Drug Study (celecoxib) 1w395j

Drug Data Generic Name Celecoxib Trade Name Celebrex Patients Dose 200 mg 1 cap BID PO Availability Capsules: 100 mg, 200 mg, 400 mg

Classification Pharmacologic Class: Cyclooxygenase (COX-2) inhibitors Therapeutic Class: Antiinflammatory NSAIDS Pregnancy Risk Category: C

Routes of istration P.O

Mechanism of Action May selectively inhibit COX-2, decreasing prostaglandin synthesis. Therapeutic Effects: Relieves pain and inflammation in ts and smooth muscle tissue. Pharmacokinetics Absorption: Level peaks in about 3 hrs.. If patient receives multiple doses, expect steady-state level within 5 days. Elderly pts. Have higher level than younger adults. Distribution: Extensive. Highly protein-bound, mainly to albumin. Metabolism: By CYP 2C9. No active metabolites have been identified. Excretion: Mainly through hepatic metabolism, with less than 3% as unchanged drug in urine and feces.

Indication General Indications -Reduction of the number of colorectal polyps in familial adenomatous polyposis (FAP) -Management of acute pain -Treatment of primary dysmenorrhea -Relief of signs and symptoms of ankylosing spondylitis -Relief of signs and symptoms of juvenile rheumatoid arthritis Patients Actual Indication -Management of acute pain .

Contraindications Contraindications Contraindicated with allergies to sulphonamides, celecoxib, NSAIDs, or aspirin; significant renal impairment; pregnancy (3rd trimester); lactation Precautions Use cautiously with impaired hearing, hepatic and CV conditions Drug interactions >drug to drug -Increased risk of bleeding if taken concurrently with warfarin. Monitor patient closely and reduce warfarin dose as appropriate. -Increased lithium levels and toxicity -Increased risk of GI bleeding with long-term alcohol use, smoking

Adverse Reactions CNS: headache, dizziness, stroke CV: hypertension, MI, peripheral edema EENT: pharyngitis, rhinitis, sinusitis GI: abdominal pain, diarrhea, dyspepsia, flatulence Metabolic: hyperchloremia, hypophosphatemia Musculoskeletal: back pain Respi: URTI Skin: erythema multiforme, exfoliative dermatitis, rash Other: accidental injury

Onset: unkown Peak : 3 hr Duration: unknown Drug Half Life 11 hours

Source: Springhouse Nurse’s Drug Guide 2002 p. 302

Source: Springhouse Nurse’s Drug Guide 2002 p. 302

Source: Springhouse Nurse’s Drug Guide 2002 p. 303

Source: Springhouse Nurse’s Drug Guide 2002 p. 303

Source:Springhouse Nurse’s Drug Guide 2002 p. 303

Source: Springhouse Nurse’s Drug Guide 2002 p. 303

Nursing Responsibilities Before - Assess patient for allergy to sulfonamides, aspirin, or NSAIDS. Patients with these allergies should not receive celecoxib. -Assess patient’s range of motion, degree of swelling, and pain in affected ts before and periodically throughout therapy. -Assess patient’s and family’s knowledge of drug therapy -Obtain baseline assessment before starting therapy -Rehydrate patient before therapy During -May be istered without regard to meals. -ister right dose -ister to right patient -ister to right route After -Instruct patient to take celecoxib exactly as directed. Do not take more than prescribed dose. Increasing doses does not appear to increase effectiveness. - Advise patient to notify health care professional promptly if signs or symptoms of GI toxicity (abdominal pain, black stools), skin rash, unexplained weight gain, edema occurs. -Instruct patient that she should discontinue celecoxib and notify health care professional if signs and symptoms of hepatotoxicity (nausea, fatigue, lethargy, pruritus, jaundice, upper right quadrant tenderness, flulike symptoms) occur. Source: Springhouse Nurse’s Drug Guide 2002 p. 303-304