Antigout Agents/ Nonsalicylate NSAIDs/Antirheymatics

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Allopurinol (Aloprim, Zyloprim): Side Effects

GI Upset, headache, drowsiness, rash

Allopurinol (Aloprim, Zyloprim): Indication

treatment of gout, uric acid neuropathy, uric acid stone formation

Allopurinol (Aloprim, Zyloprim): Nursing Consideration

encourage 10-12 glass water/day, Check CBC and renal function tests, initial therapy can increase attacks of gout, full therapeutic effect may require several months, management of patients with leukemia, lymphoma who are receiving chemotherapy that may increase uric acid, monitor liver function tests

Allopurinol (Aloprim, Zyloprim): Patient Teaching

avoid use of alcohol, eating organ meats, gravy, legumes, take with food, don't take vitamin C or iron

Allopurinol (Aloprim, Zyloprim): Pregnancy Category

C

Colchicine (Colcrys): Side Effects

nausea, vomiting, diarrhea, sign of toxicity: abdominal cramp, aganulocytosis, pharyngolaryngeal pain

Colchicine (Colcrys): Indicaiton

treatment and prevention of acute gout attacks, familial Mediterranean fever

Colchicine (Colcrys): Nursing Considerations

has analgesic, anti-inflammatory effects, may be taken without regard to meals, Encourage 101-2 glasses water/day, grapefruit and grapefruit juice should not be consumed

Colchicine (Colcrys): patient Teaching

avoid use of alcohol, eating organ meats, gravy, legumes, always carry medication to treat acute attacks

Colchicine (Colcrys): IV dosing instructions

slowly, do not administer IM/Subq

Colchicine (Colcrys):Pregnancy Category

C

Probenecid (Probalan): Side Effects

nausea, sore gums, anorexia, hypersensitivity, skin rash, hemolytic anemia

Probenecid (Probalan): Indication

Treatment of hyperuricemia associated with gout, gouty arthritis

Probenecid (Probalan): Nursing Considerations

Check BUN, renal function tests, encourage 8-10 glasses water/day, give with milk, food and antacids, may also be used with penicillin to elevate and prolong plasma of penicillin for gonococcal infection,

Probenecid (Probalan): Patient Teaching

avoid use of alcohol, eating organ meats, gravy, legumes, avoid aspirin-containing products; may take acetaminophen

Probenecid (Probalan): Pregnancy Category

B

Diclofenac NA (Voltaren): Side Effeccts

dizzines, blood dyscrasias, headache, nephrotoxicity, hypersensitivity, GI distress, bleeding or ulcer, rash

Diclofenac NA (Voltaren): Indication

used in arthritic conditions, dysmenorrhea, Opthalmic:reduce inflammation after cataract extraction

Diclofenac NA (Voltaren): Nursing Consideration

if dose missed take withing 2 hours, may increase risk of cardiovascular thrombotic events, possible cross-allergy with aspirin and other NSAIDs, may increase risk of elevated liver tests

Diclofenac NA (Voltaren):PO dosing instructions

take with full glass of water and food and remain upright for 30 minutes

Diclofenac NA (Voltaren): Patient Teaching

use sunscreen to prevent photosensitivity

Diclofenac NA (Voltaren): Pregnancy Category

C

Etodolac: Side Effects

nephrotoxicity, nausea, blood dyscrasias, anorexia, dizziness, hypertension, hypersensitivity

Etodolac: Indication

reduces pain of osteoarthritis, rheumatoid arthritis

Etodolac: Nursing Considerations

monitor for signs of toxicity: blurred vision, ringing or roaring in ears, full therapeutic effect may take up to 1 month, may increase risk of cardiovascular thrombotic events, may increase risk of GI bleeding or ulcer, may cause false positive for urinary bilirubin, may cause false positive for ketones in urine

