Mechanism of Nursing

Name of Drug Indication Contraindication Side Effects Adverse Effects

Action Responsibilities

Generic Name: Classification:  Increased risk of  Hypersensitivity  Cardiovascul Significant:  Tell patient to take
Diclofenac Central gastrointestinal to diclofenac or ar  Na and fluid retention, tablets or capsules
(Oral) 1 Nervous ulceration, other NSAIDs. Thrombotic oedema, HTN, liver with milk, meals or
System Agent; perforation or  Aspirin-sensitive Events function abnormalities antacids to minimize
Diclofenac NSAID, haemorrhage asthma, risk  GI Bleeding, (e.g. increased liver, GI distress; however,
Potassium 2 Analgesic, with other factors for Ulceration transaminase, enzyme taking Cambia or
Nonnarcotic, corticosteroids, volume and levels), anaemia, rare Zorvolex with food
Diclofenac Antipyretic SSRIs. depletion (inj). Perforation severe blood may reduce its
Sodium (Oral) 3    Increased risk  Moderate to  Hepatotoxicit dyscrasias (e.g. effectiveness.
Peak Effect: CV-related severe heart y agranulocytosis,  Instruct patient not
Brand Name: Voltaren has adverse failure,  Hypertension thrombocytopenia, to crush, break, or
Zorvolex 1 been used to reactions with  ischaemic heart  Heart Failure aplastic anaemia), risk chew delayed- or
relieve pain cardiac disease, and Edema of hyperkalaemia; extended-release
Apo-Diclo symptoms of glycosides.  peripheral  Renal keratitis (ophthalmic). tablets. Advise
Rapide, Cambia, the rheumatoid  Increased risk of arterial disease, Toxicity and patient to seek
Voltaren Rapide, arthritis, hyperkalaemia  cerebrovascular Hyperkalemi Cardiac disorders medical attention
Zipsor 2 osteoarthritis, and renal disease, a  Chest pain. immediately if chest
spondylitis toxicity with pain, shortness of
 gastrointestinal  Anaphylactic
Apo-Diclo, ankylosing, ACE inhibitors, Ear and labyrinth breath or trouble
ulceration, Reactions
Voltaren SR 3 dysmenorrhoea diuretics, disorders breathing, weakness
 perforation or  Serious Skin
and mild to ciclosporin,  Tinnitus. in one part of side of
haemorrhage, Reactions
Route & modest tacrolimus. the body, or slurred
Dosage: suffering.  proctitis (rectal).  Hematologic
 Increased risk of  Treatment in the Toxicity Eye disorders speech occurs.
 Rheumatoid Alone or with haematological  Blurred vision;  Tell patient to mix
Arthritis other setting of
toxicity with transient burning or powder form well in
adult: medicines, CABG.
zidovudine. stinging of the eyes, 30 to 60 mL of water
PO 150–200 Voltaren may  Concomitant use
 Increased levels of other
lacrimation, increased only and to drink
mg/d in 3–4 be used. and risk of intraocular pressure immediately
divided doses NSAIDs,
toxicity with (ophthalmic).  Advise patient not to
child: PO 25 Diclofenac, an antiplatelets,
digoxin, lithium, take this drug with
mg b.i.d. or NSAID anticoagulants.
methotrexate, Gastrointestinal other diclofenac-
t.i.d. derived from  Severe hepatic or
pemetrexed, disorders containing products
 Osteoarthritis phenylacetic renal
phenytoin.  Nausea, vomiting, (such as Arthrotec),
adult:PO 100– acid, has impairment.
 Decreased effect Pregnancy (3rd
diarrhoea, other NSAIDs, or
150 mg/d in 3– analgesic, anti- with colestipol, constipation, salicylates (salsalate,
 4 divided doses inflammatory cholestyramine. trimester). dyspepsia, flatulence, diflunisal).
100 mg and antipyretic  Decrease effect abdominal pain.  Teach patient signs
sustained properties. It of mifepristone. and symptoms of GI
release q.d. reversibly  Increased peak General disorders and bleeding (blood in
 Ankylosing inhibits plasma administration site vomit, urine, or
Spondylitis cyclooxygenas concentration conditions stool; coffee-ground
adult:PO 25 e-1 and 2 with CYP2C9  Injection site reactions vomit; black, tarry
mg q.i.d. and thereby, also inhibitors e.g. (e.g. pain), application stools) and to notify
25 mg h.s. inhibiting voriconazole. site reactions (e.g. prescriber
 Cataract prostaglandin irritation, erythema, immediately if any
Surgery synthesis. Potentially Fatal: itchiness, dryness, of these occur.
adult:Ophthal    Increased risk of oedema, pyrexia.  Teach patient the
mic  1 drop of gastrointestinal signs of symptoms
0.1% solution ulceration, Infections and of damage to the
in affected eye perforation or infestations liver, including
q.i.d. beginning haemorrhage  Influenza. nausea, fatigue,
24 h after with other lethargy, itching,
surgery and NSAIDs (e.g. Metabolism and yellowed skin or
continuing for aspirin), nutrition disorders eyes, right upper
2 wk antiplatelets,  Anorexia. quadrant tenderness
 Actinic anticoagulants and flulike
Keratosis (e.g. warfarin). Musculoskeletal and symptoms. Tell
adult:Topical     connective tissue patient to contact
apply to disorders prescriber
affected area  Arthralgia, immediately if these
b.i.d. for 60–90 osteoarthritis, back symptoms occur.
d. pain, limb pain.  Advise patient to
avoid drinking
Nervous system alcohol or taking
disorders aspirin during drug
 Headache, dizziness. therapy.
 Tell patient to wear
Psychiatric disorders sunscreen or
 Insomnia, somnolence. protective clothing
because drug may
Renal and urinary cause sensitivity to
disorders sunlight.
 UTI, renal function  Warn patient to
abnormality, avoid hazardous
haematuria. activities that require
alertness until it is
Respiratory, thoracic known whether the
and mediastinal drug causes CNS
disorders symptoms
 Upper respiratory tract  Tell female patient
infection, who is pregnant to
nasopharyngitis, avoid use of drug
sinusitis, bronchitis, during last trimester.
cough.  Advise patient that
use of OTC NSAIDs
Skin and subcutaneous (which may be
tissue disorders present in OTC
 Rash, pruritus. medications for
treatment of colds,
Vascular disorders fever, or insomnia)
 Hypotension. and diclofenac may
increase risk of GI
Potentially Fatal toxicity.
 Anaphylaxis reaction,
CV thrombotic events
(e.g. MI, stroke),
gastrointestinal
ulceration, perforation
or haemorrhage,
bronchospasm; rarely,
hepatotoxicity (e.g.
fulminant hepatitis,
hepatic necrosis or
failure), Stevens-
Johnson syndrome,
exfoliative dermatitis,
toxic epidermal
necrolysis.
References
Lippincott Williams & Wilkins. (2019). Nursing Drug Guide: Nursing 2020 Drug Handbook. Philadelphia: Wolters Kluwer.
RNSpeak. (2020, July 29). Diclofenac Sodium (Voltaren) Drug Study. Retrieved from RNSpeak: https://rnspeak.com/diclofenac-sodium-voltaren-
drug-study/