From the FDA Drug Label
DOSAGE AND ADMINISTRATION Carefully consider the potential benefits and risks of ibuprofen tablets and other treatment options before deciding to use ibuprofen tablets. Use the lowest effective dose for the shortest duration consistent with individual patient treatment goals [see WARNINGS] Mild to moderate pain: 400 mg every 4 to 6 hours as necessary for relief of pain. In controlled analgesic clinical trials, doses of ibuprofen tablets greater than 400 mg were no more effective than the 400 mg dose
The patient is requesting ibuprofen 800mg for pain relief, but according to the drug label, the recommended dose for mild to moderate pain is 400 mg every 4 to 6 hours. Since the patient's condition is not explicitly stated as severe, the recommended dose of 400 mg should be considered. However, the patient's request for 800mg is within the maximum daily dose of 3200 mg, and the drug label does suggest that 800 mg can be used for certain conditions. Given the patient's situation, a conservative approach would be to consider the 400 mg dose, but the decision ultimately depends on the physician's assessment of the patient's needs 1.
From the Research
I strongly recommend proceeding with COVID and flu testing as requested for preoperative clearance, and scheduling an ultrasound to evaluate the abdominal "popping" sensation before the patient's general surgery follow-up, as this will help identify any potential issues that may impact surgical planning or recovery, such as a hernia or other abdominal wall defect, as suggested by the study published in the Radiologic clinics of North America 2. The patient's symptoms, although not accompanied by pain or constipation, warrant further investigation given the upcoming gallbladder surgery. The use of ultrasound as the initial imaging modality is supported by the study published in the Journal of ultrasonography 3, which highlights its pivotal role in the management of abdominal pathology. For the jammed finger, ibuprofen 800mg can be provided, to be taken every 8 hours with food as needed for pain, not exceeding 2400mg daily, as it will help reduce both pain and inflammation, as is standard practice for such injuries. It is essential to advise the patient to use the minimum effective dose for the shortest duration needed and to report any worsening symptoms or limited mobility that might indicate a more serious injury requiring additional evaluation. The patient's previous surgery postponement due to influenza infection underscores the importance of confirming she is infection-free before proceeding with the gallbladder procedure, as emphasized by the comprehensive review of gallbladder disorders published in Disease-a-month : DM 4. Overall, prioritizing the patient's safety and the success of the upcoming surgery is crucial, and these recommendations are made with the goal of minimizing morbidity, mortality, and improving quality of life.