Is Ibuprofen a Cyclooxygenase Inhibitor?| How Does Ibuprofen Work, Know its Uses, Dosage, Side Effects, Contraindications

Ibuprofen is used as an NSAIDs since 1974 in USA. Ibuprofen was initially used in Europe since 1963 at lower dosage and was found to be well tolerated medication for pain relief. Later Ibuprofen was used for arthritis and joint pain. Non-steroidal anti-inflammatory medications are sub-classified in five groups. Propionic acid is one of the 5 subclass of NSAIDs medications. The following five anti-inflammatory medication (NSAIDs) are most often prescribed. These medications have chemical structure similar to propionic acid. Non-steroidal anti-inflammatory medications are sub-classified in five groups. Propionic acid is one of the 5 subclass of NSAIDs medications. The following five anti-inflammatory medication (NSAIDs) are most often prescribed. These medications have chemical structure similar to propionic acid. Medications classified as Propionic acid derivatives of NSAIDS are Ibuprofen, Ketoprofen, Naproxen, Oxaprozin and Fenoprofen.

Is Ibuprofen a Cyclooxygenase Inhibitor?

  1. Alternative Name of Ibuprofen

    The alternative name for ibuprofen is Advil and Motrin.

  2. Is Ibuprofen a Cyclooxygenase Inhibitor & How Does Ibuprofen Work?

    Mechanism of Action of Ibuprofen: Ibuprofen is used as an analgesic (anti-pain) and antipyretic (anti-fever). Ibuprofen is weak antipyretics and weaker than opioid as an analgesic. Ibuprofen inhibits the activities of cyclooxygenase (COX 1 and COX 2) enzyme preventing conversion of arachidonic acid to prostaglandin as well as formation of enzyme thromboxane. Decrease prostaglandin concentration secondary to inhibition of cyclooxygenase enzyme helps to reduce pain and fever as well as reduce the intensity of inflammatory reaction. Inhibition of cyclooxygenase enzyme causes decrease secretion of prostaglandin in stomach and intestine that follows decrease protection of mucosal membrane. The decrease protection of stomach and intestinal mucosa is often results in single or multiple ulcer formation.

  3. Ibuprofen Used for Treatment of Following Symptoms:

    Inflammation- The symptoms of inflammation is redness, heat, swelling and pain. Redness is caused increase blood flow and dilated blood vessels. Heat is also caused by increased blood flow and dilated blood vessels. Swelling is caused by fluid retention and tissue swelling. The swelling and prostaglandin irritates the peripheral receptors and nerve fibers that results in transmission of pain impulses. The cause of inflammatory changes is increased secretion of prostaglandin enzyme, thromboxane hormone and bradykinin. Ibuprofen decreases secretion of these chemicals by blocking cyclooxygenase enzyme that results in decrease of inflammation.

    Pain- Pain is also known as nociceptive pain. Pain is caused by irritation of pain receptors around inflamed tissue by swollen tissue as well as prostaglandin. Pain intensity is increased with tissue swelling and increase intensity of inflammation followed by increase secretion of prostaglandin as well as bradykinin secretion. Pain relief is immediate within few hours when cyclooxygenase enzymes are inhibited by ibuprofen resulting in decrease secretion of prostaglandin and bradykinin.

    Fever- The temperature is control by temperature center in brain. Prostaglandin resets the expected body temperature to higher setting and Ibuprofen resets the temperature from higher setting to normal setting. Higher temperature causes higher metabolism.

    Premedication Before Surgery For Post Op Pain- Ibuprofen and other NSAIDs have been studied and used as a premedication to achieve post op pain relief during immediate post op period following minor surgeries.

  4. Uses: Ibuprofen Used To Treat Following Diseases

    • HeadacheMigraine and tension headache;
    • Menstrual pain;
    • Arthritis– Juvenile idiopathic, Rheumatoid or osteoarthritis;
    • In premature baby suffering with patent ductus arteriosus;
    • Pain as well as inflammation caused by kidney and ureter stone.
  5. Dosage of Ibuprofen

    Ibuprofen is sold over the shelf in most pharmacies in the form of pills and syrup. The dosage advised is 10 to 15 mg per kg in pediatric cases and 600 mg to 2,400 mg in adult. The strength of pills is 200 mg, 400 mg and 600 mg. Similarly, liquid syrup is prep with concentration of 200 mg to 600 mg per 5 mls.

    Ibuprofen is tried at higher dosage and dosage varied between 100 mg / kgm and 400 mg/ kgm. The toxicity is rarely observed at dosage 100 mg / kgm and below.

  6. Duration of Action Ibuprofen

    Ibuprofen helps to relieve pain and fever. The duration of optimum effects after oral consumption of medication is 3 to 4 hours. The peak effect of Ibuprofen is observed after 2 hours.

    Side Effects Caused by Ibuprofen

    • Abdominal pain secondary to gastric and intestinal ulcer;
    • Gastric or intestinal bleeding from eroded surface of ulcer;
    • Dizziness;
    • Rash;
    • Bronchospasm;
    • Hypertension;
    • Constipation;
    • Tinnitus- ear ringing;
    • Nystagmus.
  7. Contraindications: Ibuprofen Is Avoided In Patient Suffering With Following Disease

    • Congestive heart failure and myocardial infarction;
    • Kidney failure;
    • Liver failure;
    • Metabolic acidosis;
    • Avoided in first tri-master;
    • Stroke;
    • Pemphigoid like blistering;
    • Avoided in individual who is consuming frequently alcohol.

References

  1. Effect of Premedication with Anti-inflammatory Drugs on Post-Endodontic Pain: A Randomized Clinical Trial.

    Braz Dent J. 2018 May-Jun;29(3):254-260. doi: 10.1590/0103-6440201801786.

  2. Jorge-Araújo ACA1, Bortoluzzi MC1, Baratto-Filho F2, Santos FA1, Pochapski MT1.

    Hypersensitivity Reactions to Nonsteroidal Anti-inflammatory Drugs in Children and Adolescents: Selective Reactions.

  3. J Investig Allergol Clin Immunol. 2015;25(6):385-95.

    Blanca-López N, Cornejo-García JA, Pérez-Alzate D, Pérez-Sánchez N, Plaza-Serón MC, Doña I, Torres MJ, Canto G, Kidon M, Perkins JR, Blanca M.

  4. Gastrointestinal damage by non-steroidal anti-inflammatory drugs: updated clinical considerations.

    Minerva Gastroenterol Dietol. 2014 Dec;60(4):255-61., Pellicano R1.

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