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A comprehensive overview of various non-steroidal anti-inflammatory drugs (nsaids) and salicylates, including their therapeutic and pharmacologic classifications, dosage and administration routes, onset, peak, and duration of action, as well as significant nursing implications and responsibilities. The medications covered include ibuprofen, naproxen, aspirin, salsalate, and diflunisal. The document delves into the mechanisms of action, therapeutic uses, and potential adverse effects associated with these commonly prescribed analgesic, anti-inflammatory, and antipyretic agents. This information is crucial for healthcare professionals, particularly nurses, to understand the appropriate use, monitoring, and management of these medications in various clinical settings, such as the treatment of rheumatic disorders, pain management, and fever reduction.
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*Medication & *Classification(s): Therapeutic & Pharmacologic *Dosage/Route, Time Scheduled *Onset, Peak, Duration of action *Significant Nursing Implication/Responsibilities Why is the patient taking this medication (e.g., to treat…; to prevent (clinical)? what is the mechanism of action IBUPROFEN Class: Analgesic, non- steroidal anti- inflammatory; antipyretic Pharmacologic: Analgesic, NSAID; anti-inflammatory; antipyretic Dysmenorrhea Adult: PO 400 mg q4h up to 1200mg/day Mild to Moderate Pain Adult: PO 200- 800mg 3-4 x per day IV 400mg q4-a prn or 100-200mg q4h prn Fever Adult: PO 200- mg TID or GID (max:1200mg/day) Child (6mo-12yo): PO 5-10mg/kg q6- 8h up to 40mg/kg/day Onset: 30-60mins Peak: 1-2hr Duration: 6-8hr Ibuprofen has been associated with increased risk of serious, potentially fatal GI bleeding and cardiovascular events (ex: MI and CVA); risk may increase with duration of use and may be greater in the older adult and those with risk factors for CV disease. Monitor: for strokes, observe patients with history of cardiac decompression and evidence of edema, GI bleeding Why: Chronic, symptomatic rheumatoid arthritis, and osteoarthritis; relief of mild to moderate pain; primary dysmenorrhea; reduction of fever. Mechanism of action: Has nonsteroidal anti- inflammatory, analgesic, and antipyretic effects. Inhibits platelet aggregation and prolongs bleeding time. NAPROXEN Note 200mg naproxen = 220mg naproxen sodium Onset: N/A Peak: 2hr naproxen, 1hr Has been associated with increased risk of serious, potentially fatal, GI bleeding Why: Anti-inflammatory and analgesic effects in symptomatic treatment of acute and chronic rheumatoid arthritis, juvenile arthritis, and for treatment of primary
Class: Non-steroidal anti-inflammatory drug Pharmacologic: Nonnarcotic analgesic, NSAID Inflammatory disease Adult: PO 250- 500mg BID Child (12yo or older): PO 5mg/kg BID (max: 1000mg/day) Mild to moderate pain, dysmenorrhea Adult: PO 500mg followed by 250mg q6-8h prn up to 1000mg Child (12yo or older): PO 250 to 375mg twice daily (max: 1000mg/day) naproxen sodium Duration: 7 hr and cardiovascular events (ex: MI and CVA); risk may increase with duration of use and may be greater in the older adult and those with risk factors for CV disease. Monitor: GI ulcers or bleeding, baseline blood pressure, CV thrombotic events, allergic response, auditory and ophthalmic examinations, and lab results dysmenorrhea. Also, management of ankylosing spondylitis, osteoarthritis, and gout. Mechanism of action: Analgesic, anti-inflammatory, and antipyretic effects; also inhibits platelet aggregation and prolongs bleeding time. ASPIRIN Class: Nonnarcotic analgesic, salicylate; antipyretic; Mild to moderate pain Adult: PO 500- 1000mg q4-rh (max 4q/day) Onset: N/A Peak: 15min to 2h (depending on form) Duration: N/A Monitor: for loss of tolerance to aspirin, diabetic child, salicylate toxicity, S&S of salicylate toxicity Why: To relieve pain of low to moderate intensity. Also, for various inflammatory conditions, such as acute rheumatic fever, systemic lupus, rheumatoid arthritis, osteoarthritis, bursitis, and calcific tendonitis and to reduce fever in selected febrile conditions.
Nonnarcotic analgesic, NSAID Monitor: for adverse GI effects, lab results DIFLUNISAL Class: Analgesic, non- steroidal anti- inflammatory drug (NSAID) Pharmacologic: Analgesic, NSAID; antirheumatic Arthritis Adult: PO 250- BID (max: 1500mg/day) Pain Adult: PO 100mg initial dose then 500mg q12hr Onset: 1 hr Peak: 2-3 hr Duration: 12 hr Diflunisal has been associated with increased risk of serious, potentially fatal, CV thrombotic events (ex: MI and stroke). Risk may increase with duration of use and may be greater in those with risk factors for CV disease. Monitor: for S&S thrombotic events, chronic or high does can mask fever, lab results Why: Treatment of osteoarthritis and rheumatoid arthritis; mild to moderate pain. Mechanism of action: Has analgesic and anti- inflammatory properties. Class: Pharmacologic: Onset: Peak: Duration: Class: Pharmacologic: Onset: Peak: Duration: Class: Pharmacologic: Onset: Peak: Duration: Class: Pharmacologic: Onset: Peak:
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