A 60-year-old male comes to your practice complaining of pain in his shoulder. He is currently using...
- A 60-year-old male comes to your practice complaining of pain
in his shoulder. He is currently using low dose aspirin
daily for a heart condition and has had issues with stomach ulcers
in the past. Discuss the following:
- Knowing what we know about treating pain – what would be your first recommendation for a drug for treatment and why?
- Briefly discuss on a cellular level how this drug helps mediate pain?
- What would be proper dosing of the drug and why? (hint: T½)
- When should the patient discontinue use?
- You find out your patient has diabetes; would this change your drug selection? Why or why not?
Homework Answers
a.Considering the age factor of the patient which is 60 means elderly population ,the safe drug to start on is acetaminophen. This is the first line drug used in elderly population to treat pain which are mild to moderate. Aspirin ,though is a NSAID is the second choice when this fails to treat the symptoms. This pain killers are mold and has lesser side effects compared to Apirin.
b.The simple mechanism of its action is, it acts on the receptors of the brain cells .This stops the production of the prostaglandin which is responsible for pain sensitization. As a result the pain is not felt.
c.The actual dose range for this age group should not exceed 3000mg /day or 3g/day .The half life of this drug is minimum 1 hour with a maximum half life of 4 hours.
d.The patient is strictly recommended to stop the medication in case of any allergic reaction, hypersensitivity, no pain relief for more than 10 days,develops side effects.
e.The medication is mor necessarily needed to be changed in case of diabetes because of its safety when 7sed in this patient with no side effects usually.
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