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OTC PAIN Management

9/27/2014

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One of the most common reasons a patient will come in to the pharmacy is because of pain management. Therefore, it is important for the pharmacist to know the benefits of each individual drug within its class in order to give the appropriate recommendation.   Acetaminophen is effective and generally better tolerated than ibuprofen, naproxen sodium and other nonsteroidal anti-inflammatory (NSAIDs). However, over usage of acetaminophen is associated with liver toxicity. Ibuprofen is a member of the NSAID class which can cause gastrointestinal ulcers, asthma symptoms and heartburn. In addition, Ibuprofen has the risk of Reyes syndrome in people under the age of 18.  Acetaminophen has rare minimal side effects compared to NSAIDs. NSAIDs have an anti-inflammatory effect at higher doses for which acetaminophen lacks. Naproxen Sodium will provide a longer analgesic effect than Ibuprofen and can be dosed twice a day instead of four times a day. Therefore, the naproxen sodium is preferred for pain management if acetaminophen fails or if an anti-inflammatory effect is needed. In addition, Naproxen sodium has shown to be safer compared to Ibuprofen for patients that have cardiovascular disease.
For Information on acetaminophen, ibuprofen, and naproxen sodium please refer to the links below:

1) http://www.webmd.com/drugs/2/drug-362/acetaminophen-oral/details
2)http://www.webmd.com/drugs/2/drug-5166-9368/ibuprofen-oral/ibuprofen-oral/details
3)http://www.webmd.com/drugs/2/drug-11643-1289/naproxen-sodium-oral/naproxen-oral/details
4) Aleve (naproxen sodium), Naprosyn (naproxen), & Anaprox (naproxen sodium) briefing document for US Food and Drug Administration Advisory Committee Meeting. Bayer Healthcare LLC, Consumer Care Division, Hoffmann-La Roche Inc. January 10, 2014.
http://www.fda.gov/downloads/AdvisoryCommittees/CommitteesMeetingMaterials/ Drugs/ArthritisAdvisoryCommittee/UCM383181.pdf
5)http://www.medscape.com/viewarticle/406213_1
6)http://www.rxlist.com/naprelan-drug/clinical-pharmacology.htm

Posted by Parisa Karimi, PharmD2015

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