Why is ibuprofen taken instead of tylenol?

[umharhar]

Hello I just started my first day at ob semester and I had a frustrating day ;(

I've made so many mistakes in one day already but this question I still don't know the answer to.

My instructor asked me why my patient is taking ibuprofen instead of tylenol. 

She is postpartum patient with no allergies and very stable.

My instructor got distracted by someone while she was asking me this and I didn't get to answer her (not that I even know the answer LOL). And I was afraid to ask her for the answer cuz she might say 'you should know this already'.

So I asked my classmates instead but none of them knew the answer...So that part I'm relieved that I'm not so dumb.

I tried to find the answer on lecture notes and book but I cant find anywhere.

Does any of you smart students know why its taken iNstead? Does it have to do with the fact that she's postpartum?

I wonder when I'm ever gonna stop feeling stupid in nursing classes.

[runtagua]

throwing this out there...

Tylenol has NO anti-inflammatory effects, ibuprofen does. Ibu is also a more effective analgesic because it inhibits prostaglandin synthesis and is also a Cox-2 inhibitor (so it's good for nociceptive pain).

so, pain relief and anti-inflammatory effects... relatively no side effects (compared with say the nausea effects of opioid drugs like Vicodin)... that's my guess.

Ibuprofen was the drug I asked for after my delivery. I didn't want the Vicodin they were trying to push on me.

[KAYBDT6, BSN, RN]

due to effect damage on the liver.

[runtagua]

That's another big reason, for sure.

[ShantheRN, BSN, RN]

I'm going with the first poster - being postpartum, the anti-inflammatory effects of ibuprofen would be beneficial. I've never had a baby but I'd assume the whole process would cause just a tad of swelling

If the patient is stable (and I'm assuming has no hepatic impairment) that's the only reason I can think of.

[BabyLady, BSN, RN]

I actually know the reason from personal experience.

Higher levels of Ibuprofen helps significantly with uterine bleeding...Tylenol does not.

I don't know the physiology as of why, but I do know it works per my OB GYN.

[rn/writer, RN]

The simple answer is that acetaminophen is an analgesic (a pain reliever) and an antipyretic (a fever-reducer), but it doesn't reduce inflammation. Ibuprofen is an analgesic, an antipyretic AND an anti-inflammatory medication. It reduces swelling by inhibiting the production of prostaglandins and is highly effective in those who tolerate it well.

Another consideration is that narcotics are often given to c-section patients or vag delivery patients who have had trauma (episiotomy, laceration, stitches) to the peri area. Many of the narcs we give contain acetominophen. PercoCET, DarvoCET. The CET comes from aCETominophen. So patients who are taking both ibuprofen and these narcotics ARE getting Tylenol as well as the ibuprofen. In fact, we have to keep close tabs on just how much Tylenol they are getting in a 24 hour period.

Finally, because of the prostaglandin inhibition, ibuprofen works small miracles on cramps. Postpartum cramping has a nasty habit of becoming more severe with each subsequent child. I've had grand multips tell me that the cramping after the birth (magnified greatly while breastfeeding) is worse than the labor pains before. They love their ibuprofen.

Hope this helps you give a well-understood answer to your instructor.

[ShantheRN, BSN, RN]

How does a NSAID help to curtail bleeding?

Anyone?

Anyone have a pharm book handy? LOL It's probably something easy that I'm not recalling at the moment.

Maybe....prostaglandins....don't they promote labor/contractions? Since ibuprofen blocks their production, maybe it helps the body recover faster?

I really need to give myself an A&P review

[ShantheRN, BSN, RN]

Oh! Rock on, I was partly right! :dncgbby:

[runtagua]

I don't think the NSAIDs help to curtail bleeding (in fact, I believe they thin the blood a bit, which is why they are avoided during pregnancy - especially in the last trimester).

I think the big points with the Ibu here is the anti-inflammatory action & prostaglandins.

The prostaglandin blocking definitely helps with the cramping, and maybe that somehow helps with the bleeding (makes sense), but I don't think the bleeding is the reason it's given. Does that make sense? LOL

[umharhar]

wow thanks guys i think i kinda got it...now i wanna ask my instructor to make clear what answer she wanted

but thank you so much!!! all your answers really helped!!!

[ShantheRN, BSN, RN]

Yeah it does....at least in my head LOL

It's given because it helps to stop the cramping, which would promote bleeding if it continued.

Or something like that