Josefina is a 2-year-old child with acute otitis media and an upper respiratory infection. Along with an antibiotic she receives a recommendation to treat the ear pain with ibuprofen. What education would her parent need regarding ibuprofen

Josefina should be well hydrated before taken ibuprofen. She should take her medication with enough fluid, and drink plenty fluid afterwards.

Ibuprofen is a Cox-1 inhibitors. The class of drugs that blocks prostagladins secreation. In particular it blocks kidney prostaglandins secretion and therefore reduction in blood flow to the kidney. With the drop in renal blood flow, the homeostatic function of the kidney is affected, Glomerular filtration, tubular re-absorption and secretions are affected, thus water and electrolyte balance regulatory functions of the kidney are disrupted. With drop in fluid re-absorption back into the blood, the solute potential of the blood rises, leading to dehydration.

Therefore before and after taken this drug, enough fluid should be taken, to make up for the disruptions in the kidney water balance mechanisms as a result inhibitory effects of ibuprofen on renal blood flow, which causes dehydration.