Which of the following may be recommended to reduce bronchial inflammation in a 12-year-old child with cystic fibrosis?
a. High-dose ibuprofen
b. High-dose acetaminophen
c. High-dose naproxen
d. High-dose corticosteroids
A
High-dose ibuprofen is recommended in children and young adolescents with mild CF who have good lung function (an FEV1 >60% predicted) and no contraindications (e.g., gastrointestinal bleeding or renal impairment). Ibuprofen has been shown to reduce bronchial inflammation without hindering bacterial clearance—resulting in the decline of the patient's FEV1 per year—with no remarkable side effects except painless gastrointestinal bleeding in 1% to 2% of patients. High-dose ibuprofen is thought to work by decreasing neutrophil migration and inflammation in the lungs. The initiation of ibuprofen is not recommended after the age of 13 years.
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