Ibuprofen

Question 1

Therapeutic Classification

Answer 1

Analgesic, anti-inflammatory, antipyretic

Question 2

Pharmacologic Classification

Answer 2

NSAID

Question 3

Pregnancy Category

Answer 3

B (1st and 2nd trimester), D (third trimester)

Question 4

Mechanism of Action

Answer 4

o Inhibits COX-1 and COX-2, which block prostaglandin synthesis and modulate T-cell function
o Inhibits inflammatory cell chemotaxis
o Decreases the release of superoxide radicals
o Increases scavenging of superoxide radicals at inflammatory sites.

Question 5

Indications

Answer 5

o Relief of fever and mild to moderate pain associated with chronic symptomatic rheumatoid arthritis (RA) and osteoarthritis
o Myalgia, headache, dental pain, and dysmenorrhea

Question 6

Contraindictions

Answer 6

o Allergy to aspirin or other NSAIDs
o PUD, bleeding abnormalities and perioperative pain related coronary artery bypass graft (CABG)
o Severe hepatic impairment

Question 7

Precautions

Answer 7

o Hypertension, history of GI bleeding, diabetes mellitus, impaired renal or hepatic function
o Heart failure, serious HTN, or history of stroke or MI
o Diminished respiratory function in children with asthma
o Can interfere with cardiac drugs.
o Stroke can use aspirin not ibuprofen

Question 8

Drug Interactions

Answer 8

o Oral anticoagulants can increase risk of bleeding
o Ibuprofen may increase toxicity of digoxin, lithium, or methotrexate
o Other NSAIDs, alcohol, corticosteroids may cause serious adverse GI events
o Reduced antihypertensive action of diuretics beta blockers and angiotensin-converting enzyme (ACE) inhibitors
o Feverfew, garlic, ginger, gingko may increase risk of bleeding

Question 9

Adverse Effects

Answer 9

o Bleeding, anorexia, heartburn, nausea, vomiting, constipation or diarrhea, dizziness, headache, drowsiness and light-headedness, polyuria, azotemia, cystitis, hematuria, increased creatinine and blood urea nitrogen (BUN) levels

Question 10

Serious Adverse Effects

Answer 10

o Hypotension, CHF, peripheral edema, occult blood loss, aplastic anemia, leukopenia, decreased hemoglobin and hematocrit, increased aspartate transaminase (AST) and alanine transaminase (ALT), renal impairment, including acute renal failure.

Question 11

Nursing Responsibilities

Answer 11

o Notify the presciber before therapy if the pt has a hisoty of PUD, bleeding abnormalities and perioperative pain related to CABG,
o Monitor for cardiac responses and fluid retention
o Monitor BUN and creatinine levels
o Assess complete blood count (CBC) and liver function studies, report abnormal levels

Question 12

Patient Family Teaching

Answer 12

o Notify the health care provider of blood in vomit, black tarry stools, coffee grounds emesis, or GI discomfort
o Do not take products containing aspirin or other analgesics
o Do not drink alcohol
o Take with food or milk
o Immediately report unusual bruising