NSAIDS: Anti-Inflammatory, Non-opioid analgesic, Antipyretic, antiplatelet
1st Gen (COX1 & 2 Inhibitors): aspirin, Ibuprofen, Naproxen, Indomethacin,
Dicyclofenac, Ketorolac, Meloxicam
2nd Gen (selective COX 2 inhibitor): celecoxib
Therapeutic Use
Expected Pharmacological Action
Inhibits leukotrienes and cyclooxygenase:
Inhibition of COX 1 can results in decreased platelet
aggregation and kidney damage.
Inhibition of COX2 results in decreased inflammation,
fever and pain (does not decrease platelet aggregation).
Contraindications/Precautions
Interactions
1st gen: pregnancy (Risk category D), peptic ulcer disease,
bleeding disorders, hypersensitivity to NSAIDS, children
who have viral illness (chickenpox & influenza), vitamin k
deficiency
Ketorolac: advanced kidney disease pts
2nd gen: have allergy to sulfonamides and last choice in pain
relief due to risk of MI and stroke (celecoxib)
Complications/Adverse Effects
Dyspepsia, abd pain, GI bleed, heartburn, nausea,
urine output, weight gain (noncardiogenic pulmonary
edema), BUN and creatine, risk of MI and stroke
(non-aspirin NSAIDS), salicylism (tinnitus, sweating,
headache, dizziness, respiratory alkalosis) & Reyes
syndrome (both aspirin), hepatotoxicity, acute renal
failure
Side Effects
Bleeding, GI ulcer, GI pain,
Fluid retention, Hypertension
Inflammation suppression
Non-opioid analgesia for mild to moderate pain (OA
and RA)
Fever reduction
Dysmenorrhea (painful menses)
Inhibition of platelet aggregation which protects
against ischemic stroke and MI (aspirin)
Anticoagulants: risk of bleeding
Aspirin
Corticosteroids and other ulcerogenic
drugs: risk gastric bleeding
Protein bound drugs
Diuretics and ACE inhibitors
Others
Nursing Considerations
Previous problems with NSAIDS (+OTC)
Check blood pressure before
Give after meals with water or milk
Check for sensitivity reaction and bleeding after
administrations
Evaluation Of Medication
Effectiveness
Reduced redness, pain, swelling, and warmth at
site of inflammation; increased function;
reduced fever
Client Teaching
Don’t take on empty stomach
Monitor for bleeding;
Do not take Warfarin (Coumadin)