Ibuprofen

Question 1

Mechanism of action of ibuprofen

Answer 1

1. Ibuprofen is a non-steroidal anti inflammatory (NSAID)
2. Inhibits prostaglandin production - reducing pain, fever and inflammation
3. Has proven antipyretic, analgesic and anti-inflammatory properties

Question 2

Indications for ibuprofen

Answer 2

Indicated for pain relief
Mild pain - usually in combination with paracetamol
Moderate and severe pain - in addition to other medicines. Not a priority but will reduce the need for subsequent analgesia and impover quality of pain relief

Question 3

Contraindications of ibuprofen

Answer 3

1. Known severe allergy
2. Third trimester of pregnancy

Question 4

Cautions for ibuprofen

Answer 4

1. Has taken ibuprofen in the past 4 hours
2. Abdominal pain, particularly if very unwell or vomiting
3. Aged 75 or over, particularly in presence of illness, infection or dehydration - renal impairment is likely which will worsen with administration
4. Dehydration or shock - renal impairment is likely which will worsen with administration
5. Known bleeding disorder - increased risk of bleeding with ibuprofen which must be taken into account
6. Known history of worsening of bronchospasm with NSAID
7. Taking warfarin - ibuprofen will increase activity of warfarin and displace is from binding sites. Should be withheld if bleeding is suspected
8. Pregnancy - has been associated with premature delivery. Should generally be withheld

Question 5

Dosage for ibuprofen

Answer 5

Adults over 80kg = 600mg
Adults 80kg or less = 400mg

Question 6

Pharmacokinetics of ibuprofen

Answer 6

1. Half life is between 1.9 and 2.2 hours
2. Approximately 99% is protein bound
3. Metabolised in the liver into two metabolises which do not have anti-inflammatory or analgesic properties
4. 95% is excreted via the kidneys within 24hours of a single dose
5. No significant effects from liver impairment on acute administration