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Drug Name Dosages Therapeutic Indications Adverse effects Contraindications Nursing considerations
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celecoxib Oral  Celecoxib  Acute and long-  Abdominal Hypersensitivity CLINICAL ALERT!
(sell ah cocks'  Osteoarthritis has COX-2 term treatment of pain, diarrhea, including those in  Name confusion has
ib) o Adult: 200 mg as specific signs and nausea, whom attacks of occurred between
Celebrex a single dose or in inhibitory symptoms of edema, angioedema, Celebrex (celecoxib),
2 divided doses. activity. It inhibits rheumatoid arthritis dizziness, rhinitis and Celexa (citalopram),
Pregnancy May increase to the conversion and osteoarthritis headache, urticaria have Xanax (alprazolam),
Category C 200 mg bid if of arachidonic insomnia, been precipitated and Cerebyx
(first and necessary. acid to  Reduction of the upper by aspirin, (fosphenytoin); use
second prostaglandins number of respiratory tract NSAIDs or caution.
trimester) o Hepatic while having no colorectal polyps in infections; rash. sulfonamides.
Pregnancy impairment: effect on the familial Severe hepatic Assessment
Category D Child-Pugh formation of adenomatous  Potentially impairment;  History: Renal
(third trimester) category B: prostaglandins polyposis (FAP) Fatal: Serious severe heart impairment, impaired
Reduce dose by that mediate the skin reactions failure; hearing, allergies,
50%. Child-Pugh normal  Management of such as inflammatory hepatic and CV
    Drug classes category C: Avoid homeostasis in acute pain exfoliative bowel disease; conditions, lactation,
 NSAID use. the GI tract, dermatitis, peptic ulcer; renal pregnancy
 Analgesic kidneys and  Treatment of Stevens- impairment (CrCl  Physical: Skin color
(nonopioid) platelets primary Johnson <30 ml/min);
 Rheumatoid and lesions;
catalyzed by dysmenorrhea syndrome, and pregnancy and
arthritis orientation, reflexes,
 Specific COX-1. toxic epidermal lactation. ophthalmologic and
COX-2  Relief of signs and necrolysis.
o Adult: 100-200 audiometric
enzyme symptoms of
mg bid. Absorption: evaluation, peripheral
blocker anklylosing
Absorbed from the sensation; P, edema;
o Elderly: 100 mg spondylitis
GI tract (oral); peak R, adventitious
bid. plasma sounds; liver
 Relief of signs and
concentrations after evaluation; CBC,
o Hepatic symptoms of
3 hr. LFTs, renal function
juvenile rheumatoid
impairment: Distribution: tests; serum
arthritis
Child-Pugh Protein-binding: electrolytes
category B: 97%.
Reduce dose by Metabolism: Interventions
50%. Child-Pugh Hepatic; converted  BLACK BOX
category C: Avoid to inactive WARNING: Be aware
use. metabolites. that patient may be at
Excretion: Feces increased risk for CV
 Dysmenorrhea and urine (as events, GI bleeding;
metabolites and monitor accordingly.
o Adult: Initially, 400 unchanged drug);
 Administer drug with
mg followed by 11 hr (elimination
food or after meals if
200 mg if half-life).
necessary on the
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1st day. GI upset occurs.
Maintenance: 200
mg bid.  Establish safety
measures if CNS,
o Hepatic visual disturbances
impairment: occur.
Child-Pugh
category B:  Arrange for periodic
Reduce dose by ophthalmologic
50%. Child-Pugh examination during
category C: Avoid long-term therapy.
use.
 WARNING: If
 Pain overdose occurs,
institute emergency
o Adult: Initially, 400 procedures—gastric
mg followed by lavage, induction of
200 mg if emesis, supportive
necessary on the therapy.
1st day.
 Provide further
Maintenance: 200
comfort measures to
mg bid.
reduce pain (eg,
o Hepatic positioning,
impairment: environmental control)
Child-Pugh and to reduce
category B: inflammation (eg,
Reduce dose by warmth, positioning,
50%. Child-Pugh and rest).
category C: Avoid
use. Teaching points
 Take drug with food or
 Familial meals if GI upset
adenomatous occurs.
polyposis  Take only the
prescribed dosage; do
o Adult: 400 mg bid. not increase dosage.

o Hepatic  You may experience

impairment: these side effects:
Child-Pugh Dizziness, drowsiness
category B: (avoid driving or the
Reduce dose by use of dangerous
50%. Child-Pugh machinery while
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category C: Avoid taking this drug).
use.
 Report sore throat,
fever, rash, itching,
weight gain, swelling
in ankles or fingers;
changes in vision.

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