NSAIDS Flashcards
names of nsaids
- ibuprofen
- meloxicam
- indomethacin
- ketorolac
- cox-2 inhibitor
moa of nsaids
- block prostaglandin synthesis
- block cox 1-2 (exception of cox-2 inhibitor)
indications for nsaids
- ra
- oa
- gout
- mild to moderate pain
- dysmenorrhea
ae of nsaids
- gi bleeding
- bleeding ulcer
contraindications for nsaids
- cabg surgery
- renal impairment
- hx of GI bleed
- risk of bleeding
nsaids bbw
increased risk of serious cv thrombotic events (stroke, mi)
ibuprofen use in children
- fever
- older than 6 months
ibuprofen use in elderly
- analgesic and antipyretic
- long term: watch for GI blood loss, renal dysfunction, edema, htn, drug interactions
adverse effects of ibuprofen
- gi: dyspepsia, heartburn, epigastric pain, nausea, gi ulceration with occult blood loss
- gu: nephrotoxicity, increased bun and cr, edema
- resp: dyspnea, bronchospasm, hemoptysis, pharyngitis
ibuprofen implications
- don’t exceed 3200 mg daily
- always dilute fluids
- assess for dyspepsia/gi bleeding
- monitor cbc/clotting times
- hypersensitivity: rash and bronchospasm
education for ibuprofen
- take with food/liquid
- drink 2-3 quarts of water daily
- report any sign of bleeding or difficulty breathing
meloxicam ae
- ha
- dizziness
- drowsiness
- insomnia
meloxicam contraindications
- aspirin allergy
- cabg surgery
meloxicam implications
- don’t exceed 3200 mg daily
- always dilute fluids
- assess for dyspepsia/gi bleeding
- monitor cbc/clotting times
- hypersensitivity: rash and bronchospasm
indomethacin main use
anti inflammatory
indomethacin ae
- ha, dizziness, somnolence, insomnia
- decreased clotting time
- iv prep: pulmonary hemorrhage
indomethacin caution/contraindications
- hx of salicylate hypersensitivity
- contraindicated in elderly, high risk of severity
indomethacin implication
- take after meals or with antacid
- keep tabs in light protected container
- dilute for iv, admin 5-10 seconds
- potenial for extravasation
ketorolac use
pain
ketorolac route
-parenteral
ketorolac risks
- gi irritation, inflammation, ulceration, bleeding, and perforation
- limit for 5 days due to risk of bleeding and nephrotoxicity
cox 2 inhibitor route
po
cox 2 inhibitor moa
- activated with inflammation, it inhibits enzyme decreasing the inflammation
- no effect on cox 1 thus protecting the gi tract and no effect on clotting factors
cox 2 inhibitor indications
- juvenille ra
- ra
- oa
- acute pain
- dysmenorrhea
cox 2 inhibitor contraindications
- sulfa allergy!
- nsaid allergy
- aspirin allergy
- renal impairment
- perioperative pain
- cabg surgery
cox 2 inhibitor ae
- derm: rash, pruritis, sweating stomatitis
- anaphylactic reactions with surgery
cox 2 inhibitor implications
- etoh and cigarette increase risk for bleeding
- take 2 hours before or after antacids
- light protected container
