NSAIDS (continued)
GENERIC NAME BRAND NAME(S)USE: DOSAGE RANGE
naproxen Anaprox Arthritis: 250–550 mg/day
Naprosyn Pain/1° dysmenorrhea/bursitis/tendonitis: 500 mg, then 250 mg q6–8h
Juvenile arthritis: 10 mg/kg in 2 divided doses
Gouty arthritis: 750 mg, then 250 mg q8h
oxaprozin Daypro Arthritis: 600–1,800 mg/day
piroxicam Feldene Arthritis: 20 mg/day
sodium salicylate Sodium Salicylate Arthritis/pain/fever: 325–650 mg q4h prn
sulindac Clinoril Arthritis: 300 mg/day
Acute gouty arthritis/painful shoulder: 400 mg/day
tolmetin Tolectin Arthritis: 600–1,800 mg/day
Juvenile arthritis: 15–30 mg/kg/day
1° = primary; prn= as circumstances may require.
USES
Provides symptomatic relief from pain/inflammation in the treatment of musculoskeletal disorders (e.g., rheumatoid arthritis,
osteoarthritis, ankylosing spondylitis); analgesic for low to moderate pain; reduces fever (many agents not suited for
routine/prolonged therapy due to toxicity). By virtue of its action on platelet function, aspirin is used in treatment or prophy-
laxis of diseases associated with hypercoagulability (reduces risk of stroke/heart attack).
PRECAUTIONS
Contraindications: Aspirin sensitivity or allergy to other components; pregnancy; lactation; children <14 yrs of age, gastroin-
testinal disorders. Cautions: Renal or hepatic dysfunctions, cardiac or hypertensive disorders, severe infections, elderly, coag-
ulation defects, otic disease.
INTERACTIONS
Salicylates: Antacids, NSAIDs may increase risk of GI effects (e.g., ulceration). Urinary alkalinizers, antacids increase excretion.
Anticoagulants, heparin, thrombolytics increase risk of bleeding. Large doses may increase insulin, oral hypoglycemic effects.
Valproic acid, platelet aggregation inhibitors may increase risk of bleeding. May increase toxicity of methotrexate, zidovudine.
Ototoxic medications, vancomycin may increase ototoxicity. May decrease effect of probenecid, sulfinpyrazone.
NSAIDs: May increase effects of oral anticoagulants, heparin, thrombolytics. May decrease effect of antihypertensives,
diuretics. Salicylates, aspirin may increase risk of GI side effects, bleeding. Bone marrow depressants may increase risk of
hematologic reactions. May increase methotrexate toxicity. Probenecid may increase concentration.
SIDE EFFECTS
Gastrointestinal upset, dizziness, headache, constipation or diarrhea. Ophthalmic: Burning, stinging on instillation, keratitis,
elevated intraocular pressure.
TOXIC EFFECTS/ADVERSE REACTIONS
Hypersensitivity reactions, including skin rash or urticaria. Renal or hepatic toxicity, bone marrow suppression, bleeding, esp.
of gastrointestinal tract. Tinnitus and hearing disturbances. Reactions vary by individual drug.
NURSING IMPLICATIONS
General: Check for aspirin sensitivity (cross-sensitivity). Administer on schedule to maintain blood levels. Provide rest, posi-
tioning, and other comfort measures for pain relief. Baseline Assessment: Assess pain (type, location, intensity). Check tem-
perature, pulse, respirations. Intervention/Evaluation: Assess pain, therapeutic response (decreased temperature, pain
relief, improved mobility). Patient/Family Teaching: Take with meals or on empty stomach, as indicated by individual drug;
however, all drugs may be taken with food, if necessary, to reduce GI side effects. Avoid alcohol and consult physician about
other medications. Refrain from driving or other activities requiring motor response until certain no dizziness present. Inform
other physicians or dentist of drug therapy.
© 2001 W.B. Saunders Company