The effects of medications to pharmacokinetics pharmacodynamics

Advanced Pharmacology: Case Study on Gastroesophageal Reflux Disease
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1 What are the potential effects of the medication-related to pharmacokinetics and pharmacodynamics?
Proton pump inhibitors (PPIs) are typically used in combination with clopidogrel to reduce the incidence of gastrointestinal (GI) bleeding from the lone use of clopidogrel. One of the most potent PPIs is omeprazole, which has been taken by the patient to decrease the severity of heartburn. This is a weak base, lipophilic drug, that readily traverses the parietal cell canaliculi to gain a proton and irrevocably inactivate the parietal cell hydrogen-potassium ATPase pump. This pump is the chief producer of stomach acid that induces heartburn (Raidal, Andrews, Nielsen, & Trope, 2017).
Omeprazole can have a drug interaction with clopidogrel through the induction of the CYP metabolic pathway. This results in the mitigation of the effect of clopidogrel as an antiplatelet drug (Bouziana & Tziomalos, 2015).
Clopidogrel has also been co-administered with aspirin. This drug combination amplifies the antiplatelet activity of each other through the induction of the coagulation pathway (Wang, Chen, Zhu, et al., 2015). Aspirin, on the other hand, does not have a drug interaction with omeprazole (Russo, Petrucci, & Rocca, 2016).
2 What are the considerations related to Jamie’s current medication regime on the CYP metabolic pathway?
The following are the considerations concerning the patient’s case: 1) The previous incidence of acute myocardial infarction (MI) that required percutaneous coronary intervention (PCI). This signifies the blockage of blood flow that may be due to excessive coagulation.; and 2) 30-60 minutes of mid-epigastric burning abdominal pain which is more pronounced in an empty stomach. These instances are secondary to the drug-to-drug interaction that affects the CYP metabolic pathway (Bouziana & Tziomalos, 2015).
3 What CYP metabolic pathway is impacted?
CYP2C19 is a liver enzyme that mainly regulates the formation of the active metabolite of Clopidogrel that is necessary to execute its function. Omeprazole, on the other hand, prevents the induction of CYP2C19, thereby inhibiting the action of Clopidogrel (Pye...