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James Smith, 45 years old, is new to your practice. This is your first meeting with him, and you would like to ask him

 

James Smith, 45 years old, is new to your practice. This is your first meeting with him, and you would like to ask him some questions regarding his medication/health history. During the course of your conversation you learn that he has a history of coronary heart disease and is currently taking a baby aspirin each day. He takes acetaminophen for general aches and pains. He also likes to have a glass of wine with dinner each night and does not mind a few beers when he is watching football. During the course of his examination you and the dentist find two cavities, which are filled that day. Mr. Smith is experiencing some mild pain after the procedure. 1. What is the rationale for using acetaminophen instead of an NSAID to treat Mr. Smith's pain? 2. What dose and duration of therapy should be recommended for Mr. Smith? 3. At what doses does hepatotoxicity occur with acetaminophen? 4. How can Mr. Smith avoid acetaminophen toxicity? 5. Compare and contrast acetaminophen to aspirin in terms of pharmacology, adverse effects, and therapeutic effects. 6. What is the role of aspirin in the prevention of heart attack or stroke? 7. Are any dental concerns associated with low-dose aspirin? 8. Can Mr. Smith take a drug like ibuprofen? 9. What should be said to Mr. Smith during a counseling session regarding acetaminophen?

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