Pain-mediated altered absorption and metabolism of ibuprofen: an explanation for decreased serum enantiomer concentration after dental surgery.

摘要: Aims Rapid onset of analgesia is essential in the treatment acute pain. There evidence that conditions stress cause delayed and decreased pain relief from oral analgesic products through impaired absorption. The aim was to determine effect surgery for removal wisdom teeth on plasma concentration-time profile ibuprofen enantiomers. Methods Racemic ibuprofen, 200 mg one group (n=7) 600 mg another administered 1 week before (control) again after (test) surgical teeth. Serum concentrations enantiomers were measured 6 h. Results During control phase, S- R-ibuprofen within suggested therapeutic range. Surgery resulted a 2 h delay mean time peak concentration, significant decreases serum concentration following both doses, fall sub-optimal dose. During first 2 h dose, dental extraction reduction area under drug (AUC (0, 2 h) mg l−1 h) 5.6±2.9 1.6±1.8 (P<0.01) 5.5±3.0 2.1±2.0 (P<0.05) S R-ibuprofen, respectively. Similar observations made dose AUC 2 h) S-ibuprofen (from 14.2±6.1 7.2±5.5 mg l−1 h, P<0.05) with no difference 14.4±9.5 5.8±7.1). 6 h) also significantly reduced by surgery. pattern stereoselectivity reversed such enantiomer predominant phase but not post-surgery which suggestive metabolic chiral inversion. Conclusions Surgery tooth substantial prolongation concentration. Reduced absorption altered metabolism are likely these changes. Thus, patients may experience response possible failure when taking Our observation have implications other diseases.