ch. 24 - antiiflammatories Flashcards
- we want to know how long they been taking them
- ensure to ASSESS
- ALWAYS report to surgeon BEFORE surgery that the patient takes these meds
- We need a good med rec
- Assess for GI distress (diarrhea, gastric pain, bloody stools)
- GI distress is 4 X more likely in the older adult
- Older adults need to have renal function assessed and encourage increased fluid intake to maintain healthy kidneys
- Always assess for allergies
- Ask if they have improvement of pain using these drugs
- Assess blood pressure
NSAIDS in general
Class: NSAID- Salicylate group
- Blocks Cox 1 and Cox 2
- This medication reduces inflammation which can decrease your pain, an antiplatelet to decrease clotting
Peak action- 1-2 hours (reassess pain and fever)
aspirin
take aspirin w/
food or water
take it w/ food to decrease GI distress
tinnitus (ringing in the ears), dizziness, bronchospasms (don’t take another dose), signs of bleeding, GI upset, GI ulcer, pancytopenia
side effects of aspirin
- Assess your CBC
- Assess for signs of bleeding!
- Assess for reports of GI upset
- Are they taking anything else OTC?
- Do they drink alcohol?
- Explain what signs of bleeding look like to the patient
- Monitor salicylate levels (15-30) Severe toxicity occurs when this level reaches 50+
- Stop taking 7 days before a surgery
- Tell dentist you take aspirin
- Never break EC tablets
- Keep out of reach of children!
- Make sure you take it with food and plenty of water
nursing interventions for aspirin
- Do not give to pregnant women-especially once they are in 3rd trimester
- Can cause premature closure of the ductus arteriosus = heart complications
- Do NOT give to children with flu like symptoms à REYE Syndrome can occur
Contraindications for aspirin
Class: OTC NSAID
- This can be taken to reduce pain and inflammation. Can also reduce fever
- may take several days before effects are seen.
ibuprofen (Motrin)
- GI upset, peripheral edema (caution use in heart failure), bleeding, dizziness, rash
- if edema is occurring we need to be assessing our BP as well to notice any inclines
side effects of ibuprofen
- Assess for allergies
- Obtain drug and herbal hx
- Assess for signs of bleeding and educate patient on what to look for
- Take NSAIDS with meals or small amounts of food to decrease GI upset
- Assess for peripheral edema (may be worse in the am)
- Do NOT take several NSAIDS at same time
- Monitor glucose levels in diabetics
- Tell surgeon you take this before any surgery
- Do not take if pregnant
- Take acetaminophen if you have menstrual cramping instead of ibuprofen
- Ibuprofen + insulin/ oral hypoglycemic drugs= increase risk for hypoglycemia
Ginger, garlic, ginkgo can increase risk of bleeding with NSAIDS
nursing interventions for ibuprofen
- if you have a hypersensitivity to NSAIDS, peptic ulcer, bleeding, or severe renal and/or liver disease
- Caution use if on anticoagulants or hx of bleeding disorders
- Highly protein bound
contraindications for ibuprofen
protects the stomach lining, decreases fever, and promotes blood clotting.
When we give a drug to inhibit, we reduce the risk for clotting but risk ulcer development
COX-1 enzyme
triggers pain and inflammation so when we give the inhibitor we reduce our pain and inflammation.
Drugs that are these inhibitors will have less risk for gastric ulcer development
COX-2 enzyme
Class: Anti-inflammatory gout drug
- Used for an acute gout attack and prophylaxis
- Decreases pain and inflammation in acute attacks and reduces # of future attacks
- Take with food because GI upset is common
Colchicine
- nausea, vomiting, diarrhea, peripheral neuropathy (abnormal sensation)
side effects of Colchicine
- Encourage increased fluid intake (water)
- Assess the affected joint for improvement
- Assess for a family hx
- Assess for numbness and tingling
- Make sure to assess for uric acid levels and kidney function before we start therapy
nursing interventions for Colchicine
