Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that is used to treat pain, fever, and inflammation. It works by inhibiting the cyclooxygenase enzymes. Common uses include headaches, toothaches, back pain, arthritis, and minor injuries. Ibuprofen has a low risk of adverse effects compared to other NSAIDs, but can cause nausea, dyspepsia, gastrointestinal bleeding, and hypertension. It interacts with drugs like ACE inhibitors, aspirin, diuretics, and warfarin. Ibuprofen is contraindicated for those with asthma, hypertension, heart conditions, ulcers, liver or kidney disease, or who are pregnant
2. OutLines:
✓ Definition
✓ Uses
✓ Mechanism of action
✓ Dosage
✓ Adverse effects
✓ Drug interaction
✓ Contraindication
✓ History
✓ uses in dentistry
✓ References
3. What is IBuprofen ?!
✓
a Nonsteroidal antiinflammatory drug (NSAID)
used as analgesic to reduce
fever and treat pain or
inflammation. Ibuprofen is
a 'core' medicine in the
WHO Model List of Essential
Medicines necessary in the
minimum medical needs of a
basic healthcare system.
✓ Originally marketed as Brufen, and its
available under a variety of popular trademarks
such as Motrin and Advil.
✓
it has Anti-Platlet effect and act as
Vasoconstrictor.
5. Mechanism
• Non steroidal anti-inflammatory drugs
such as ibuprofen work by inhebiting
theCyclooxygenase (COX), which
converts archidonic Acid to
prostaglandin (PGH2).
•
PGH2, in turn, is converted by other
enzymes to several other
prostaglandins (which are mediators of
pain, inflammation, and fever) and to
thromboxane A2 (which stimulates
platelet aggregation, leading to the
formation of blood clots)
7. Doses:
• Usual Adult Oral Dose for Mild to
Moderate Pain:
200 to 400 mg orally every 4 to 6
hours as needed.
•
Under Medical description the maximum amount
for adults is 800 mg per dose or 3200 mg per
day based on an individual's response and
tolerance
•
“over-the-counter” (OTC) preparations of
ibuprofen are, in general, labeled to advise a
maximum daily dose of 1,200 mg
8. ibuprofen Side Effects:
• Ibuprofen appears to have
the lowest incidence of
digestive Adverse effect
reaction of all the
nonselective NSAIDs
• Nausea , Dyspepsia
gastrointestinal ulceration
, bleeding, Diarrhea,
constipation and
Hypertension
9. Ibuprofen Drug interaction:
• ACE-inhibitors
NSAIDs may diminish the antihypertensive effect of ACE
inhibitors.
• Aspirin
administration of ibuprofen and aspirin is not
generally recommended because of the potential for
increased adverse effects.
• Diuretics
Ibuprofen can reduce the natriuretic effect-of
furosemide and thiazides in some patients. the
patient should be observed closely for signs of renal
failure as well as to assure diuretic efficacy.
• Warfarin-type anticoagulants
users of both drugs together have a risk of serious
bleeding higher than users of either drug alone.
•
10. Contraindication:
•
Ibuprofen tablets are contraindicated in
patients with known hypersensitivity to
Ibuprofen.
•
Asthma
•
Hypertensive patients.
•
Heart Attack
•
Stomach or Intestinal Ulcer
•
Liver Problems and Blood Clotting Disorder
•
Bleeding of the Stomach or Intestines
•
Kidney Disease
•
Pregnant in 3rd trimester
11. History:
✓
The invention of Ibuprofen arose out of a
Boots study to treat rheumatoid arthritis
before evolving into a drug to relieve a range
of conditions.
✓
Dr Stewart Adams was the project leader on
the team which made the amazing
discovery.He was subsequently awarded an
OBE in 1987
✓
Ibuprofen was launched on to the market in
1969, with an over-the-counter version
available from 1983.
12. IBuprofen in Dentistry:
•
Analgesic medications in dentistry are indicated for the relief of acute
pain, postoperative pain, and chronic pain.
•
Endodontic pain management Pain control particularly during the early
phases of endodontic treatment.
•
Wisdom tooth extraction Managing post operative pain.
•
Pediatric dentistry for relieving moderate to severe pain. They found that
single doses of ibuprofen (4–10 mg/kg )
•
Orthodontic pain management Pain and discomfort are common clinical
symptoms in orthodontic patients, especially 2 to 4 days after the
placement of fixed orthodontic appliances.
•
Periodontal Pain managment: Chronic periodontitis is a common
inflammatory disease of the gingiva.
13. ✓
Uses in Dentistry:
the combination of 600mg of
ibuprofen with 1000mg of
Paracetamol taken every six
hours increases pain relief
compared with ibuprofen taken
alone.
✓
ibuprofen and Codiene (which
enhances ibuprofen analgesia but
with a increase in adverse
effects)
✓
use of gel caps that provide
faster absorption and therefore
a quicker effect.
14. References
•
http://www.fda.gov/
•
Drugs.com/ibuprofen
•
Cyclooxygenase-1-Selective Inhibitors Based on the (E)-2′-Des-methyl-sulindac Sulfide Scaffold Andy J. Liedtke, Brenda C.
Crews, Cristina M. Daniel, Anna L. Blobaum, Philip J. Kingsley, Kebreab Ghebreselasie, and Lawrence J. Marnett Journal of
Medicinal Chemistry
•
Lambert, Victoria (2007-10-08). "Dr. Stewart Adams: 'I tested ibuprofen on my hangover'". The Daily Telegraph (London).
Retrieved 2008-01-20.
•
McElwee, N. E.; Veltri, J. C.; Bradford, D. C.; Rollins, D. E. (1990). "A prospective, population-based study of acute ibuprofen
overdose: Complications are rare and routine serum levels not warranted". Annals of Emergency Medicine 19 (6): 657–662. doi
:10.1016/S0196-0644(05)82471-0. PMID 2188537.
•
WHO Model List of Essential Medicines for Children (2nd ed.). World Health Organization (WHO). March 2010. Retrieved 201103-30.
•
Parameter on chronic periodontitis with slight to moderate loss of periodontal support. American Academy of Periodontology.
•
176. Xiaoting L, Yin T, Yangxi C. Interventions for pain during fixed orthodontic appliance therapy. A systematic review. Angle
Orthod. 2010;80:925–932. J Periodontol. 2000 May; 71(5 Suppl):853-5.
•
Review Administering local anaesthesia to paediatric dental patients -- current status and prospects for the future.Ram D,
Peretz B Int J Paediatr Dent. 2002 Mar; 12(2):80-
•
Hitchcock M, Ogg TW Br J Hosp Med. 1995 Sep 6-19; 54(5):202-6.
•
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0000915/
•
http://www.ada.org.au/App_CmsLib/Media/Lib/0612/M32720_v1_633009138786195000.pdf
•
1. Weibert RT, Townsend RJ, Kaiser DG et al. Lack of ibuprofen secretion into human milk. Clin
Pharm. 1982;1:457-8. PMID: 7184678