title: Pharmacist's evolving role in the nonopioid, over-the-counter, analgesic selection process.
abstract: The pharmacist provides an integral role in pain management and treatment by focusing on the selection and evaluation of analgesic agents in a process that is patient specific, patient focused, and patient centered in a personalized care plan. Counseling patients (and the families of patients) who are using acetaminophen, aspirin, and/or nonsteroidal anti-inflammatory drugs for acute musculoskeletal pain and inflammation regarding the appropriate use of these agents is a key component of the pharmacist's overall pharmacotherapeutic role. This article reviews the importance of explaining the therapeutic and nontherapeutic effects of these agents, cautions, contraindications, dosing parameters, and the avoidance of acetaminophen/aspirin and multiple nonsteroidal anti-inflammatory drug use to patients and prescribers. The article also discusses the need to evaluate the cytochrome P450 system and the patient's pharmacotherapy and comorbid disease history to identify potential drug-mediated interactions. Evaluation of patients for comorbidities, allergies, and gastrointestinal, renal, hepatic, hematologic, and cardiovascular risks is also addressed, as are essential laboratory tests and the special needs of elderly patients.
authors.affiliation: Departments of Anesthesiology, Pharmacology, and Family Medicine, Rush Medical College, Rush University Medical Center, Chicago, IL; and Pain Centers of North Shore University Health System, Department of Anesthesiology, Skokie Hospital, Skokie, IL; and Evanston Hospital, Evanston, IL.
authors.forename: Robert L
authors.initials: RL
authors.lastname: Barkin
mesh_terms: D000082:Acetaminophen / Q000627:therapeutic use; D000700:Analgesics / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use; D003376:Counseling; D006801:Humans; D004366:Nonprescription Drugs / Q000627:therapeutic use*; D010595:Pharmacists; D024382:Professional Role; D012017:Referral and Consultation
chemical_list: D000700:Analgesics; D000894:Anti-Inflammatory Agents, Non-Steroidal; D004366:Nonprescription Drugs; D000082:Acetaminophen; D001241:Aspirin