Severe adverse reactions caused by omeprazole: A case report

Area of Science:

• Pharmacology
• Clinical Medicine
• Genetics

Background:

• A 61-year-old female presented with a severe whole-body rash, diarrhea, and shock.
• These symptoms emerged after a month of non-steroidal anti-inflammatory drug use for arthritis, followed by omeprazole prescription.
• Initial treatments in the ICU were ineffective, necessitating transfer to a specialized hospital.

Purpose of the Study:

• To investigate the cause of severe adverse drug reactions in a patient treated with omeprazole.
• To determine the role of genetic factors in omeprazole metabolism and subsequent toxicity.

Main Methods:

• Clinical case observation and treatment documentation.
• Genetic screening for drug-metabolizing enzymes.
• Analysis of omeprazole metabolite levels and their correlation with adverse events.

Main Results:

• The patient developed a rash, severe diarrhea, nausea, vomiting, and shock after omeprazole administration.
• Genetic analysis identified the patient as a poor metabolizer of omeprazole.
• Accumulation of omeprazole metabolites due to slow metabolism was identified as the cause of the severe adverse reactions.

Conclusions:

• Slow omeprazole metabolism in genetically predisposed individuals can lead to toxic metabolite accumulation.
• This accumulation can manifest as severe adverse reactions, including allergic shock, rash, and diarrhea.
• Genetic screening is crucial for identifying patients at risk for severe omeprazole-induced adverse events.