3 Oct 2023 • 'Stop Prescribing Etoricoxib!'🚨

'It is the most cardiotoxic NSAID, hence stop prescribing Etoricoxib permanently.'

In this session on Unlearning in Pharmacologic Management of Pain, Medflix superstar, Dr. Tushar Shah urges us to reevaluate our strategies to manage pain in clinical practice.

In fact, he tells us about the NSAID Garbage Bin, where in he wittily explains the various NSAIDs and their side - effects and tells us which NSAID according to him best deserves a place in the trash 🚮

But here's a sneak peek into the insights discussed by Dr. Shah regarding the commonly used medications for pain:

Paracetamol: Prescribe no more than 2g/day to patients with compensated liver diseases, chronic alcoholics, and frail elderly individuals.👵

Beware about prescribing paracetamol to patients taking warfarin as it can increase the blood levels of warfarin.🚨

NSAIDs: Doctors! Watch out!😨

NSAIDs can affect the gut and heart, particularly Etoricoxib which is infamously the most cardiotoxic NSAID.❤️‍🩹

What about Nimesolide?

Trash it! It is known to be the most hepatotoxic NSAID🚫

Alright, what about Diclofenac?

Nope! It has way too many GI side effects, and deserves to be in the garbage bin.🚮

However, Dr. Shah explains that drugs like Naproxen, Indomethacin, Mefenamic Acid and Ibuprofen are much safer than the previously mentioned NSAIDs.✅

To find out more, check out Dr. Tushar's NSAID Garbage Bin, featured in this session.

Gabapentinoids: Never ever prescribe a combination of Gabapentinoids and TCAs or a combination of Gabapentinoids and Opioids⚠️

It can be disastrous to the patient!

TCAs: Always remember to start very low doses and go slow, and note that the doses used for pain are very low compared to the doses used for depression.

Opioids: Don't wait for constipation!

Always give prophylactic laxatives while prescribing opioids.

As for cancer pain, opioids must be given round-the-clock rather than on demand.

And there's so much more to learn from Dr. Shah! Tune in now!🤗

Click here to access the replay of Unlearning in Pharmacologic Management of Pain by Dr. Tushar Shah right here on Medflix💛