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Pharmacology · single question

What is the MOST appropriate analgesic prescription for moderate pain following extraction of third molars?

  1. Ibuprofen 400mg + acetaminophen 325-500mg (combination)
  2. Hydrocodone/acetaminophen (Vicodin) as needed
  3. Tramadol alone
  4. Oxycodone 5mg as needed
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Correct answer: A. Ibuprofen 400mg + acetaminophen 325-500mg (combination)

  • A. Correct. Current evidence-based recommendations for moderate dental pain favor the COMBINATION of ibuprofen + acetaminophen over opioids. This combination provides synergistic analgesic effect through different mechanisms (COX inhibition + central analgesia) with fewer side effects than opioids. Standard dosing: ibuprofen 400mg + acetaminophen 325-500mg every 6-8 hours.
  • B. Hydrocodone/APAP is an opioid combination — not first-line for moderate post-extraction pain.
  • C. Tramadol is a weak opioid — not recommended as first-line for moderate dental pain.
  • D. Oxycodone is an opioid — should not be first-line for moderate post-extraction pain.

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