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"PAIN" - Pain relief, Anti-inflammatory, Inhibits fever, No COX selectivity (most NSAIDs)
| Category | Examples | Special Considerations |
|---|---|---|
| Salicylates | Aspirin | Irreversible platelet inhibition |
| Propionic Acids | Ibuprofen, Naproxen | OTC availability, GI upset common |
| COX-2 Selective | Celecoxib | Reduced GI risk, increased CV risk |
| Acetic Acids | Indomethacin | CNS effects, used for specific conditions |
A 65-year-old patient with osteoarthritis requests ibuprofen for joint pain. They have a history of peptic ulcer disease and take warfarin. What should the nurse consider?
Answer: Contraindicated - NSAIDs increase bleeding risk with warfarin and can cause GI bleeding in patients with ulcer history.
"GUT PUNCH" - GI bleeding, Ulcers, Third trimester pregnancy, Platelet disorders, Uncontrolled hypertension, Nephritis, Cardiac failure, Hypersensitivity
Never give NSAIDs to patients in third trimester of pregnancy - can cause premature closure of ductus arteriosus
| NSAID | Acetaminophen |
|---|---|
| Anti-inflammatory: YES | Anti-inflammatory: NO |
| Affects platelets: YES | Affects platelets: NO |
| GI bleeding risk: HIGH | GI bleeding risk: LOW |
| Hepatotoxicity: Rare | Hepatotoxicity: High risk |
| Kidney effects: YES | Kidney effects: Minimal |
□ Can you name 3 contraindications for NSAID use?
□ What lab values should be monitored during NSAID therapy?
□ How do COX-2 selective NSAIDs differ from traditional NSAIDs?
□ What patient teaching is essential for NSAID safety?
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