A person who does not respond to one salicylate may respond to a different one.
Copyright © 2017 Wolters Kluwer • All Rights ReservedNSAIDsNSAIDs•Provide strong anti-inflammatory and analgesic effects•Sold over the counter, which may lead to abuse•Anti-inflammatory, analgesic, and antipyretic effects
Copyright © 2017 Wolters Kluwer • All Rights ReservedNonsteroidal Anti-inflammatory and Related Agents Nonsteroidal Anti-inflammatory and Related Agents •Propionic Acids –Fenoprofen–Ibuprofen•Acetic Acids–Declofenac–Etodolac•Fenamates –Mefenamic acid•Cyclooxygenase-2 Inhibitors–Celecoxib
Copyright © 2017 Wolters Kluwer • All Rights Reserved
Copyright © 2017 Wolters Kluwer • All Rights ReservedNSAIDSNSAIDS•Therapeutic actions and indications - Block two enzymes, known as COX-1 and COX-2•Pharmacokinetics- Rapidly absorbed from the GI tract, reaching peak levels in 1 to 3 hours. They are metabolized in the liver and excreted in the urine•Contraindications and cautions- Allergy to any NSAID or salicylate, and celecoxib is also contraindicated in the presence of allergy to sulfonamides, CV dysfunction or hypertension, peptic ulcer, GI bleeding, pregnancy, lactation, renal and hepatic dysfunction
Copyright © 2017 Wolters Kluwer • All Rights ReservedNSAIDSNSAIDS•Adverse effects- Nausea, dyspepsia, GI pain, constipation, diarrhea, or flatulence caused by direct GI effects of the drug. GI bleed, dizziness, somnolence, platelet inhibition, hypertension, and even bone marrow depression•Drug-to-Drug interactions- Decreased diuretic effect when these drugs are taken with loop diuretics; there is a potential for decreased antihypertensive effectof beta-blockers if these drugs are combined; and there have been reports of lithium toxicity, especially when combined with ibuprofen
Copyright © 2017 Wolters Kluwer • All Rights ReservedNursing Considerations for Patients Receiving NSAIDs and Related AgentsNursing Considerations for Patients Receiving NSAIDs and Related Agents•Assess: –Known allergies to any salicylates, NSAIDs, or tartrazine–Baseline status before beginning therapy and for any potential adverse effects–Pregnancy or lactation; hepatic or renal disease; CV dysfunction; hypertension; and GI bleeding or peptic ulcer–Presence of any skin lesions; temperature; orientation, reflexes, and affect; pulse, blood pressure, and perfusion; respirations and adventitious sounds; liver evaluation; bowel sounds; and CBC, liver and renal function tests, urinalysis, stool guaiac, and serum electrolytes.
Copyright © 2017 Wolters Kluwer • All Rights ReservedAcetaminophen Acetaminophen •Actions- –Acts directly on the thermoregulatory cells of the hypothalamus–Mechanism of action unknown but related to analgesic effects–Used to treat pain and fever•Treat pain and fever associated with a variety of conditions, including influenza•Prophylaxis of children receiving diphtheria–pertussis–tetanus (DPT) immunizations •Relief of musculoskeletal pain associated with arthritis
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- Spring '18
- Stephen Marrone