Compare and contrast ibuprofen and tramadol as analgesic agents in intensive care.

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College Answer

Ibuprofen - inhibition of the cyclooxygenase (COX) and synthesis o fprostaglandins, which
are important mediators for peripheral sensitization and hyperalgesia. Act peripherally and
spinal COX - non selective. Oral and PR only Associated with a number of side effects,
including decreased haemostasis, renal dysfunction, gastrointestinal haemorrhage, and effects
on bone healing and osteogenesis

Tramadol - is a synthetic opioid that exhibits weak μ-agonist activity and inhibits reuptake of
serotonin and noradrenaline. Analgesic effects primarily through central mechanisms, it may
exhibit peripheral local anaesthetic properties.
Tramadol is comparable in analgesic efficacy to ibuprofen. Common side effects (overall
incidence of 1.6% to 6.1 %) include dizziness, drowsiness, sweating, nausea, vomiting, dry
mouth, and headache. Tramadol should be used with caution in patients with seizures or
increased intracranial pressure and in those taking monoamine oxidase inhibitors. IV and oral
preparations. No bleeding, GIT and renal complications. More expensive

Both have advantage of lack of respiratory depression, major organ toxicity, and depression
of gastrointestinal motility and a low potential for abuse.