Celecoxib (Celebrex)

NSAID (non-steroidal anti-inflammatory drug)

Analgesic (non-narcotic)
Specific COX-2 enzyme blocker
Therapeutic actions
Analgesic and anti-inflammatory activities related to inhibition of the COX-2 enzyme, which is activated in inflammation to
cause the signs and symptoms associated with inflammation; does not effect the COX-1 enzyme, which protects the lining of the GI tract
and has blood clotting and renal functions.
Indications

Acute and long-term treatment of signs and symptoms of rheumatoid arthritis and osteoarthritis

Unlabeled use: mild to moderate pain

Contraindications/cautions

Contraindicated in the presence of significant renal impairment, pregnancy, lactation.

Use caution in the presence of impaired hearing, allergies, hepatic and cardiovascular conditions.
Dosage
Available Forms: Tablets--100, 200 mg

Adult

Initial dose--100 mg PO bid; or 200 mg qd PO.

Pediatric

Safety and efficacy have not been established.

Adverse Effects

CNS: headache, dizziness, somnolence, insomnia, fatigue, tiredness, dizziness, tinnitus, ophthamologic effects

Respiratory: dyspnea, hemoptysis, pharyngitis, bronchospasm, rhinitis

Dermatologic: rash, pruritus, sweating, dry mucous membranes, stomatitis

Hematologic: neutropenia, eosinophilia, leukopenia, pancytopenia, thrombocytopenia, agranulocytosis, granulocytopenia,

aplastic anemia, decreased hemoglobin or hematocrit, bone marrow depression, menorrhagia

Other: peripheral edema, anaphylactoid reactions to fatal anaphylactic shock

Nursing Considerations
Assessment
History: Renal impairment, impaired hearing, allergies, hepatic and cardiovascular conditions, lactation
Physical: Skin--color and lesions; orientation, reflexes, ophthalmological and audiometric evaluation, peripheral sensation; P, edema; R,
adventitious sounds; liver evaluation; CBC, renal and liver function tests; serum electrolytes
Implementation

Administer drug with food or after meals if GI upset occurs.

Establish safety measures if CNS, visual disturbances occur.

Arrange for periodic ophthalmologic examination during long-term therapy.

Institute emergency procedures if overdose occurs--gastric lavage, induction of emesis, supportive therapy.

Provide further comfort measures to reduce pain (positioning, environmental control, etc), and to reduce inflammatio