Acetaminophen: Non-Opioid Analysis

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Acetaminophen is an non-opioid analgesic while ibuprofen is a non-steroidal anti-inflammatory drug (NSAIDs). Acetaminophen is an equipotent inhibitor of cyclooxygenase 1 and 2, while ibuprofen is more selective for cyclooxygenase 1 than 2. Although the mechanism of action of acetaminophen is unclear, it is generally believed to work the same was as ibuprofen. Ibuprofen and acetaminophen produce therapeutic effects by reversibly inhibiting cyclooxygenase and thus blocking the synthesis of proinflammatory prostaglandins, prostacyclins and thromboxanes from arachidonic acid. The effects of these prostanoids include lowering the pain threshold thereby exaggerating pain perception. Inhibiting the synthesis of these prostanoids increases the pain…show more content…
This makes ibuprofen the most suitable drug for treatment of inflammation and acetaminophen the preferred choice in treating pain. The drugs have a comparable onset of action and half-life, acetaminophen has a half-life of 2 hours while ibuprofen is 2 to 4 hours. Since ibuprofen is longer acting than acetaminophen it has a greater adverse effect profile compared to acetaminophen. In addition, ibuprofen has higher plasma protein binding than acetaminophen. Acetaminophen’s daily dose is 650 mg orally every 4 to 6 hours as needed with a strong recommendation not to exceed 3250 mg per day. Dosages of 200 mg/kg or 10 g per day can cause toxicity and lead to nephrotoxicity. In addition, acetaminophen is a common ingredient found in many over the counter medications, this increases the chances of a patient taking more than the recommended dose without realising. It is advisable to counsel a patient on avoiding other medications that contain acetaminophen. On the other hand, the ibuprofen dose is 400 – 800 mg orally every 4-6 hours and should not exceed 3,200 mg per day. Taking 400 mg/kg in a day can cause serious toxicity. Since acetaminophen has a safer GI profile, a patient can take it with or without food. Ibuprofen causes severe GI bleeding and ulceration and as a result it must be taken with food to avoid these adverse
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