Etodolac: patient Teaching

avoid concurrent use of ASA, NSAIDs, acetaminophen, alcohol

Etodolac: Pregnancy Category

C

Ibuprogen (Advil, Motrin IB): Side Effects

nausea, vomiting, diarrhea, constipation, headache, dizziness, fluid retention, GI bleeding, hives, rash

Ibuprogen (Advil, Motrin IB): Indication

treatment of rheumatoid arthritis/osteoarthritis relief of mild/ moderate pain; antipyretic

Ibuprogen (Advil, Motrin IB): Nursing Considerations

use cautiously with aspirin allergy, monitor for visual disturbances, tinnitus, monitor for increased weight gain, edema, fever, hematuria, arthralgia,

Ibuprogen (Advil, Motrin IB): Patient Teaching

avoid alcohol, take with milk or food,

Ibuprogen (Advil, Motrin IB): Pregnancy Category

C

Indomethacin (Indocin): Side Effects

peptic ulcer, dizziness, bone marrow depression, hypersensitivity, blurred vision, tinnitus, hypertension, drowsiness

Indomethacin (Indocin): Indication

treatment of rheumatoid arthritis/osteoarthritis, acute gout, acute painful shoulder

Indomethacin (Indocin): Nursing Considerations

observe for bleeding problems, may increase risk for cardiovascular thrombotic evetnst, monitor for weight gain

Indomethacin (Indocin): Patient Teaching

use caution with potentially hazardous activites, avoid use with alcohol,aspirin, other NSAIDs,

Indomethacin (Indocin): PO dosing instructions

take with food/milk, encourage upright positions for 15-30 minutes

Indomethacin (Indocin): Pregnancy Category

C

Naproxen NA ( Aleve, Anaprox, Naprosyn): Side Effects

nausea, dizziness, headache, asthma, GI bleeding, Hives

Naproxen NA ( Aleve, Anaprox, Naprosyn): Indications

for mild to moderate pain, treatment of arthritis, primary dysmenorrhea

Naproxen NA ( Aleve, Anaprox, Naprosyn): PO dosing instructions

with food to decrease GI upset, on empty stomach to increase absorption

Naproxen NA ( Aleve, Anaprox, Naprosyn): Nursing Considerations

monitor for signs of toxicity: blurred vision, ringing or roaring in ears, full therapeutic effect may take up to 1 month, monitor for melena, weight gain, arthralgia, hematuria

Naproxen NA ( Aleve, Anaprox, Naprosyn): Patient Teaching

Avoid concurrent use of ASA, steroids, alcohol

Naproxen NA ( Aleve, Anaprox, Naprosyn): Pregnancy Category

C

Piroxicam (Feldene): Side Effects

drowsiness, headache, hypertension, hypersensitivity, GI disturbances, bleeding or ulcer

Piroxicam (Feldene): INdication

for mild to moderate pain, osteoarthritis, rheumatoid arthritis

Piroxicam (Feldene): Po dosing instructions

with food to decrease GI upset, on empty stomach to increase absorption

Piroxicam (Feldene): Nursing Considerations

monitor for signs of toxicity: blurred vision, ringing or roaring in ears, jaundice, full therapeutic effect may take up to 1 month, may icrease risk of cardiovascular thrombotic events

Piroxicam (Feldene):Patient Teaching

take at same time every day, avoid concurrent use of ASA, OTC meds, alcohol

Piroxicam (Feldene): Pregnancy Category

C

Salsalate (Disalcid): Side Effects

nausea, vomiting, GI bleeding, vertigo, heartburn, rash, tinnitus

Salsalate (Disalcid): Indications

for mild to moderate pain, rheumatoid arthritis, and osteoarthritis

Salsalate (Disalcid): Po dosing instructions

can be crushed or taken whole, take with food or milk to decrease GI upset

Salsalate (Disalcid): Nursing Considerations

full therapeutic effect may take 2 weeks, read label on OTC meds, may contain ASA, monitor for signs of toxicity: changes in liver, kidney, eye, ear functions

Salsalate (Disalcid): Pregnancy Category

C

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