Ibuprofen

Question 1

What type of medication is Ibuprofen?

Answer 1

Ibuprofen is a Non-Steroidal Anti-Inflammatory (NSAID)

Question 2

What is the mechanism of action of Ibuprofen?

Answer 2

• Inhibition of prostaglandin synthesis which is important in the mediation of pain, fever and inflammation.
• Provides anti-inflammatory and analgesic effects well suited to musculoskeletal injuries.

While the exact mechanism of action is unknown, Ibuprofen is considered to be an NSAID, and thus a non-selective Cyclooxygenase inhibitor; this inhibits the activity of both COX-1 and COX-2. The inhibition of COX-2 activity decreases the synthesis of prostaglandins involved in creating inflammation, pain, fever, and swelling.

Question 3

What is the route, onset, peak and duration for ibuprofen?

Answer 3

• Route: PO
• Onset: 15-30min
• Peak: N/A
• Duration: 3-4hrs

Question 4

What are the adverse effects of Ibuprofen?

Answer 4

• GI irritation
• Renal impairment
• Uncommon: Hypersensitivity reactions with urticaria and pruritus (itching)
• Nausea and vomiting
• Diarrhoea

Question 5

What are the contraindications of Ibuprofen?

Answer 5

• History of allergic reactions to NSAID’s
• Active, suspected or known bleeding tendency
• Renal impairment
• Dehydration
• Patients <7yo
• Active peptic ulcer disease or gastrointestinal bleeding
• Multiple previous doses:
  
  • self administration within 4-6hrs; and/or
  • 1.2g (6 tablets) within 24hrs for 12yo or less; or
  • 800mg (4 tablets) within 24hrs for patients 7 - <12yo
• Pregnancy
• Severe heart failure
• Patients with asthma who have a history of wheeze post NSAID administration or who have not previously taken an NSAID

Question 6

What is the preparation, and the dosage for the uses of Ibuprofen?

Answer 6

• Preparation: 200mg tablet
• Pain management:
  
  • 7 - <12yo: 200mg (max initial dose 200mg) - 1 tablet
    
    • Repeat: 4-6hrs
    • Max total daily dose: 800mg in 24hrs - 4 tablets
  • 12yo+: 200-400mg (max initial dose 400mg) - 1-2 tablets
    
    • Repeat: 4-6hrs
    • Max total daily dose: 1.2g in 24hrs - 6 tablets

Notes:

• Paramedics should check for previous administration within 4-6 hrs and within the 24hr period prior to administration of ibuprofen
• Reduced doses should be used in patients with advanced age, smaller than average size or general debility
• Paramedics MUST NOT leave ibuprofen tablets with a patient. This includes not cutting the packet or preparation to leave with a patient