Page 213 - COMMUNITY PHARMACY PRACTICE
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02/04/2024
SOME COMBINATIONS……..: 430
¨ Many oral analgesics contain NSAIDs and\or paracetamol in
combination with caffeine and antihistaminic.
¨ There is some evidence to support that these adjuvants
ingredients increase analgesic efficacy. Other studies have failed
to demonstrate a benefit from these adjuvants.
¨ Caffeine may be used as central nervous system stimulant so it
will alleviate depression associated with pain.
¨ Antihistaminics have sedative effect, also their anticholinergic
decongestant effect appears to be useful during treatment of
tension headache.
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431
Contraindications!
• NSAIDs may decrease renal blood flow and glomerular
filtration rate as a result of inhibition of renal prostaglandin
synthesis.
• Consequently, increased blood urea nitrogen and serum
creatinine values can occur, often with concomitant
sodium and water retention.
• Advanced age, hypertension, diabetes, atherosclerotic
cardiovascular disease, and use of diuretics appear to
increase the risk of renal toxicity with ibuprofen use.
• Therefore, patients with a history of …….., or
diseases that compromise ……..should not self-
medicate with NSAIDs.
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