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What is the purpose of the COX1 & COX2 enzymes?
- 1: normal cell function.
- 2: produce prostaglandins that cause inflammation, swelling, joint pain.
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aspirin
X=NOT FOR ADOL/CHILDREN
Uses:
Max dose:
Action
Pt teaching
SFX/AFX
Nurse interventions
- Uses: mild-mod pain, prevent TIA/MI, reduce fever.
- Max dose: 4 g/24 hrs
- Action: inhibit COX1 & decrease prosta.
- Pt teaching:
- -Take with food/milk to reduce GI distress.
- -DO NOT crush/chew sustained-release/enteric-coated
- -Watch for bleeding gums, pink spots, GI bleeding
- -Notify prescriber if taking other OTC drugs containing aspirin
- -Pregnant women should avoid.
- *Drug is leading cause of POISONING in CHILDREN.
- SFX: confusion, headache, hypotension, N/V
- AFX: anaphylaxis, GI bleeding, seizures, REYE'S SYNDROME in children w/ chickenpox.
- Nurse interventions:
- -Better for long-term therapy.
- -May be given as a suppository.
- -May inhibit platelet aggregation, stop few days before surgery (blood thinner)
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celecoxib (ONLY COX2-inhibitor in US; inhibits prosta. synth)
X = NOT FOR ADOL/CHILDREN
Usesmild
Max dose
Action
Pt teaching
SFX/AFX
Nurse interventions
- Uses: mild-mod pain, similar to ibuprofen.
- Max dose: N/A
- Action: inhibits prosta. synth.
- Pt teaching:
- -Report allergies to NSAIDs.
- -Report black, tarry, bloody stools, GI bleeding.
- -If pregnant
- -Can be taken w/ applesauce.
- -Taking w/ other OTC NSAIDs may cause toxicity.
- SFX: headache, hypertension, nausea.
- AFX: Stevens-Johnson Syndrome, edema
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acetaminophen
O=GOOD FOR CHILDREN
Uses
Max dose
Action
Pt teaching
SFX/AFX
Nurse Interventions
- Uses: mild-mod pain, fever, Pts who are hypersensitive to aspirin or NSAIDs or receiving anti-coagulant therapy.
- Max dose: 4 g/24 hrs (same as aspirin)
- Action: Inhibit prosta. synthesis
- Pt teaching:
- -Short-term use only (<5 days)
- -Excessive alcohol use may increase liver damage.
- SFX: headache, fatigue, N/V
- AFX: skin reactions, Stevens-Johnson Syndrome
- Nurse Interventions:
- -In children, don't exceed 5 doses in 24 hrs.
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naloxone (Narcan)
Uses
Action
Pt teaching
SFX/AFX
Nurse Interventions
- Uses: reveres effect of morphine (resp. dep)
- Action: BLOCKS ops receptors.
- Pt teaching:
- -will monitor Pt until opioid effects resolve.
- -Instruct on use of autoinjector and if used, seek emergency care ASAP.
- SFX: hypertension, N/V
- AFX: tachycardia, vfib, seizures
- Nurse Interventions:
- -Monitor respiratory depth and rate. Provide oxygen, ventilation, and other resuscitation measures.
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