Pharmacology · single question
A patient with hepatitis B and a PAST history of opioid addiction needs pain management after dental surgery. What is the MOST appropriate choice?
Show answer and explanation
Correct answer: B. Acetaminophen + ibuprofen
Avoid all opioids in prior opioid use disorder. In hepatic disease, use acetaminophen cautiously; ibuprofen provides non-opioid analgesia.
- A. Tramadol acts on opioid receptors and has significant abuse potential — it should be avoided in patients with prior opioid use disorder.
- B. CORRECT. Acetaminophen (used cautiously at ≤2g/day in liver impairment) combined with ibuprofen provides effective non-opioid analgesia, avoiding addiction risk. This is the preferred analgesic combination when opioids must be avoided.
- C. Hydrocodone is an opioid — CONTRAINDICATED in a patient with past opioid addiction. Addiction history = avoid opioids.
- D. Oxycodone is an opioid — same concern as hydrocodone. Contraindicated in prior opioid use disorder.