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NSAID gastroprotection — GPhC CRA MCQ

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HardGastro-intestinal TherapeuticsNSAID gastroprotectionGPhC CRA

A patient taking clopidogrel after coronary stenting is prescribed omeprazole for persistent dyspepsia. There is no history of gastrointestinal bleeding. What is the most appropriate pharmacy action?

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Correct answer: A — Ask the prescriber to consider a less-interacting proton-pump inhibitor

Omeprazole inhibits CYP2C19 and can reduce formation of clopidogrel’s active metabolite. When gastroprotection is needed, the prescription should be reviewed and a proton-pump inhibitor with less potential for this interaction considered. Dose separation does not reliably avoid a metabolic interaction, and clopidogrel should not simply be stopped after coronary stenting.

Reference: https://www.pharmacyregulation.org/students-and-trainees/pharmacist-education-and-training/registration-assessment