Drug Class - Nonsteroidal Anti-Inflammatory Agents
Terms
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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.