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Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
12 - 2
Nonsteroidal Anti-inflammatory Drugs
Group of frequently prescribed drugs Treat pain Common drug
Acetylsalicylic acid (ASA) Hermann Kolbe
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
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Uses for NSAIDs
Analgesic (mild to moderate) Antigout Anti-inflammatory Antipyretic Relief of vascular headaches Platelet inhibition
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
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How NSAIDs Work
Stop the activation of the arachidonic acid pathway
Reduce: Pain Headache Fever Inflammation
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
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Analgesics
Reduce pain by blocking prostaglandins
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
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Antipyretics
Inhibit prostaglandin E2 in the brain
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
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Inflammation Relief
Inhibit either the: Leukotriene pathway Prostaglandin pathway Or both pathways
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
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Pain Relief
Relief of mild to moderate pain Bone, joint, and muscle pain Osteoarthritis Rheumatoid arthritis Juvenile rheumatoid arthritis Dysmenorrhea
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
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Common NSAIDs
Common drugs that are used: Ibuprofen (Motrin, Advil) Ketoprofen (Orudis) Ketorolac (Toradol) Naproxen (Naprosyn)
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
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Gastrointestinal Side Effects
First-generation NSAIDs Dyspepsia, heartburn, epigastric distress,
nausea Gastrointestinal bleeding Mucosal lesions (erosions or ulcerations)
(continues)
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
12 - 11
Gastrointestinal Side Effects
Second-generation NSAIDs Called COX-2 inhibitors
More specific in their action Reduce gastrointestinal distress
(continued)
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
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Cardiovascular Side Effects
Second-generation NSAIDs Serious side effects:
Cardiac arrhythmias Heart attack Stroke
Celecoxib (Celebrex) may be removed Rofecoxib (Vioxx) removed from market by
the FDA
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
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Precautions
First and second generation Do not take if you:
Have or had stomach ulcers and bleeding Have had asthma Have had an allergic response to aspirin or sulfa Have severe kidney problems Have severe liver problems Are pregnant
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
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Renal Side Effects
Creatinine clearance reduced Renal failure
Acute tubular necrosis
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
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Nursing Assessment
Before beginning therapy, perform thorough assessment for:
Gastrointestinal lesions or peptic ulcer disease
Bleeding disorders Heart disorders Perform lab studies
CBC, platelet count, cardiac, renal, and liver
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
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Medical History
Medication history Serious drug interactions
Alcohol Heparin and warfarin (Coumadin) Phenytoin Steroids Sulfonamides
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
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Salicylates
Do not give salicylates to children under age 12.
Reye’s syndrome Give with food and milk.
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
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Client Education
Educate clients about precautions. Watch for:
Unusual bleeding, abdominal pain, and cardiac problems
Enteric-coated tablets should not be crushed or chewed.
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