QuestionPrescription
QuestionComment
i'm a little confused. if paracetamol is ineffective then why not go up the pain ladder to co-codamol?
40053
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Dysmenorrhoea is usually treated with NSAIDs rather than opioids. They usually provide better pain relief hence mefenamic acid is prescribed in endometriosis as well :)
42998
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Suture Zygomatic
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aaaaa
QuestionComment
Hummm, Naproxen is prescribed as "Initially 500 mg for 1 dose, then 250 mg every 6–8 hours as required" according to the BNF for dysmenorrhea. 
40074
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Mary
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BNF states 3-4 times a day so why is QDS wrong?
40447
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Acute Hematoma
QuestionComment
why is tranexamic acid not accepted
40461
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for heavy bleeding, not pain 
61278
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H
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Sandeep 
QuestionComment
Why not ibuprofen 300mg?
43769
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Acute Botox
Concept
Chapter
2693
6070
Dysmenorrhoea
Topic
320
Obstetrics & Gynaecology
# Drug choice feedback

This patient presents with symptoms of primary dysmenorrhoea. Management of this condition if simple analgesia such as paracetamol is ineffective involves the use of nonsteroidal anti-inflammatory drugs (NSAIDs). If the patient does not wish to conceive, the combined oral contraceptive pill can also be considered, however this is not the case in the above scenario.

# Dose/Route/Frequency/Duration feedback

Each of these NSAIDs can be taken orally, and a short course has been prescribed so that the medication is only taken around the time of menstruation, which can last from 2 to 7 days.
18094
PrescriptionAnswer
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500 mg
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mefenamic acid 500 mg tablets
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2 weeks
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three times daily (TDS)
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oral (PO)
PrescriptionAnswer
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400 mg
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ibuprofen 400 mg tablets
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2 weeks
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three times daily (TDS)
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oral (PO)
Case Presentation: A 28-year-old presents to the GP complaining of severe pelvic pain around the time of menstruation. The pain is so severe it requires her to take time off work. This has been going on for several months and she takes regular paracetamol however the pain still persists. She is currently married and actively trying to conceive with her husband.


## PH

Eczema

## DH

Allergies - penicillin

## On examination

No cyanosis. Alert and orientated. Abdominal examination normal, with no palpable masses.

Temperature 36.9°C, HR 76, RR 12, BP 120/88, O<sub>2</sub> saturation 97% RA, GCS 15, Weight 64kg

## Investigations

Urine beta-HCG -ve

# Prescribing Request

Write a prescription for one drug that is most appropriate for managing this patient's symptoms.

