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NSAID for sorethroat

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					NSAID for sorethroat
Things that we already
know
• Sore throats / URTI are self limiting
  illnesses
• Simple analgesics are helpful in the
  management of pain of sore throat
• NSAID appear to be more effective:
  • “The non-steroidal anti-inflammatory drug (NSAID)
    ibuprofen appeared to have immediate efficacy,
    reducing throat pain in adults by between 32% and
    80% relative to placebo after two to four hours, and
    70% at six hours.”
         − How effective are treatments other than antibiotics for acute
           sore throat
         − Thomas M. Del Mar C. Glasziou P.
         − British Journal of General Practice. 50(459):817-20, 2000 Oct.
Acute pain management:
  Scientific Evidence
• Second edition 2005
• Aus and NZ college of
  Anaesthetist and Faculty of
  Pain Medicine
Level I evidence

• Paracetamol is an effective
  analgesia for acute pain
• NSAIDs and COX2i are effective
  analgesics of similar efficacy
  for acute pain
• NSAIDs given in addition to
  paracetamol improve analgesia
Psychological Aspects
of pain
• Pain is an individual,
  multifactorial experience
  influenced by:
  •   Culture
  •   Previous pain events
  •   Beliefs
  •   Mood
  •   Ability to cope
Pain

• May be an indicator of tissue
  damage but may also be present in
  the absence of and identifiable
  cause
• The degree of disability in relation to
  the experience of pain varies
• There is individual variation in
  response to methods of pain relief.
Corticosteroids?

• Seems helpful in sore throats of
  bacterial pathogen and if used
  in conjunction with antibiotics
Gargles?

• No study found
• Commented as a home remedy
Applications

• Should we give treatments to
  self limiting illness?

• Depends on how much the pain
  is bothering.
• How much its affecting function.
• +/- expectation of patient (?)
PICO

•   Patients with sore throat
•   using NSAIDs to compare with,
•   Paracetamol
•   Resolution of sore throat
IFs

• IF the patient has presented
  with URTI and that pain is the
  main complaint, I’d consider
  using NSAID
AND…

• If the patient does not have any
  contra-indication
• If the patient is aware of the
  risk of GIB and agrees

				
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posted:7/28/2011
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