely to be important for single-dose fluconazole regimens. More study is needed to establish whether it is advisable to reduce the omeprazole dose in those given both drugs longer-term. 

In vivo, induction by omeprazole translated into acceleration of caffeine demethylation by 40 mg of omeprazole [66]. However, as analyzed elsewhere [41], quantitative changes (an - 13% increase in exhalation of C02) were trivial. Omeprazole doses up to 80 mg failed to influence theophylline elimination kinetics [20]. A dose of 20 mg left the metabolism of phenacetin unchanged [67]. By contrast, both 30 and 60 mg of lanso-... 

Comparable daily doses of PPIs are omeprazole 20 mg = esomeprazole 20 mg = lansoprazole 30 mg = rabeprazole 20 mg = pantoprazole 40 mg. The PPIs degrade in acidic environments and are therefore formulated in delayed-release capsules or tablets.16 Lansoprazole, esomeprazole, and omeprazole contain enteric-coated (pH-sensitive) granules in a capsule form. For patients unable to swallow the capsule or in pediatric patients, the contents of the capsule can be mixed in applesauce or placed in orange juice. If a patient has a nasogastric tube, the contents of an omeprazole capsule can be... 

Patients presenting with atypical symptoms may require higher doses and longer treatment courses than patients with typical symptoms. These patients are best diagnosed with ambulatory pH testing or an empiric trial with a PPI.23 These tests can confirm reflux in patients who have persistent symptoms without evidence of mucosal damage by endoscopy.1 In patients presenting with non-cardiac chest pain, a short course (1 to 8 weeks) of omeprazole 20 mg twice daily has been advocated.23... 

Polymorphisms of CYP2C19 cause differences in metabolism of omeprazole, a proton pump inhibitor used for treatment of gastroduodenal ulcers or reflux esophagitis. Such polymorphisms result in resistance to treatment at a standard dose regimen in nearly 20% of European Caucasians, and in an even higher percentage of Asians [12]. 

Most patients require standard doses to prevent relapses. H2RAs may be an effective maintenance therapy in patients with mild disease. The PPIs are the drugs of choice for maintenance treatment of moderate to severe esophagitis. Usual once-daily doses are omeprazole 20 mg, lansoprazole 30 mg, rabeprazole 20 mg, or esomeprazole 20 mg. Lower doses of a PPI or alternate-day regimens may be effective in some patients with less severe disease. 

Shimatani, T., Inoue, M., Kuroiwa, T., et al. (2006) Acid-suppressive effects of rabeprazole, omeprazole, and lansoprazole at reduced and standard doses a crossover comparative study in homozygous extensive metabolizers of cytochrome P450 2C19. Clin. Pharmacol. Ther. 79, 144-152. 

Chiidren - For the treatment of GERD or other acid-related disorders, the recommended dose for pediatric patients 2 years of age and older is as follows 10 mg omeprazole for patients weighing less than 20 kg, and 20 mg omeprazole for patients weighing 20 kg or more. On a per kg basis, the doses of omeprazole required to heal erosive esophagitis are greater than those for adults. 

Preparation and administration of orai suspension - Take on an empty stomach 1 hour before a meal. The powder for oral suspension is supplied as unit-dose packets containing an immediate-release formulation of omeprazole. 

Diazepam (Valium, Diastat) [C-IVj [Anxiolytic, Skeletal Muscle Relaxant, Anticonvulsant, Sedative/Hypnotic/ Benzodiazepine] Uses Anxiety, EtOH withdrawal, muscle spasm, status epilepticus, panic disorders, amnesia, preprocedure sedation Action Benzodiazepine Dose Adults. Status epilepticus 5-10 mg IV/IM Anxiety 2-5 mg IM/IV Preprocedure 5-10 mg IV just prior to procedure Peds. Status epilepticus 0.5-2 mg IV/IM Sedation 0.2-0.5 mg/kg IV (onset w/in 5IV and 30 min IM duration about 1 h IV and IM) Caution [D, / -] Contra Coma, CNS depression, resp d es-sion, NAG, severe uncontrolled pain, PRG Disp Tabs 2, 5, 10 mg soln 1, 5 mg/mL inj 5 mg/mL rectal gel 2.5, 5, 10, 20 mg/mL SE Sedation, amnesia, bradycardia, i BP, rash, X resp rate Interactions T Effects W/ antihistamines, azole antifungals, BBs, CNS depressants, cimetidine, ciprofloxin, disulfiram, INH, OCP, omeprazole, phenytoin, valproic acid, verapamil, EtOH, kava kava, valman T effects OF digoxin, diuretics X effects w/ barbiturates, carbamazepine. 

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