A note from the author

Hello and welcome! I am so excited that you have found your way to my

rd
platform – Petite Pharmacist. My name is Angel and I am a current 3 year

Pharmacy student at the University of Queensland. The inspiration behind this

booklet stems from my passion in pharmacy and my desire for the general

public to have access to medicinal knowledge that is so prevalent in our

everyday lives. Happy studying!

As always, if you have any questions feel free to reach me via:

Instagram: @petitepharmacist

E-mail: [email protected]

YouTube: Petite Pharmacist

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Just a note…
• My notes only serve as GENERAL guidelines and are NOT a substitute for
your own clinical judgment. ALWAYS consult a professional health
practitioner before starting or changing a medicine.

• Every country has different rules and regulations for medicines. My booklet
will be based on medicines in Canada.

• Regarding dosing, I have only listed an example dose which does not apply
to every single medicine containing the same active ingredient. There may
be variations between different brands and dosage forms.

• My booklet is not a comprehensive guideline and does not contain all of the
information pertaining to that particular medicine. I have only listed common
examples and general information under each section.

• The field of medicine is rapidly evolving with new findings being discovered
on a regular basis. This book is written in January 2019 and effective until
that time. I cannot guarantee that my book will be applicable and relevant in
the future.

Useful abbreviations
Defn – definition
Sx – symptom
Tx – treatment
Hrs – hours
OTC – over the counter (medicines that doesn’t require doctor’s prescription)
Max – maximum; do not exceed
Tx – treatment
Yrs – years

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Pain
Background information
The sensation of pain serves as a protective mechanism to our bodies. For example,
if you touch a hot stove, your brain registers pain which causes you to withdrawal
your hand from the source of discomfort immediately.

Types of pain
Nociceptive pain
♦ Cause: activation of pain fibers by stimuli
♦ Example: burns, wounds, muscle injury

Neuropathic Pain
♦ Cause: injury affecting nervous system
♦ Example: spinal chord injury

Psychogenic pain
♦ Cause: psychological factors such as mental, emotional, or behavioral
♦ Example: headaches, muscle pain, stomach pain are common types

Acute pain
♦ Occurs suddenly and is not long lasting. Usually has a specific cause
such as damage to bones or muscles. Pain usually goes away when
underlying cause of pain is treated
♦ Example: surgery, labor or childbirth

Chronic pain
♦ Ongoing pain that is longer lasting than acute pain. May arise from injury
which continues after the underlying illness or injury has been addressed.
However, there may be no specific cause to the pain.
♦ Example: osteoarthritis

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Acetaminophen/Paracetamol

♦ Brand examples
o Tylenol, Panadol

♦ Indication
o Pain relief (1st line Tx for mild – moderate pain)
o Fever reduction

♦ Dose
o Regular strength Tylenol tablets (325mg acetaminophen)
§ Adults (>12 yrs)
• 2 tablets every 4-6 hrs while symptoms last
• Max 10 tablets in 24 hrs unless directed by doctor
§ Children (6-12 yrs)
• 1 tablet every 4-6 hrs while symptoms last
• Max 5 tablets in 24 hrs unless directed by doctor

♦ Counselling
o Can be taken with or without food
o At recommended dose, can be safely taken long term
o Duration depends on condition treated (acute VS chronic pain)
o Many cold and flu products contain acetaminophen. Do NOT take
any other medicines that contain acetaminophen at the same time

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NSAIDS (Non-Steroidal Anti-Inflammatory Drugs)

♦ OTC product examples

♦ Indication
o Pain relief associated with inflammation
§ Ex/ period pain, rheumatoid arthritis, toothache, headache
o Fever reduction

♦ Mechanism of action
o NSAIDs blocks cyclooxygenase (COX) enzymes which reduces
prostaglandin production
o Prostaglandins are chemicals that promote inflammation, pain and
fever. They also protect the stomach lining from stomach acid
damage and promote blood clotting

♦ Counselling
o Take with food (reduces risk of stomach upset)
o Can be taken with acetaminophen
o Only use ONE NSAID at a time (low dose aspirin is OK)
o For short term use only to reduce risk of side effects (unless
recommended by doctor)
o Consult health practitioner prior to use about your medical history,
especially if you have history of stomach ulcers, are taking blood
thinning or are taking steroid medicine

♦ Interactions
o Alcohol intake exceeding daily limit (consult doctor/pharmacist prior)
o Warfarin
o SSRIs used to treat depression (ex/ sertraline)

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Ibuprofen

♦ Brand examples
o Advil, Nurofen

♦ Indication
o Pain relief ex/ menstrual cramps, arthritis, toothache, backache
o Fever reduction

♦ Dose
o Advil normal strength tablets (200mg ibuprofen)
§ Adults (>12 years)
• 1 or 2 tablet every 4-6 hours while symptoms persist
• Max 6 tablets unless directed by doctor

Naproxen Sodium

♦ Brand examples
o Aleve, naproxen

♦ Indication
o Pain relief ex/ menstrual cramps, arthritis, toothache, backache
o Fever reduction

♦ Dose
o Aleve tablet (220mg naproxen sodium)
§ Adult (>12 years)
• 1 tablet every 8-12 hours as required. For first
dose, can take 2 tablets within the first hour
• Do not exceed more than 2 tablets in 12 hours
• Do not exceed more than 3 tablets in 24 hours

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Acetylsalicylic acid

♦ Brand example
o Aspirin, asproclear

♦ Indication
o Pain relief ex/ menstrual cramps, arthritis, toothache, backache
o Fever reduction
o Blood thinner: prevent blood clot and reduce chance of heart
attack

♦ Dose
o Regular strength Aspirin tablets (325mg acetylsalicylic acid)
§ Adults (>16 years)
• Used for anti-inflammatory pain relief
o 1 or 2 tablets every 4 hours as necessary
• Max 12 tablets per 24 hours
o Anti-platelet (blood-thinning)
§ Adults (>16 years)
• 100mg once daily
• can be used with other NSAIDs

♦ Counselling
o Should NOT be used in children <16 years
§ Associated with Reye’s syndrome

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Diclofenac

♦ Brand example
o Voltaren

♦ Indication
o Pain relief from especially areas affecting joint and muscle

♦ Dose
o Voltaren Emugel Original (Diclofenac Diethylamine gel 1.16%)
§ Adult (>16 years)
• Apply gel 3-4 times a day to painful or swollen area

♦ Counselling
o Wash hands after application to avoid accidental contact with
sensitive areas such as the eyes
o Do not use for more than 7 consecutive days unless
recommended by a doctor
o Do not apply where skin is cut, open or broken

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