A patient is taking 81 mg of aspirin daily to decrease MI risk ...

[maegan_martin]

A patient is taking 81 mg of aspirin daily to decrease MI risk and uses acetaminophen for mild osteoarthritis symptoms. For flare-ups of osteoarthritis pain, the primary care NP should prescribe:
 
  a. ibuprofen (Motrin).
  b. celecoxib (Celebrex).
  c. naproxen (Naprosyn).
  d. increasing the dose of aspirin.

Question 2

A patient with mild to moderate osteoarthritis pain has been taking acetaminophen for pain. The primary care NP prescribes a nonselective NSAID. At a follow-up visit, the patient reports mild GI side effects. The NP should:
 
  a. order misoprostol to take with the NSAID.
  b. discontinue the NSAID and order tramadol.
  c. change the medication to a COX-2 inhibitor.
  d. change the medication to naproxen (Naprosyn).

[nixon_s]

Answer to Question 1

C
Concomitant use of an NSAID with aspirin has been shown to reduce the cardioprotective effects of aspirin. However, naproxen does not appear to have this risk.

Answer to Question 2

A
If the patient experiences GI distress, coadministration of histamine-2 blockers, proton pump inhibitors, or misoprostol may be considered. Tramadol is used for severe pain. A COX-2 inhibitor is generally used for long-term therapy. Naproxen is another nonselective NSAID and would likely have similar GI side effects.

[maegan_martin]

TYSM

[kusterl]

Excellent