2. TIME/ ACTION PROFILE: ROUTE: Capsules (adults) 100 mg twice daily (children over age 2) 50 mg twice daily ONSET: 24-48 hr PEAK: unknown DURATION: 12-24 hr May be taken without food, capsules may be opened and sprinkled in applesauce
3. NURSING IMPLICATIONS: assess range of motion, degree of swelling, level of pain of effected joint, skin rash, allergy to sulfa, aspirin or NSAIDs. LAB: may cause an increase in AST and ALT levels, hypophosphatemia, hyperkalemia and increased BUN
4. PATIENT/FAMILY TEACHING: take exactly as directed, do not take more than prescribed dose, notify doctor if signs or symptoms of GI toxicity (abdominal pain, black stools) skin rash, edema or chest pain, notify if pregnancy is planned or suspected DOCUMENTATION: vital signs, pain level before, during and after ,reduction in pain, joint tenderness,and swelling
5. CLASS: Non steroidal anti inflammatory agent (prescription required)
6. INDICATION: relief of signs and symptoms of osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, management of acute pain
7. CONTRADICTIONS/PRECAUTIONS: hypersensitivity, renal disease, severe hepatic dysfunction, CABG surgery, do not use in late pregnancy ( may cause premature closure of ductus arteriosus, hx of allergic reaction to sulfa, asthma, not safe for children under age 2, , htm, fluid retention, may increase risk of serious cardiovascular thrombotic event, myocardial infarction, and stroke
8. INTERACTIONS WITH COMMON MEDICATIONS OR HERBS: may decrease effectiveness of ACE inhibitors, thiazide diueretics and furosemide, increased bleeding with anticoagulants, aspirin, clopidogrel, ticagrelor, prasugrel, corticosteroids, fibrinolytics, SNRIs, or SSRIs, may increase serum lithium levels,
