Question

1. A 70-year-old osteoporotic female recently broke her hip and is in severe pain with an exaggerated inflammatory response. Discuss the following
   1. Identify 2 drugs that can be used concurrently to treat pain and inflammation that your patient can take at home and why?
   2. Briefly discuss on a cellular level how these drugs can mediate pain and the inflammatory response
   3. What would be the proper dosing of the drugs and why?
   4. Your patient is taking Xanax for anxiety, would this change any of your drug treatments? Why or why not?
   5. Identify a drug that can be used if the patient is in the hospital and needs greater pain relief – identify the route of administration

Answer 1

SOLUTION;

a.Patient can use both NSAID(Non steroidal anti inflammatory drug) and OPIODIS to treat the pain and inflammation.

But for the osteoporotic patient NSAID such as IBUPROFEN ,CELECOXIB, ACETAMINOPHEN etc are mostly recommended because the opioids have more side effects compared to the NSAIDS. OPIOIDS cannot be used in long term because of these side effects.

b.MECHANISM OF NSAIDS FOR REDUCING PAIN AND INFLAMMATION;

ARACHIDINOIC ACID $\huge \rightarrow$ PROSTAGLANDINS$\huge \rightarrow$ PAIN AND INFLAMMTION .This is the process normally occured in our body and here this arachidinoic acid is converted to prostaglandins by the enzyme cox-1 and cox-2 (cycloxygynase 1&2).The NSAIDS block the actions of the enzyme cox-1&2 .This action inhibits the prostaglandin synthesis.There bt reducing pain and inflammation. Prostaglandin is a lipid compound mainly causing pain and inflammation.

c.dose for celecoxib initially 400 mg and followed by 200 mg twice daily.dose for acetaminophen 325 mg should taken every four hour.

d.xanax (alprazolam) the patient can take with NSAID like acetaminophen and celecoxib,ibuprofen etc.Because there is no drug interaction between xanax and these drugs.So there is no need of drug change.

If the patient is taking opioids like morphine and tramadol for reducing pain then xanax should be avoided because this may cause serious side effects.

e.If the patient is in hospital and needs greater pain relief then opioids like morphine,tramadol,codeine etc can administered through intravenous route to get great pain relief.