Question 43

A pharmacist should be alerted if a patient presents a prescription for Nexium.

Therapeutic duplication occurs when a patient is prescribed two medications that have similar effects or actions, which can lead to increased risk of side effects. In this case, both pantoprazole and Nexium are proton pump inhibitors, so using them together could result in unnecessary duplication of therapy.

A) Valium

Valium, or diazepam, is a benzodiazepine used primarily for anxiety, muscle spasms, and seizures. It does not share the same therapeutic class or mechanism of action as pantoprazole, which makes it an inappropriate choice in this context. There is no risk of therapeutic duplication with these two medications.

B) Crestor

Crestor, or rosuvastatin, is a statin used to manage cholesterol levels. Similar to Valium, it does not interact with pantoprazole in a way that would cause therapeutic duplication. Each medication works in different pathways and does not have overlapping effects.

C) Nexium

Nexium, or esomeprazole, is another proton pump inhibitor that works similarly to pantoprazole. Because both medications reduce stomach acid by the same mechanism, prescribing Nexium to a patient currently taking pantoprazole would lead to therapeutic duplication, warranting alertness from the pharmacist.

D) Ultram

Ultram, or tramadol, is a pain reliever that operates through a different mechanism than pantoprazole. As it is not in the same therapeutic class, there is no concern of therapeutic duplication when it is prescribed alongside pantoprazole.

Conclusion

Nexium is the only medication listed that poses a risk of therapeutic duplication with pantoprazole, as they are both proton pump inhibitors. The other options do not overlap in therapeutic action, making them safe to use concurrently with pantoprazole. Therefore, the pharmacist should be particularly cautious with any prescription for Nexium in a patient already on pantoprazole.