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1. Why a Prescription Medication Might Be Prescribed

A doctor may prescribe a drug when the benefits for managing a specific
health problem outweigh the risks of possible side‑effects.

Common reasons include:

Condition Typical Medication Class Key Benefit

High blood pressure ACE inhibitors, ARBs, calcium‑channel blockers Lowers blood pressure, reduces risk of stroke
& heart attack

Type 2 diabetes Metformin, GLP‑1 agonists, insulin Controls blood sugar levels, prevents complications

Chronic pain (e.g., osteoarthritis) NSAIDs, tramadol, opioids (short‑term use)
Relieves pain and improves mobility

The prescribing doctor evaluates your overall health, other medications you’re taking, and any risk factors before
choosing a drug.

—

2. Why doctors prescribe specific medicines

Reason Example

Targeted effect A beta‑blocker lowers blood pressure by blocking β‑adrenergic
receptors; it wouldn’t work if you took an antihistamine instead.

Side‑effect profile Some patients cannot tolerate certain drugs (e.g., liver disease → avoid NSAIDs).

Drug interactions Avoid giving warfarin with aspirin because both
increase bleeding risk.

Patient compliance A once‑daily medication is easier to remember than a drug that must be
taken three times per day.

Thus, «any medicine» does not guarantee the desired outcome; using the wrong type of
medicine can leave symptoms untreated or cause harm.

—

2. Why Paracetamol (Acetaminophen) Is Often Recommended
for Fever

Property Paracetamol Aspirin / NSAIDs

Analgesic / antipyretic potency High Moderate–high (depends on dose)

Side‑effect profile in children & adults Very
low at therapeutic doses; hepatotoxic only with overdose or chronic misuse.
Gastric irritation, ulcers, bleeding, nephrotoxicity; severe hypersensitivity reactions; Reye’s syndrome
in kids recovering from viral infections (especially
when combined with viral illness).

Drug interactions Minimal; can be safely combined with many other drugs.
Interacts with anticoagulants, steroids, etc.; additive GI effects.

Contraindications Rare; only severe liver disease or
allergy to NSAIDs. Avoid in patients with peptic ulcer disease,
bleeding disorders, chronic kidney disease, asthma (COX-2 selective).

Clinical evidence Numerous RCTs and systematic reviews confirm
efficacy in pain relief, fever reduction, anti‑inflammatory effects.
Evidence for safety in children is limited; many
guidelines recommend avoiding ibuprofen in certain populations.

—

4. Clinical Recommendations

A. For the Present Case (Adult with Fever & Pain)

Step Action

1. Confirm diagnosis of acute pain/fever (e.g., viral infection, musculoskeletal).
Physical exam + basic labs if indicated.

2. Initiate ibuprofen 400‑600 mg PO every 6–8 h as needed.
Start with lowest effective dose; monitor for GI upset or other side effects.

3. Assess response after 4–6 hrs. If pain/fever persists,
consider increasing to 800 mg (max 2400 mg/day) but do not exceed two tablets per
dose if >400 mg.

4. Monitor for adverse events: abdominal pain, GI bleeding, dizziness.
Advise patients on taking with food or antacid if needed.

5. If inadequate control after 24–48 hrs
at maximum dose OR side effects develop, consider NSAID (e.g.,
ibuprofen) or acetaminophen if contraindicated for aspirin therapy.

2B. High‑Dose Aspirin (≥1000 mg/day) – e.g.,
secondary prevention in a patient with known coronary artery disease.

Step Action

1 Start at lowest therapeutic dose that provides adequate platelet inhibition, typically 81–325 mg PO daily.

2 Assess response after 4–6 weeks: 48 h Balances
bleeding vs thrombosis risk Is the patient undergoing major surgery?

5. Document and communicate Ensure all team members are aware of
anticoagulation status Prevents medication errors Have we updated the EMR and
communicated to the surgical team?

—

How This Helps You

Clear, actionable steps for each phase (initiation, monitoring, adjustment, reversal).

Evidence‑based recommendations that are simple to remember.

A checklist format so you can quickly confirm compliance
during busy shifts.

Feel free to adapt the table or incorporate it into your hand‑off sheets
and patient charts. This structure will keep you organized and confident when managing anticoagulated patients in the hospital
setting.

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