Ibuprofen headache

Less severe pain states (e.g., arthritis, menstruation, headache, minor surgery) are commonly treated with nonselective NSADDs (e.g., aspirin, ibuprofen, indo-methacin, diclofenac). NSAIDs are mostly used orally. 

This drug is available to individuals as an over-the-counter drug and may be purchased without a prescription. The drug is used in children with juvenile arthritis and for fever reduction in children 6 months to 12 years. Common adverse reactions seen with ibuprofen include headache, dizziness, somnolence, nausea, dyspepsia, gastrointestinal pain, and rash. 

A 28-year-old healthy woman seeks your advice. She is about to leave on a 7-day Caribbean cruise and is concerned about motion sickness. She recently experienced nausea and one episode of vomiting while on a sailboat on Lake Michigan for an afternoon. She is not allergic to any medications. She does not smoke and only occasionally drinks alcohol. She takes an oral contraceptive (ethinyl estradiol and norgestimate) and occasional ibuprofen for headaches. 

Antacids as needed for heartburn, ibuprofen as needed for headache... 

Ibuprofen 400 mg prn headache (uses approximately once weekly)... 

Indometacin, which is a non-steroidal anti-inflammatory drug, inhibits the enzyme cyclo-oxygenase implicated in inflammatory reactions. Indometacin is more effective as an anti-inflammatory agent than ibuprofen and tends to have a higher side-effect profile, including headache, diarrhoea and gastrointestinal disturbances. Rectal administration reduces but does not prevent gastrointestinal tract disturbances. 

CNS Dizziness (mefenamic acid, meloxicam, piroxicam, flurbiprofen, diciofenac, fenoprofen) headache (ketorolac, fenoprofen, indomethacin, diclofenac, flurbiprofen, meclofenamate, meloxicam, nabumetone, naproxen, tolmetin, ketoprofen, sulindac, celecoxib, mefenamic acid, piroxicam, ibuprofen) somnolence/drowsiness (fenoprofen, naproxen) asthenia (tolmetin, etodolac) malaise (etodolac) fatigue (indomethacin) insomnia (meloxicam). Dermatologic Rash/dermatitis, including maculopapular type (ibuprofen, sulindac, meclofenamate, oxaprozin, nabumetone, mefenamic acid, meloxicam) desquamation angioneurotic edema ecchymosis petechiae purpura alopecia pruritus (nabumetone, naproxen) eczema skin discoloration hyperpigmentation skin irritation peeling skin eruptions (naproxen). 

Naproxen (Naprosyn) also has pharmacological properties and clinical uses similar to those of ibuprofen. It exhibits approximately equal selectivity for COX-1 and COX-2 and is better tolerated than certain NSAIDs, such as indomethacin. Adverse reactions related to the GI tract occur in about 14% of all patients, and severe GI bleeding has been reported. CNS complaints (headache, dizziness, drowsiness), dermatological effects (pruritus, skin eruptions, echinoses), tinnitus, edema, and dyspnea also occur. 

Clinical use Ibuprofen (Busson, 1986) is a nonsteroidal anti-inflammatory drug, commonly used for the treatment of mild to moderate pain. It is used in conditions like rheumatoid arthritis, osteoarthritis, joint and soft tissue pain, dental pain, postoperative pain, dysmenorrhoea and headache, including acute migraine attacks. 

Many headache medications also contain caffeine, which can increase the effectiveness of the other drugs that alleviate both tension and migraine headaches. People who get migraines can have their headaches controlled by pills that combine caffeine with aspirin or acetaminophen. A study in 2000 showed that the effect of caffeine also increases the effectiveness of ibuprofen. 

Sparano, Nicole. Is the Combination of Ibuprofen Plus Caffeine Effective for the Treatment of Tension-type Headache Journal of Family Practice 50 (January 2001) 312-319. 

In 1992, BASF opened a 35 000 tons per year ibuprofen production plant in Bishop, Texas. This plant was the result of the elegant green chemistry route developed by the BHC consortium. The clean synthesis of ibuprofen is an excellent example of how combining catalysis and green chemistry can yield both commercial success and environmental benefits. Ibuprofen is a nonsteroidal, anti-inflammatory painkiller. It is a popular over-the-counter drug against headache, toothache, and muscular pains. You may know it better as Advil , Motrin , or Nurofen. 

The synthesis of ibuprofen will now be used as an example of the determination of atom economy (see Cann, 2000). This synthesis results in rather small amounts of unwanted by-products, thus lessening the need for disposal and remediation of waste products. Ibuprofen is widely used for the relief of headache (including migraine). It is marketed as an analgesic agent for general pain conditions that arise from various injuries. The synthetic route commonly used is shown in Figure 12.13. 

A review of certain chemicals is essential. Ethylene glycol is an antifreeze used for gasoline engines and may produce somnolence, imreactive pupils, disc swelling, and kidney failure. Systemic lead poisoning produces headaches, coma, cranial nerve palsies, and papilledema. Wood alcohol, or methanol, may produce severe toxic neuropathy and disc edema. Drugs known to produce toxic optic neuropathy include amiodarone (an antiar-rhythmic), quinine, aminoquinolines, ibuprofen, ethambutol, isoniazid, and chloramphenicol. 

Nonsteroidal anti-inflammatory drugs (NSAIDs) are helpful for early and mild headache. NSAIDs include acetaminophen, ibuprofen, naproxen, and others. A recent study concluded that a combination of acetaminophen, aspirin, and caffeine could effectively relieve symptoms for many migraine patients. One such over-the-counter preparation is available as Exedrin Migraine. 

Packman, B. Packman, E. Doyle, G. Cooper, S. Ashraf, E. Koronkiewicz, K. Jayawardena, S. Solubilized ibuprofen evaluation of onset, relief, and safety of a novel formulation in the treatment of episodic tension-type headache. Headache 2000, 40 (7), 561-567. 

Hypersensitivity reactions are uncommon, but they can be severe. Aseptic meningitis, hjrpotension, fever, conjunctivitis, arthralgias, and leukopenia were reported in a woman with systemic lupus erythematosus (2). Other similar patients have experienced fever with rashes, abdominal pain, headache, nausea and vomiting, signs of liver damage, and meningitis. This type of reaction seems to occur especially (but not exclusively) in patients with connective tissue diseases (SEDA-5,105) (SEDA-10, 84) and it can be difficult to differentiate between a hypersensitivity reaction and a flare-up of the disease. Ibuprofen can provoke bronchos-pasm and anaphylaxis in asthmatics (SEDA-22,116). 

NSAIDs cause headaches and confusion in a relatively small number of patients. Headache and dizziness are common with indometacin, and it has been suggested that its chemical similarity to serotonin, which can cause severe headaches, may be responsible (37). Headache due to long-term use of ibuprofen has been reported in children (38,39). 

Tension headaches are initially treated with analgesics such as aspirin, acetaminophen, or nonsteroidal anti-inflammatory agents such as ibuprofen or naproxen. If these agents are ineffective, combination products such as those composed of acetaminophen/caffeine/butalbital may be effective. Amitriptyline is the agent most commonly used for headache prophylaxis in patients with recurrent symptoms. 

A 46-year-old woman is prescribed doxycycline for a diagnosis of community-acquired pneumonia. Her PMH is significant for iron-deficiency anemia, peptic ulcer disease, HTN, a recent DVT, and headaches. Her current medications include ferrous sulfate, ibuprofen, enalapril, acetaminophen, famotidine, and warfarin. Which of her following medications is most likely to result in decreased levels of doxycycline ... 

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