Question | Answer |
Salicylates Drugs | Aspirin (Bayer, Ecotrin).....baby:81mg, regular: 325mg
given PO/PR/SR
Mechanism:
-Inhibit COX 1 and 2 enzymes
Results in:
-Anti inflammitory, Prostaglandins inhibition
-Decreased platelet aggregation |
Salicylates Drugs | Indicat:
Chest Pains,Post cardiac event
to reduce pain and inflammation, antipyretic
Drug interaction: with (anticoagulant, anti platelets and NSAIDS)
Adverse Reaction:
-bleeding
- allergy to aspirin(present with tennitis and broncospasms) |
Salicylates Drugs | Precaution:
-surgical stop 7-10 days prior
-don't crush meds (enteric coated)
-no ETOH
-NOT FOR KIDS (cause rey's syndrome), Cat D |
NSAIDS DRUGS | Ibuprofen (Motrin) and Advil PO
Mechanism: Inhibits COX enzymes 1 & 2
Indication: antininflammatory, Antipyretics and Analgesics
dosage: max 2400mg/day...highly protein bound
Loss of stomach linning |
NSAIDS DRUGS | Drug interaction:
-Oral anticoagulant
-increase effects of phenotoin(compete for same site)
-Not for pregnancy
-cause Nephrotoxicity
-anaphylaxis
-causes fluid retention |
NSAIDS Contraindictions | -nsaids allergy
-peptic ulcers
-renal/hepatic failure
-3rd trimester pregnancy
-bleeding disorders
-heart disease (exept ASA)
-children
-allergy to aspirin(present with tennitis and broncospasms) |
NSAIDS N/I and P/T | - dosage adjustment for renal/hepatic pts
-mon. s/s of bleeding
-take with food
-no othe anticoagulant unless px
-no ETOH
-off for 7-10 days b/4 surgery
-avoid in trimester
-deceses effectiveness of antihypertensives
- for long term consider PPI |
Herbal alert (may increase risk of bleeding with NSAIDS | -Garlic
-Ginger
-Ginko |
Celecoxib (Celebrex)-PO | selective COX 2 INHIBITOR
Indication:
-Rheumatoid and osteoarthritis
dosage: 200mg daily or divided****
Caution:
renal/hepatic dysfunction
heart failure
hx of GI Bleeding
anticoagulant use
cardiac disease |
Celecoxib (Celebrex)-PO
Patient education | baby aspirin maybe px
take with food
no ETOH
report gastric irritation
cause fluid retention
report s/s of heart attack
S/E: gastric upset,diarrhea, heart burn, nausea ulcer, renal dysfunction
give 2hrs before or after aluminum antacids |
NSAIDS AND CELEBREX
BLACK BOX WARNING | Cardiovascular risk
may incr risk of serious and fatal cardiovascular thombotic events: MI and Stroke
GI Risk
may incr risk of serious and fatal GI adverse events:bleeding, ulcer and stomach or intestine perforations, elderly at most risk. |
What is gout | its an inflammatory condition caused by increased uric acid.Gout, a painful form of arthritis, occurs when high levels of uric acid in the blood cause crystals to form and accumulate around a joint.
-Its common in the big toe
-purines increase acids |
What is gout
foods to avoid | purines in:
- Meat
-fish
-alcohol
-increase in fructose syrup
normal levels 2.6-7.2 |
ANTI GOUT DRUGS
Allopurinols (Zyloprim) | -gout tx/prophylaxis
-inhibits uric acid synthesis
-take with food and fluid
-can increase effect of warfarin(slow met. down warfar)
-S/E: N/V, stomatitis,metallic taste
Monitor CBC. Gout is assoc. with agranulation (critical decrease in WBC count) |
ANTIGOUT Nursing Intervention | -Assess for renal/hepatic impairment (broken down through the liver)
-dietary teaching
-I/O's
-assess serum uric acid levels
-increase fluid intake
- report S/E to HCP |