NSAIDs: Generic & Trade Names, MOA, Indications, Side Effects, Monitoring Parameters, Notes
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Arthritis
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Post-Operative Pain
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Acute Gout
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Inflammatory Pain r/t Tissue Injury
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Dysmenorrhoea
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Fever
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Headache & Migraine
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Lower Back Pain
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Renal Colic
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Macular Edema
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Antipyretic
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Fever Reduction
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Analgesic
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Pain Relief
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Antithrombotic
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Reduces Blood Clotting
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Anti-Inflammatory
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Reduces Inflammation
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Inhibits Cyclooxygenase (COX): COX-1 and COX-2 helps in the production of prostaglandins, which are responsible for aiding the inflammatory response by acting as a vasodilator and inhibiting the aggregation of blood platelets.
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Antipyretic Properties: Can be used to treat fever. Works on the hypothalamus by inhibiting prostaglandin E2 (PGE2) via COX, which raises the thermal set point.
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COX-1 acts on the mucosa lining of the stomach to keep it from being eroded away by stomach acid.
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COX-2 does not act on the lining of the stomach, so certain NSAIDs which work on COX-2 but not COX-1 are preferable to keep the function of the stomach intact and protected.
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Generic
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Trade
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Route
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Diclofenac
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Voltaren
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Oral,
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Ibuprofen
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Advil, Motrin
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Oral, Parenteral
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Naproxen
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Aleve
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Oral
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COX-2 Selective
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Celecoxib
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Celebrex
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Morniflumate
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Etoricoxib
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Nimesulide
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Parecoxcib
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Talniflumate
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-Coxib
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COX-2 inhibitor
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-Profen
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Anti-inflammatory/Analgesic
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-Fenac
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Anti-inflammatory Agent
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Not Recommended For...
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Pregnancy
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Cardiovascular Disease
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Renal Disease
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GI Bleeds (history of & currently)
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Uncontrolled Hypertension
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Interactions
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Increases
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Decreases
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Aspirin
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GI Side Effects
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Effectiveness of NSAID
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Diuretics
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Effects of Diurectic
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Antihypertensive
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Effects of Antihypertensives
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Gastrointestinal Ulcers & Bleeds
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Dry Eyes
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Myocardial Infarction
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Dizziness
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Nephropathy
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Diarrhea
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Raised Liver Enzymes
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Nausea
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Hypertension
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Dyspepsia
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Salt & Fluid Retention
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Bronchospasms
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Oral
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Serum
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Onset
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30-60 Minutes
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.
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Peak
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2-4 Hours
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2-2.5 Hours
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Duration
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6-8 Hours
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.
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Absorption
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Rapid
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Readily
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Nursing Diagnoses
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Acute Pain
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Indications
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Risk for imbalanced body temperature
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Indications
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Deficient knowledge r/t 1. disease process or/and 2. medication regimen
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Indicates Teaching
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Assessment
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Following Administration
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Pain
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Limitation of movement, type, location, intensity
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Fever
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note associated signs (diaphoresis, tachycardia, malaise, chills)
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What
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Focus
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CBC
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GI Effects
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Pain, Bleeding, Bruising, Dyspepsia
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Renal Function
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Urine Output, Serum BUN, Creatinine
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Response
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Pain, ROM, Grip Strength, Mobility, ADL Functions
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Liver Functions
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Take NSAIDs with meals or a glass of milk.
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Remain upright for 15-30 minutes after taking NSAIDs.
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Avoid use of alcohol to prevent GI ulceration & Bleeding
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Do not take in combination with other NSAIDs, acetaminophen, and salicylates.
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Avoid taking for long periods of time, advise COX-2 inhibitor NSAID use and stomach protectant (Ex. Pantoporazole)
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Avoid taking before surgery
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