Medicaton Comparisons, Questions

1. Acetaminophen vs. ibuprofen: Which do you prefer for analgesia? For fever reduction?

EML Medication Comparisons Questions2. PPIs vs. H2 Blockers: Which is your first choice for GERD/gastritis?

3. Meclizine vs. benzodiazepenes: Which do you prescribe for vertigo?

4. Calcium channel blockers vs. beta blockers: which is your first choice for rate control in atrial fibrillation?

Medication Comparisons poster

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5 Responses to Medicaton Comparisons, Questions

  1. justinhensleymd says:

    1. Either if dosed appropriately. Depends on patient. NSAID if h/o liver problems, Tylenol if gastritis problems.
    2. H2, faster onset, etc
    3. Meclizine, I don’t have a reason for this. Great, now you’ve made me look something up.
    4. CCBs. Then dig load.

  2. pbafuma says:

    1) either, though slight edge to ibuprofen for both. nsaids for liver dz, tylenol for kidney dz. if gastritis, i give it with some food.
    2) H2
    3) Ive been trying to look this up myself this week, which is why im writing. i cant find anything after 1990 on meclizine for vertigo. personal experience is zofran / valium / IVF. if abnormal HINTS testing or intractable, they come in.
    4) CCB for me. though cards tells me to give whatever theyve been on (ie, if on beta blockers, stick with beta blockers). I get where cardiology is coming from, but cant find liton this.

  3. GMete says:

    1. I like Ibuprofen. Lasts longer, seems to perk the kids up a bit better so they take more fluid. I try to discourage using both.
    2. I like H2′s for nocturnal break-thru symptoms. PPI’s don’t work as well during fasting.
    3. Meclizine is less sedating
    4. CCB

  4. Eric a says:

    1. Both – if I have to pick, ibuprofen

    2. H2 blocker – cheaper, very effective, can be upgraded to ppi if fail h2 as outpatient.

    3. Benzo, and consider dopaminergic. Meclizine only supposed to work in bppv, even then, if it fails you go to the others. And evidence for me closing is weak.

    4. Ccb has a bit better rate control. Try bb it’s if pt already on it or concomitant ACS.

  5. scottyruben says:

    1. In reality either/or will work with the caveats already mentioned. However, when using NSAIDs remember to think about their classes. Have you ever heard, “Motrin/Toradol/etc doesn’t work for me”? There are different classes and some people, for whatever reason, will respond better to one versus the other.

    2. H2, it cheaper.

    3. typically use meclizine for no real reason except I was told so by a neurologist. but I have no problem using a benzo.

    4. CCB

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