ANNOUNCEMENT: Minor Ailment Prescribing Templates are now available along with several other practice tools, free with your subscription to the Cue Cards! Check them out in the same place you would normally find the Counselling Cue Cards, only in a different folder.
Benefits:
-Fully customizable MS Word documents
-Structured to show your work, assess, prescribe, and bill, all in one template
-No hard stops like software; use your full clinical judgement
-Get your staff involved; print our patient screening questionnaires to streamline workflow
-Automatic dating to today's date
-Clickable check boxes
-ODB and IA medication coverage built-in
-Compounded options also listed
-Thorough yet no fluff
Now for this week's newsletter!
We know not to mix NSAIDs, but what about ASA?
Click here for previous newsletters.
1. Counselling Conundrum: a real question from a patient
2. Concise Conclusion: a straight-forward patient-friendly answer
3. Quick Wrap-up
Clearly, there are nuances that may not be captured in this format. The goal here is to provide you with helpful counselling tips which often draw from multiple sources or those which are not commonly accessed by busy healthcare providers serving the community.

Counselling Conundrum: "My Nurse Practitioner said it's ok to take ibuprofen even though I'm taking ASA 81 mg daily, but on the bottle it says not to. What gives?"
Concise Conclusion: If your Nurse Practitioner has told you your risk for bleeding is low enough, ibuprofen will be fine. On the bottle it says that because anti-inflammatory medications like ibuprofen can increase your risk of bleeding. One important note: make sure to take your ASA about 1 hour before taking the ibuprofen (or 8 hours after taking ibuprofen), as the ASA will not work as well otherwise.
Quick Wrap-up: Two-for-one here; bleed risk with NSAIDs and also ASA function DI with NSAIDs. We have found the latter to be frequently overlooked: ASA irreversibly binds COX-2, which does not occur if another NSAID is already bound to it. Studies have also shown an increase in all-cause mortality in patients at high risk with this drug interaction, so in our practice we recommend separating ASA from other NSAIDs.
Dive Deeper
We hope you have found this useful. Would appreciate your reply to this email with any feedback or topic suggestions you can; it will be the key to making this newsletter the best it can be.
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