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    Diclofenac

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    api-3797941
    Diclofenac is a nonsteroidal anti-inflammatory drug (NSAID) used to treat mild to moderate pain, rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, and actinic keratosis. It works by inhibiting prostaglandin synthetase. Common side effects include headache, dizziness, nausea, and GI upset. It should be used cautiously in those with renal impairment, impaired hearing, allergies, or cardiovascular and liver conditions due to increased risk of toxicity and bleeding. Nursing considerations include monitoring for side effects and toxicity, administering with food if GI upset occurs, and arranging eye exams during long-term use.

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    Diclofenac

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    api-3797941
    4K views3 pages
    Diclofenac is a nonsteroidal anti-inflammatory drug (NSAID) used to treat mild to moderate pain, rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, and actinic keratosis. It works by inhibiting prostaglandin synthetase. Common side effects include headache, dizziness, nausea, and GI upset. It should be used cautiously in those with renal impairment, impaired hearing, allergies, or cardiovascular and liver conditions due to increased risk of toxicity and bleeding. Nursing considerations include monitoring for side effects and toxicity, administering with food if GI upset occurs, and arranging eye exams during long-term use.

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    Diclofenac is a nonsteroidal anti-inflammatory drug (NSAID) used to treat mild to moderate pain, rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, and actinic keratosis. It works by inhibiting prostaglandin synthetase. Common side effects include headache, dizziness, nausea, and GI upset. It should be used cautiously in those with renal impairment, impaired hearing, allergies, or cardiovascular and liver conditions due to increased risk of toxicity and bleeding. Nursing considerations include monitoring for side effects and toxicity, administering with food if GI upset occurs, and arranging eye exams during long-term use.

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    Download as DOC, PDF, TXT or read online from Scribd
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    4K views3 pages

    Diclofenac

    Uploaded by

    api-3797941
    Diclofenac is a nonsteroidal anti-inflammatory drug (NSAID) used to treat mild to moderate pain, rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, and actinic keratosis. It works by inhibiting prostaglandin synthetase. Common side effects include headache, dizziness, nausea, and GI upset. It should be used cautiously in those with renal impairment, impaired hearing, allergies, or cardiovascular and liver conditions due to increased risk of toxicity and bleeding. Nursing considerations include monitoring for side effects and toxicity, administering with food if GI upset occurs, and arranging eye exams during long-term use.

    Copyright:

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    Download as DOC, PDF, TXT or read online from Scribd
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    of 3

    diclofenac

    (dye kloe' fen ak)

    diclofenac potassium
    Cataflam, Voltaren Rapide (CAN)

    diclofenac sodium
    Novo-Difenac (CAN), Nu-Diclo (CAN), Solaraze, Voltaren, Voltaren Ophtha
    (CAN), Voltaren-XR

    Pregnancy Category B

    Drug classes
    Anti-inflammatory
    NSAID

    Therapeutic actions
    Inhibits prostaglandin synthetase to cause antipyretic and anti-inflammatory effects; the
    exact mechanism is unknown.

    Indications
    • Acute or long-term treatment of mild to moderate pain, including dysmenorrhea
    • Rheumatoid arthritis
    • Osteoarthritis
    • Ankylosing spondylitis
    • Treatment of actinic keratosis in conjunction with sun avoidance
    • Ophthalmic: Postoperative inflammation from cataract extraction

    Contraindications and cautions


    • Contraindicated with allergy to NSAIDs, significant renal impairment, pregnancy,
    lactation.
    • Use cautiously with impaired hearing, allergies, hepatic, cardiovascular, and GI
    conditions.

    Available forms
    Tablets—50 mg; DR tablets—25, 50, 75 mg; ER tablets—100 mg; topical gel—30 mg/g;
    ophthalmic solution—0.1%

    Dosages
    ADULTS
    Oral
    • Pain, including dysmenorrhea: 50 mg tid PO; initial dose of 100 mg may help
    some patients (Cataflam).
    • Osteoarthritis: 100–150 mg/day PO in divided doses (Voltaren); 50 mg bid–tid
    PO (Cataflam).
    • Rheumatoid arthritis: 150–200 mg/day PO in divided doses (Voltaren); 50 mg
    bid–tid PO (Cataflam).
    • Ankylosing spondylitis: 100–125 mg/day PO. Give as 25 mg qid, with an extra
    25-mg dose hs (Voltaren); 25 mg qid PO with an additional 25 mg hs if needed
    (Cataflam).
    Topical
    • Actinic keratosis: Cover lesion with gel and smooth into skin; do not cover with
    dressings or cosmetics.
    Ophthalmic
    1 drop to affected eye qid starting 24 hr post-op for 2 wk
    PEDIATRIC PATIENTS
    Safety and efficacy not established.

    Pharmacokinetics
    Route Onset Peak Duration
    Oral (sodium) Varies 2–3 hr 12–15 hr
    Oral (potassium) Rapid 20–120 min 12–15 hr

    Metabolism: Hepatic; T1/2: 1.5–2 hr


    Distribution: Crosses placenta; enters breast milk
    Excretion: Urine and feces

    Adverse effects
    • CNS: Headache, dizziness, somnolence, insomnia, fatigue, tiredness, tinnitus,
    ophthamologic effects
    • Dermatologic: Rash, pruritus, sweating, dry mucous membranes, stomatitis
    • GI: Nausea, dyspepsia, GI pain, diarrhea, vomiting, constipation, flatulence
    • GU: Dysuria, renal impairment
    • Hematologic: Bleeding, platelet inhibition with higher doses
    • Other: Peripheral edema, anaphylactoid reactions to fatal anaphylactic shock

    Interactions
    Drug-drug
    • Increased serum levels and increased risk of lithium toxicity
    • Increased risk of bleeding with anticoagulants; monitor patient closely

    Nursing considerations
    Assessment
    • History: Renal impairment; impaired hearing; allergies; hepatic, CV, and GI
    conditions; lactation
    • Physical: Skin color and lesions; orientation, reflexes, ophthalmologic and
    audiometric evaluation, peripheral sensation; P, edema; R, adventitious sounds;
    liver evaluation; CBC, clotting times, renal and liver function tests; serum
    electrolytes, stool guaiac

    Interventions
    • Administer drug with food or after meals if GI upset occurs.
    • Arrange for periodic ophthalmologic exam during long-term therapy.
    • Institute emergency procedures if overdose occurs (gastric lavage, induction of
    emesis, supportive therapy).

    Teaching points
    • Take drug with food or meals if GI upset occurs.
    • Take only the prescribed dosage.
    • These side effects may occur: Dizziness, drowsiness (avoid driving or using
    dangerous machinery while using this drug).
    • Report sore throat, fever, rash, itching, weight gain, swelling in ankles or fingers,
    changes in vision; black, tarry stools.

    Adverse effects in Italic are most common; those in Bold are life-threatening.

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