Ibuprofen Case Study

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Pharmacokinetics of Ibuprofen Hui-Ju Liu New York University: Rory Meyers College of Nursing Introduction Case scenario Mr.A is a 72-year old elderly who has constant bilateral knee pain. He was recently diagnosed with osteoarthritis and is using ibuprofen for pain management. He has no other past medical histories. Currently he is taking ibuprofen 600mg one tablet every day for pain control. Patient is asking another analgesic or adjusting dosage because his pain is not improving. Rationale Ibuprofen is a common pain-killer for various occasions, including arthritis pain, post-surgical pain management, or treating menstrual cramps. Ibuprofen is widely prescribed to patients with chronic osteoarthritis pain in clinical…show more content…
Ibuprofen has >99% protein-binding ability. When reaching a concentration>20 μ g/mL, the drug will be saturate and remain stable(Mazaleuskaya, et al., 2015). Half-life Half-life indicates when the concentration of the drug is reduced by 50% from its total amount. The efficacy of a drug is regarded as ignorable is it already goes through 4 half-lives. Ibuprofen has about 2hours' half-life, and with increase of dosage, its half-life can be up to 4 to 8 hours. It has a relatively long half-life compared with aspirin, which means longer duration(Bushra, & Aslam, 2010). Metabolism Through biotransformation in the liver, the drug is metabolized into a more hydrophilic state and easier to excrete form the body. The metabolism of ibuprofen is through cytochrome P450 enzymes. The S-enantiomer ibuprofen is metabolized primarily by CYP2C9 and the R-enantiomer ibuprofen is metabolized primarily by CYP2C8. The activity of ibuprofen to inhibit cyclooxygenases is also determined by the CYP2C9 gene group. CYP2C9 has different genotypes, including CYP2C9*2/*2, CYP2C9*1/*3, CYP2C9*2 and CYP2C9*3. What influences the clearance of racemic mixture ibuprofen most is the CYP2C9*3 alleles(Mazaleuskaya, et al.,…show more content…
In addition, adverse effects on gastrointestinal tract caused by NSAIDs take approximately 30% of arthritis treatment. Although acetaminophen is recommended as a first-line therapy for mild to moderate pain, it is less effective for patients with severe form such as arthritis or menstrual cramp. Carefully assess patient symptoms and potential side effects among risky populations is crucial in determining the most suitable and cost-effective medication of treatment(Crofford,

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