“It’s Just OTC”—The Pain-Medication Conversation Every PA Student Should Practice

A patient says, “I haven’t taken any medications.”

Then, a few questions later: “Well, some ibuprofen. And something for my cold. But those don’t count, right?”

That is exactly where an important conversation begins.

Over-the-counter medicines count. And for PA students and practicing PAs, asking about them deserves the same attention we give to the prescription list.

A timely conversation in PA practice

In an October 29 report, AAPA shared insights from a discussion group of 12 PAs about non-opioid pain management. Participants emphasized individualized treatment decisions, clear instructions, and helping patients recognize medication ingredients.

An important distinction: this was a small, Kenvue-sponsored discussion-group report—not a new clinical guideline or a survey representing all PAs. Its themes offer a starting point for teaching; medication recommendations still require independent evidence and patient-specific judgment.

Did you know?

The same active ingredient can appear in products marketed for completely different symptoms.

Acetaminophen, for example, is found in some pain relievers, cold-and-flu medicines, and prescription combination products. Different packaging does not necessarily mean different medicine. FDA warns that taking too much acetaminophen can cause severe liver damage.

For learners, that makes “What have you tried?” only the beginning. Follow it with: “Which product, what strength, how much, and when?”

Familiar does not mean appropriate for everyone

Ibuprofen and naproxen belong to the same medication class: nonsteroidal anti-inflammatory drugs, or NSAIDs.

These medicines can cause gastrointestinal bleeding and kidney problems in susceptible patients. NIDDK also cautions that NSAIDs can contribute to acute kidney injury during dehydration or low blood pressure.

The teaching opportunity is to connect pharmacology to the person in front of you. A familiar product still calls for a review of the patient’s conditions, other medications, and current illness.

A quick practice moment for PA students

Imagine a patient tells you they took a pain reliever and a cold medicine earlier today.

Before recommending anything else, practice saying:

“Could we look at the bottles or photos of the labels together? I want to check the ingredients and how much you’ve already taken before we decide what is safe next.”

After reviewing the products and explaining an individualized plan, try a teach-back question:

“To make sure I explained that clearly, can you walk me through what you’ll take at home and which products you’ll avoid?”

That puts the responsibility on how clearly we explained the plan, while giving the patient an opportunity to ask questions.

PRO-PA Tip

Read the ingredient—not just the brand.

When explaining a pain-treatment plan, make the instructions specific: the medication, dose, timing, duration, products to avoid, and when to seek reassessment. Follow the product label and any individualized clinician instructions.

Your turn

PA students: What question helps you uncover medications a patient initially forgot to mention?

Practicing PAs: What is one counseling phrase that helps your patients understand their pain-treatment plan?

Share your approach in the comments.

Additional reading

FDA: Don’t Overuse Acetaminophen https://www.fda.gov/consumers/consumer-updates/dont-overuse-acetaminophen

NIDDK: Keeping Kidneys Safe—Smart Choices About Medicines https://www.niddk.nih.gov/health-information/kidney-disease/keeping-kidneys-safe

Educational content only; medication decisions should be individualized with a qualified healthcare professional.