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Nurofen plus

M J Blackstock, A Lee
Nurofen Plus is a common analgesic containing ibuprofen and codeine. We present a case of a 38-year-old lady who developed renal tubular acidosis with severe hypokalaemia, after chronic abuse of Nurofen Plus tablets. She presented with confusion and profound biochemical abnormalities requiring critical care admission for electrolyte replacement. Ibuprofen causes renal tubular acidosis due to its effects on carbonic anhydrase activity.
2012: Case Reports in Critical Care
David Ernest, Michelle Chia, Carmela E Corallo
We report an unusual and emerging cause of profound hypokalaemia associated with a severe myopathy, attributable to misuse of Nurofen Plus, a readily available over-the-counter medication containing ibuprofen and codeine, and excessive ingestion of the caffeine-containing energy drink, Red Bull. The mechanism of the hypokalaemia may be ascribed to ibuprofen-mediated type 2 renal tubular acidosis, and caffeine-mediated antagonism of adenosine receptors or intercompartmental shift of potassium into the intracellular space...
June 2010: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
Martin J Dutch
Over a 6-month period, two patients presented to a community hospital emergency department with perforated gastric ulcers as the result of recreational misuse of over-the-counter ibuprofen-codeine preparations. Misuse of these medications appears to be an emerging cause of significant morbidity in patients with codeine addiction.
January 7, 2008: Medical Journal of Australia
A Paul Lambert, Colin Close
No abstract text is available yet for this article.
January 2005: Journal of the Royal Society of Medicine
B T Dyer, J L Martin, J L Mitchell, N C Sauven, B Gazzard
Ibuprofen abuse may be more prevalent than generally considered. Although normally benign, serious complications have been documented. We report an unusual presentation of hypokalaemia and its associated symptoms as a result of Nurofen Plus (200 mg ibuprofen + 12.8 mg codeine phosphate) abuse. Ibuprofen is generally not included in a standard toxicology screen, but should be considered as a rare cause of hypokalaemia.
November 2004: International Journal of Clinical Practice
R Chetty, Y Baoku, R Mildner, A Banerjee, D Vallance, A Haddon, M Labib
Nephrotoxicity from non-steroidal anti-inflammatory drugs (NSAID) is well recognized. We report a case of severe hypokalaemia and weakness due to renal tubular acidosis in a young woman who was taking 40-60 tablets per day of Nurofen Plus (ibuprofen 200 mg and codeine phosphate 12.8 mg). Proprietary brands of ibuprofen are freely available to the public and those containing codeine may be potentially subject to abuse. This case highlights the need to be aware of this potential and of the life-threatening electrolyte and acid-base disturbances that might be encountered with the widespread availability of these types of NSAID...
July 2003: Annals of Clinical Biochemistry
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