CLASSIFICATION INDICATION MECHANISM OF CONTRAINDICATION SIDE EFFECTS NURSING CONSIDERATIONS

OF DRUG ACTION
Generic Name: To relieve signs and Selectively inhibits Allergic reaction (such as Common side  Use celecoxib with extreme
A. Chemical:  symptoms of osteo- the enzymatic anaphylaxis or caution in patients who
effects of Celebrex
celecoxib arthritis activity of angioedema) to aspirin, have a history of ulcer
Diarylsubstituted cyclooxygenase2 other NSAIDs, or include
Brand Names: disease or GI bleeding
pyrazole derivative To relieve signs and (COX2), the enzyme sulfonamide derivatives
because NSAIDs, such as
Celebrex symptoms of needed to convert or history of aspirin  headache,
arachidonic acid to induced nasal polyps with celecoxib, increase the risk
B. Therapeutic:  abdominal of GI bleeding and
rheumatoid arthritis prostaglandin. bronchospasm;
Dose: 200mg Prostaglandins are hypersensitivity to pain, ulceration. In these patients,
Antiinflammatory, drug should be used for
antirheumatic
respon sible for celecoxib or its  indigestion,
mediating the components; treatment of  diarrhea, shortest time possible.
Frequency: BID
To relieve signs and inflammatory perioperative pain after  Be aware that serious GI
C. Pregnancy   response and causing coronary artery bypass  nausea,
symptoms of tract ulceration and
Category: C local vasodilation, graft surgery  upset bleeding, as well as
Route:P.O swelling, and pain. stomach, perforation of stomach or
juvenile rheumatoid
Prostaglandins also
:   arthritis  bloating, intestine, can occur without
play a role in
peripheral pain  gas, warning or symptoms.
To relieve pain from transmission to the  dizziness, Elderly patients are at
Pharmacokinetics: ankylosing spinal cord. By greatest risk. To minimize
spondylitis  nervousness risk, give celecoxib with
inhibiting COX2
Onset: 24–48 hr  headache,
activity and food. If patient develops GI
As adjunct to reduce prostaglandin  runny distress, withhold celecoxib
Peak: unknown adenomatous production, this or stuffy and notify prescriber
Duration: 12–24 hr
NSAID reduces immediately.
Half Life: 8-12 hours colorectal polyps in inflammatory nose,
 •Use celecoxib cautiously
patients with symptoms and  sore throat,
in patients with
relieves pain.  skin rash,
familial adenomatous Celecoxib’s
hypertension, and monitor
and blood pressure closely
polyposis mechanism of action
in reducing the insomnia. throughout therapy because
To manage acute number of colorectal drug can start or worsen
pain, to treat primary polyps is unknown. hypertension.
 Use celecoxib cautiously in
dysmenorrhea children with systemic
onset juvenile rheumatoid
arthritis because serious
ADVERSE EFFECTS: adverse reactions can occur,
CNS: Aseptic including disseminated
meningitis, cerebral intravascular coagulation.
hemorrhage, depression,  Use celecoxib cautiously in
dizziness, fever, patients known to be poor
headache, insomnia,
CYP2C9 metabolizers
ischemic stroke, stroke,
suicidal ideation, based on history or
syncope, transient experience with other
ischemic attacks, vertigo CYP2C9 substrates, such as
CV: Aortic valve warfarin or phenytoin.
incompetence, chest Dosage should start at half
pain, congestive heart the lowest recommended
failure, deep vein throm amount. For patients with
bosis, fluid retention, juvenile rheumatoid
hypertension, MI, arthritis who are also poor
palpitations, peripheral CYP2C9 metabolizers,
edema or gangrene,
alternative management
sinus bradycardia,
tachycardia, thrombosis, should be considered.
unstable angina,  Monitor patient—especially
vasculitis,ventricular if elderly or receiving long-
fibrillation, ventricular term celecoxib therapy—
hypertrophy for less common but
EENT: Conjunctival serious adverse GI
hemorrhage, deafness, reactions, including
labyrinthitis, anorexia, consti pation,
nasopharyngitis, diverticulitis, dysphagia,
pharyngitis, rhinitis,
esophagitis, gastritis,
sinusitis, vitreous
floaters gastroenteritis,
ENDO: Hyperglycemia, gastroesophageal reflux
hypoglycemia disease, hemorrhoids, hiatal
GI: Abdominal pain, hernia, melena, stomatitis,
diarrhea, elevated liver and vomiting.
function test results,  Monitor liver function test
esophageal perforation, results because, in rare
flatulence, GI bleeding cases, elevation may
or ulceration, hepatic progress to severe hepatic
failure, ileus,
reaction, including fatal
indigestion, jaundice,
nausea, pancreatitis,
hepatitis, hepatic necrosis,
perforation of stomach and hepatic failure.
or intestine, vomiting  Monitor BUN and serum
GU: Acute renal failure, creatinine levels in elderly
interstitial nephritis, patients; patients taking
ovarian cyst, diuretics, ACE inhibitors,
proteinuria, UTI, urinary
or angiotensin II receptor
incontinence
HEME: antagonists; and patients
Agranulocytosis, with heart failure, impaired
aplastic anemia, renal function, or hepatic
decreased hematocrit dysfunction because drug
and hemoglobin, may cause renal failure.
leukopenia,  Monitor CBC for decreased
pancytopenia, prolonged hemoglobin level and
APTT, hematocrit because drug
thrombocytopenia may worsen anemia.
MS: Arthralgia, back
pain, elevated serum CK
 Assess patient’s skin
level, epicondylitis, regularly for signs of rash
tendon rupture RESP: or other hypersensitivity
Bronchospasm, cough, reaction because celecoxib
dyspnea, pneumonia, is a sulfur drug and may
pulmonary embolism, cause serious skin reactions
upper respiratory tract without warning, even in
infection patients with no history of
SKIN: Erythema sensitivity to sulfur. At first
multiforme, exfoliative sign of reaction, stop drug
dermatitis,
and notify prescriber.
phototoxicity, rash,
Stevens Johnson  Avoid using celecoxib with
syndrome, toxic a nonaspirin NSAID,
epidermal necrolysis, regardless of the dose,
urticaria because celecoxib reduces
Other: Anaphylaxis, inflammation and fever,
angioedema, which may mask signs of
hyperkalemia, infection.
hypernatremia,
hyponatremia, sepsis