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NSAIDs: Generic & Trade Names, MOA, Indications, Side Effects, Monitoring Parameters, Notes
Commonly Prescribed For...
Arthritis |
Post-Operative Pain |
Acute Gout |
Inflammatory Pain r/t Tissue Injury |
Dysmenorrhoea |
Fever |
Headache & Migraine |
Lower Back Pain |
Renal Colic |
Macular Edema |
Indications
Antipyretic |
Fever Reduction |
Analgesic |
Pain Relief |
Antithrombotic |
Reduces Blood Clotting |
Anti-Inflammatory |
Reduces Inflammation |
Mechanism Of Action - Enzyme Inhibitor
Inhibits Cyclooxygenase (COX): COX-1 and COX-2 helps in the production of prostaglandins, which are responsible for aiding the inflammatory response by acting as a vasodilator and inhibiting the aggregation of blood platelets. |
Antipyretic Properties: Can be used to treat fever. Works on the hypothalamus by inhibiting prostaglandin E2 (PGE2) via COX, which raises the thermal set point. |
COX-1 acts on the mucosa lining of the stomach to keep it from being eroded away by stomach acid. |
COX-2 does not act on the lining of the stomach, so certain NSAIDs which work on COX-2 but not COX-1 are preferable to keep the function of the stomach intact and protected. |
Generic & Trade Names
|
Generic |
Trade |
Route |
Diclofenac |
Voltaren |
Oral, |
Ibuprofen |
Advil, Motrin |
Oral, Parenteral |
Naproxen |
Aleve |
Oral |
|
COX-2 Selective |
Celecoxib |
Celebrex |
Morniflumate |
Etoricoxib |
Nimesulide |
Parecoxcib |
Talniflumate |
Name Endings
-Coxib |
COX-2 inhibitor |
-Profen |
Anti-inflammatory/Analgesic |
-Fenac |
Anti-inflammatory Agent |
Precautions
Not Recommended For... |
Pregnancy |
Cardiovascular Disease |
Renal Disease |
GI Bleeds (history of & currently) |
Uncontrolled Hypertension |
Interactions
Interactions |
Increases |
Decreases |
Aspirin |
GI Side Effects |
Effectiveness of NSAID |
Diuretics |
|
Effects of Diurectic |
Antihypertensive |
|
Effects of Antihypertensives |
|
|
Side Effects
Gastrointestinal Ulcers & Bleeds |
Dry Eyes |
Myocardial Infarction |
Dizziness |
Nephropathy |
Diarrhea |
Raised Liver Enzymes |
Nausea |
Hypertension |
Dyspepsia |
Salt & Fluid Retention |
Bronchospasms |
Pharmacodynamics/Kinetics
|
Oral |
Serum |
Onset |
30-60 Minutes |
. |
Peak |
2-4 Hours |
2-2.5 Hours |
Duration |
6-8 Hours |
. |
Absorption |
Rapid |
Readily |
Nursing Diagnoses
Nursing Diagnoses |
Acute Pain |
Indications |
Risk for imbalanced body temperature |
Indications |
Deficient knowledge r/t 1. disease process or/and 2. medication regimen |
Indicates Teaching |
Assessments
Assessment |
Following Administration |
Pain |
Limitation of movement, type, location, intensity |
Fever |
note associated signs (diaphoresis, tachycardia, malaise, chills) |
Laboratory Test Considerations
What |
Focus |
CBC |
GI Effects |
Pain, Bleeding, Bruising, Dyspepsia |
Renal Function |
Urine Output, Serum BUN, Creatinine |
Response |
Pain, ROM, Grip Strength, Mobility, ADL Functions |
Liver Functions |
Patient Education
Take NSAIDs with meals or a glass of milk. |
Remain upright for 15-30 minutes after taking NSAIDs. |
Avoid use of alcohol to prevent GI ulceration & Bleeding |
Do not take in combination with other NSAIDs, acetaminophen, and salicylates. |
Avoid taking for long periods of time, advise COX-2 inhibitor NSAID use and stomach protectant (Ex. Pantoporazole) |
Avoid taking before surgery |
ADDITIONAL NOTES
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