Omeprazole
A proton pump inhibitor (PPI) that irreversibly suppresses gastric acid secretion; used for GERD, peptic ulcers, and H. pylori eradication.
Expect NCLEX to test timing and onset: PPI effect is cumulative, so full acid suppression takes several consecutive daily doses (roughly 1–4 days) — a patient expecting instant relief is the teaching cue, and the exam wants an antacid or H2 blocker like famotidine for breakthrough symptoms, not a second PPI dose. The other favorite is clopidogrel: omeprazole inhibits CYP2C19, blunting clopidogrel’s antiplatelet activation, so the answer is to question that combination or switch to pantoprazole (less CYP2C19 effect). Long-term, the answer often hinges on serum magnesium, and new-onset diarrhea raises C. difficile.
The classic trap is confusing the “-prazole” PPIs with the “-tidine” H2 blockers — H2 blockers are weaker but faster, PPIs stronger but delayed. Students also assume PPIs are harmless long-term; flag fractures, hypomagnesemia, B12 deficiency, and rebound acid hypersecretion on abrupt discontinuation. Memory hook: “prazoles pump the brakes” on the proton pump.
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