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Drug Class - Nonsteroidal Anti-Inflammatory Agents

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Name 2 groups of nonsteroidal anti-inflammatory agents (NSAIDS)?
NSAIDS
ophthalmic NSAIDS
Name 15 NSAIDS?
celecoxib
diclofenac
flurbiprofen
ibuprofen
indomethacin
ketoprofen
ketorolac
meloxicam
nabumetone
naproxen
oxaprozin
piroxicam
sulindac
tolmetin
valdecoxib
Name 4 ophthalmic NSAIDS?
diclofenac
flurbiprofen
ketorolac
suprofen
NSAIDs are used to control? (3)
mild to moderate pain
fever
various inflammatory
conditions
Two examples of inflammatory conditions that NSAIDs treat are?
osteoarthritis
rheumatoid arthritis
Ophthalmic NSAIDs are used to? (3)
decrease postop ocular
inflammation
inhibit perioperative miosis
decrease inflammation due to
allergies
What 3 properties do nonsteroidal anti-inflammatory agents have?
analgesic
antipyretic
anti-inflammatory
Analgesic and anti-inflammatory effects are due to inhibition of ______ synthesis.
prostaglandin
Antipyretic action is due to _____ and inhibition of prostaglandin synthesis in the CNS.
vasodilation
COX-2 inhibitors (celecoxib, rofecoxib, valdecoxib) may cause less _____ _____.
GI bleeding
Contraindication?
Hypersensitivity to ____ is a contraindication for the whole group of NSAIDs. Cross-sensitivity may occur.
aspirin
Precautions?
Use cautiously in patients with a history of _____ disorders, GI bleeding, and severe hepatic, renal, or cardiovascular disease. Safe use in pregnancy is not established and, in general, should be avoided during the second half of pregn
bleeding
Interactions?
NSAIDs prolong bleeding time and potentiate the effect of
(6)?
warfarin
thrombolytics
plicamycin
some cephalosporings
antiplatelets
valproates
Interactions?
Prolonged use with aspirin may result in (increased, decreased) GI side effects and decreased effectiveness.
increased
Interactions?
NSAIDs may also (increase, decrease) response to diuretics or antihypertesnive therapy.
decrease
Interactions?
Which drug negates the cardioprotective benefits of low-dose aspirin?
Ibuprofen
Which drug does NOT negate the cardioprotective effect of low-dose aspirin?
COX-2 inhibitors
ASSESSMENT:
Patients who have asthma, allergies, and nasal polyps or who are allergic to _____ are at an increased risk for developing hypersensitivity reactions.
tartrazine
ASSESSMENT:
PAIN: Assess pain and limitation of movement...what 3 characteristics of pain should be noted?
type
location
intensity
(assess prior to and at the peak)
ASSESSMENT:
FEVER: Assess fever and note associated signs. Four signs are?
diaphoresis
tachycardia
malaise
chills
Lab Test Considerations:
Most NSAIDs prolong bleeding time due to suppressed platelet aggregation and, in large doses, may cause prolonged ___. Monitor periodically in prolonged high-dose therapy to assess for ___ blood loss.
PT
GI
List 3 potential nursing diagnoses?
Pain, acute
Body temperature, Risk for
imbalanced
Knowledge, deficient, related
to disease processes and
medication regimen
IMPLEMENTATION:
PO: Administer NSAIDs after ____ or with food or an antacid to minimize gastric irritation.
meals
Instruct patient to take NSAIDs with a full glass of water and to remain in an upright position for ___-___ min after administration.
15 to 30 minutes
Caution patient to avoid concurrent use of alcohol with this medication to minimize possible _____ irritation.
gastric
Three or more glasses of alcohol per day may increase the risk of ____ bleeding with salicylates or NSAIDs.
GI
Caution patient to avoid taking acetaminophen, salicylates, or NSAIDs concurrently for more than a few days, unless directed by hcp to prevent analgesic ______.
nephropathy
Advise patient on long-term therapy to inform hcp of medication regimen prior to surgery. NSAIDs may need to be _____ prior to surgery.
withheld
EVALUATION:
Effectiveness of therapy can be demonstrated by:
Relief of mild to moderate discomfort...
Reduction of fever.

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