Patient was educated on the side effects of using Ibuprofen as follows:
- Nausea and vomiting: This is the most common side effect of Ibuprofen. Taking the pain pill with some food and water can minimize the effects of nausea and vomiting.
- Dyspepsia and heartburn: Ibuprofen can cause irritation of the stomach with upper abdominal discomfort and heartburn.
- Gastric ulcers: Reduced synthesis of protective prostaglandins in the stomach, secondary to intake of Ibuprofen, can lead to increased exposure of the stomach lining to the action of gastric acid, leading to erosion of gastric mucosa and development of gastric ulcers.
- Anaphylaxis: A rare, but serious anaphylactic response can occur for Ibuprofen. Patients can present with extreme itching and rash, swelling of the face and throat, dizziness, bronchoconstriction, and difficulty breathing. This is an emergency and medical attention should be sought immediately, without any delay.
- Renal damage and hypertension: Renal prostaglandins help dilation of blood vessels in the kidneys and thereby, reduce the blood pressure. Ibuprofen inhibits the production of prostaglandins in all the tissues, including the renal. Inhibition of prostaglandin synthesis in the kidneys, result in vasoconstriction and elevated blood pressure. Constriction of the blood vessels in the kidney can contribute to reduced blood flow to the renal tissue. Reduced blood flow to the renal tissue can contribute to renal failure overtime. Also, renal prostaglandins help with elimination of sodium in the urine. Inhibition of prostaglandin synthesis in the kidneys by Ibuprofen leads to sodium retention in the body. Increased levels of sodium in the body contribute to elevated blood pressure.
- Chest pain and myocardial infarction: Ibuprofen can cause vasoconstriction in the coronary blood vessels, thereby, resulting in chest pain and myocardial infarction.
- Asthma and shortness of breath: In some individuals, use of Ibuprofen can lead to exacerbation of SOB with episodes of asthma and growth of nasal polyps. The reason for this response is unknown.
- Skin rash: Ibuprofen intake can result in photosensitivity and skin rash with blister formation.
- Edema and weight gain: Reduced renal function, secondary to Ibuprofen intake, can contribute towards compromise in filtration of blood, leading to reduced formation of urine and fluid back up in the body. Increased fluid volume in the circulation can result in further elevation of blood pressure. Fluid accumulation in the body outside the circulation can result in edema and weight gain.
- Central nervous system findings: Ibuprofen use can sometimes result in severe dizziness, confusion, and hallucinations.
- Hepatic damage: Ibuprofen intake can lead to hepatic injury, thus compromising liver function. Hepatic injury and altered liver function can result in increased bilirubin levels in the body, resulting in itching, jaundice with yellowing of skin and sclera, dark urine, altered metabolism with nausea and vomiting, pain in the right upper abdominal quadrant, and fatigue.
- Ringing in the ears and hearing loss: Ibuprofen can sometimes result in ringing in the ears and hearing loss, especially, when taken with Lasix.
