Compare and contrast the pharmacology of ibuprofen and paracetamol.
This was a standard compare and contrast question of common analgesic pharmacology and it
was generally well answered. The use of a table ensured all areas were covered including
class, indications, pharmaceutics, mode of action, pharmacodynamics, pharmacokinetics and
adverse effects. The uncertain nature (and possibilities) of the mechanism of action of
paracetamol was alluded to in better responses.
Details of the comparative pharmacokinetics were often lacking. Answers should have included
a comment on first-pass effect, the significance of the difference in protein binding and the
details of metabolism, particularly paracetamol. Metabolism limited to "hepatic metabolism and
renal excretion” gained no marks as better responses were more detailed and clearer about the
differences between the two drugs. Knowledge of metabolism at therapeutic doses and the
effect of overdose were expected. Better answers included potential interactions with other
drugs (e.g. warfarin) and contraindications to the use of these drugs.