NONSTEROIDAL ANTI-INFLAMMATORY DRUGS

Brief History. D.B., a 38-year-old man, began to develop pain in his right shoulder. He was employed as a carpenter and had recently been working long hours building a new house. The increasing pain required medical attention. A physician evaluated the patient and diagnosed subacromial bursitis. The patient was referred to physical therapy, and a program of heat, ultrasound, and exercise was initiated to help resolve this condition. Problem/Infl uence of Medication. During the initial physical therapy evaluation, the therapist asked if the patient was taking any medication for the bursitis. The patient said the physician advised him to take aspirin or ibuprofen as needed to help relieve the pain. When asked if he had done this, the patient said that he had taken some aspirin once or twice, especially when his shoulder pain kept him awake at night. When he was asked specifi cally what type of analgesic he had taken, he named a commercial acetaminophen preparation.

Questions to Consider

1. How does acetaminophen differ from NSAIDs such as aspirin and ibuprofen, and why is this difference important in this case?

2. What should the therapist tell D.B. about taking over-the-counter pain medications?