Clinical Pharmacist

Omeprazole, a widely prescribed proton pump inhibitor (PPI), is a cornerstone therapy for acid?related gastrointestinal disorders, including gastroesophageal reflux disease, peptic ulcer disease, and Zollinger–Ellison syndrome. While generally safe and effective, prolonged or inappropriate use has been linked to a spectrum of adverse drug reactions (ADRs). Common ADRs include headache, abdominal discomfort, nausea, diarrhea, and flatulence, which are usually mild and self?limiting. However, serious complications—such as Clostridioides difficile infection, interstitial nephritis, hypomagnesemia, vitamin B12 deficiency, bone fractures, hepatotoxicity, and severe cutaneous reactions—though rare, pose significant clinical challenges. Risk factors influencing ADR incidence include treatment duration, high dosage, advanced age, polypharmacy, comorbid conditions, and genetic polymorphisms in CYP2C19 metabolism, which alter drug bioavailability and efficacy. Clinical pharmacists play a crucial role in mitigating these risks through therapeutic optimization, monitoring of laboratory parameters, early identification of drug interactions, and patient education. Evidence?based deprescribing strategies and routine safety surveillance are essential to minimize preventable harm while preserving therapeutic benefit. This review highlights the clinical significance of omeprazole?associated ADRs from a pharmacist’s perspective, emphasizing the importance of rational prescribing, vigilant monitoring, and interdisciplinary collaboration in ensuring patient safety.

A 20-years-old male patient was admitted in government hospital with chief complaints of 6 episodes of seizure with the time interval of 1 hour, fever for one day, vomiting for one day (1 episode). The patient complaints in psychiatric interview; that he lacks concentration, isolation himself from family and avoiding to go out as he was getting sudden seizure episode. He belongs to low socio economic status, so he thinks that his health issue would cause financial difficulties. The patient was given a specialized questionnaire named HADS (Hospital Anxiety and Depression scale) to analyse the severity of anxiety disorder. The patient scored 15 on 21 which represents that the patient has abnormal case of anxiety. He also suffered from anxiety and depressive symptoms like sleeplessness, irritability, lack of interest, hopelessness for past 6 months. The diagnostic and psychiatric interview indicated that the patient was suffering from generalized tonic-clonic seizure with anxiety. The patient has advised to overcome from her anxiety state and cognitive behavioural therapy was suggested. As Clinical pharmacist, patient counselling had given regarding diseased condition, medications and lifestyle modification to control the problem and to improve the patient’s quality of life.