DRUG REVIEW Drug Name Etoricoxib (Arcoxia) 120mg/tab every 4 hours as needed for pain Mode of Action Selectively

y inhibits cyclooxygenase- 2 (COX-2) COX-2 which is an isoform of the enzyme that has been postulated to be primarily responsible for the synthesis of mediators of pain, inflammation, and fever. Affects central nervous system functions towards fever induction, pain perception and cognitive function. Does not inhibit COX-1 at thereby has no effect on gastric prostaglandin synthesis and on platelet function Indication Short-term treatment of moderate pain Contraindication Adverse Drug Reaction Hypersensitivity Reactions: Swelling of the face, lips, tongue or throat which may cause difficulty in swallowing or breathing Insomnia or increased anxiety Severe increase in blood pressure Confusion, Hallucinations Decreased Platelets Atrial Fibrillation or abnormal rhythm of the heart Heart failure Stomach pain or Stomach ulcers that may become serious and may bleed, and may occur at any time during use and without warning Nursing Responsibilities Assess client for history of allergic reaction to Arcoxia or for previous heart failure, heart attack, bypass surgery, angina, peripheral arterial disease, or transient ischaemic attack. Monitor blood pressure regularly while taking this medication. Take medication with a glass of water to avoid dehydration. Arcoxia may be taken regardless of food intake. Stop the medication immediately if gastrointestinal lesions occur.

Active peptic ulceration or active gastro-intestinal (GI) bleeding. For the symptomatic relief of Patients who have osteoarthritis (OA), experienced rheumatoid arthritis (RA), bronchospasm, acute ankylosing spondylitis, and the rhinitis, nasal polyps, pain and signs of inflammation angioneurotic oedema, associated with acute gouty urticaria, or allergic-type arthritis. reactions after taking acetylsalicylic acid or NSAIDs including COX-2 inhibitors. Severe hepatic dysfunction (serum albumin <25 g/l or Child-Pugh score 10). Estimated renal creatinine clearance <30 ml/min. Inflammatory bowel disease. Patients with hypertension whose blood pressure is persistently elevated above 140/90mmHg and has not been adequately controlled. Established ischaemic heart disease, peripheral arterial disease, and/or cerebrovascular disease.