Use of ibuprofen in unusual circumstances

The clinical pharmacology of ibuprofen (Motrin, Upjohn) in relation to the pathophysiologic aspects of various diseases is explained. An understanding of prostaglandin's numerous effects can help the clinician to expand the use of ibuprofen (as in Barttern's syndrome) and to exercise caution as warranted, as when treating patients with renal disease. Knowledge of ibuprofen's clinical pharmacology may also enable practitioners to prescribe the drug rationally in situations not well represented in the literature, as in the elderly or in individuals with bleeding diatheses or severe liver disease. The use of ibuprofen in multiple-drug therapy with aspirin, warfarin, phenytoin, digoxin, or lithium is explored. Perusal of the literature enables the clinician to gain an awareness of patient subpopulations warranting careful use of medication, including the elderly or individuals with systemic lupus erythematosus, mixed connective tissue disease, or aspirin-induced asthma.