What are the differences between primary and secondary line of defense? What factors interfere with these mechanisms? How are these levels of immunity affected in a child, an elderly person, or a person with a chronic disease? Include active, passive, innate, and acquired immunity.

Proton Pump Inhibitor (Omeprazole)

Proton-pump inhibitors (PPIs) are a family of medications best recognized for their use in treating acid-related illnesses. When used as part of an all-natural treatment plan with other medicines, this effect can help heal a peptic ulcer, treat gastroesophageal reflux disease, treat Barrett’s esophagus, and even get rid of Helicobacter pylori (Ahmed & Clarke, 2021). With my experience in home health nursing before, most older patients take Omeprazole, especially if they have multiple drug maintenance. Some of the patients were prescribed maybe eight or more medications, and one of those is Omeprazole. Most of the time, they are discharged from hospital admission new medication will be added. It was always a struggle to coordinate with multiple physicians that the patient is seeing to verify the necessary medication they need to take as long term, and that is only short term. There was a patient that during the initial intake visit I asked him about why he is taking Omeprazole, he said because of GERD from all the medications that he is taking. Therefore, it is essential to be careful about our older patients’ medications. Because the more medications they are taking, the more susceptible they are to the adverse reactions from medications. Therefore, it is essential to educate the patient, give them an updated medication list, and instruct them or the family that they bring all the medication they are taking each time they see a physician to avoid duplication or unnecessary medication prescription.  

Pharmacokinetics of Proton Pump Inhibitor 

Absorption

The proximal small bowel absorbs these drugs, and when they reach the stomach’s parietal cells, they influence the cells (Ahmed & Clarke, 2021). The proton pump is an enzyme in the parietal cells that PPIs stop. This enzyme is the last step in releasing acid into the stomach, and it does this job very well.

Metabolism

Omeprazole is broken down by the hepatic cytochrome P450 enzyme system, mainly through CYP2C19 and CYP3A4 isozymes. It has a short half-life of a half-hour to an hour in healthy people and about three hours for people who have a problem with their liver (Shah, 2020).

Distribution

Within an hour of taking Omeprazole, the drug’s effects start to slow down. It takes two hours for the drug’s full effects to kick in. The effects of the drug last for about 72 hours after it is taken, and they usually wear off in 3 to 5 days. It will take four days for the effects to level off when taking medicine every day (Shah, 2020).

Excretion

Urinary excretion is the principal mechanism of omeprazole metabolite elimination (Shah, 2020).

Reference

Ahmed, A., & Clarke, J. O. (2021, August 1). Proton pump inhibitors (PPI) – StatPearls – NCBI bookshelf. National Center for Biotechnology Information. https://www.ncbi.nlm.nih.gov/books/NBK557385/