part 6 Flashcards
What are the drug interactions for Celeoxib (Celebrex)?
warfarin
may decrease diuretic effect of furosemide
may decrease antihypertensive effect of ACE inhibitors
-may increase lithium levels
-may be increased by fluconazole
What do we need to teach pt’s about NSAIDs?
- take with food, milk, or water to reduce gastric upset
- do not crush or chew extended release
- discard if smells like vinegar
- do not consume alcohol
- notify if gastric irritation is severe/persistent
What do we need to inform pt’s about ASA and surgery?
- high doses stop 7-10 days before surgery
- low doses may continue up until surgery
Does acetaminophen (tylenol) have any anti-inflammatory or anti rheumatic actions?
NO
What are the therapeutic uses for acetaminophen (tylenol)?
analgesic
antipyretic
-not associated with reyes syndrome
Inhibits prostaglandin synthesis in CNS and reduces fever and pain.
mechanism of action for acetaminophen (tylenol)
Why does acetaminophen (tylenol) have no anti-inflammatory effects?
Unable to inhibit prostaglandin synthesis outside CNS = no anti-inflammatory effects
What stronger analgesics contain acetaminophen (tylenol)?
norco and percocet
What should you consider when giving an alcoholic acetaminophen (tylenol)?
a lower dose because of liver issues
What are the adverse effects of acetaminophen (tylenol)?
- few at normal doses
- hepatotoxicity (overdoes or pt’s with liver failure)
- SJS
- toxic epidermal necrolysis (sever skin peeling and blistering)
A risk of acetaminophen (tylenol) is hepatotoxicity. What are the S and S of hepatic failure?
N. V, D
sweating
abd pain
-can take week before the liver fails
What is the treatment for overdose of acetaminophen (tylenol)?
acetylcysteine (Mucomyst)
