Bagona Lhea Jane BSN 309 Group 33

DRUG

DOSAGE

Generic Name: Diclofenac potassium Brand name: Cataflam Classification: NSAID Therapeutic classification: antiarthritic; antiinflammatory
PREGNANCY RISK CATEGORY B; D IN 3RD TRIMESTER

Available Forms Tablets: 50 mg

Doctors Order: 50mg TID

THERAPEUTI C ACTIONS May inhibit prostaglandin synthesis, to produce antiinflammatory, analgesic, and antipyretic effects.

INDICATIONS Ankylosing spondylitis Adults: 25 mg delayedrelease diclofenac sodium P.O. q.i.d.; may add another 25mg dose at bedtime. Osteoarthrit is Adults: 50 mg P.O. b.i.d. or t.i.d., or 75 mg P.O. b.i.d. diclofenac potassium or delayedrelease diclofenac

CONTRAINDI CATION Contraindic ated in patients hypersensiti ve to drug and in those with hepatic porphyria or history of asthma, urticaria, or other allergic reactions after taking aspirin or other NSAIDs. Avoid using during late pregnancy or breastfeeding. Use cautiously

ADVERSE EFFECTS

NURSING CONSIDERATI ONS CNS Administratio aseptic n meningitis P.O. anxiety Give drug depression with milk, dizziness meals, or drowsiness antacids. headache Don't crush insomnia or break irritability enteric-coated CV tablets. heart failure Clinical edema Consideration fluid retention s hypertension Because EENT NSAIDs impair laryngeal the synthesis of edema renal blurred vision prostaglandins, epistaxis they can eye pain decrease renal night blindness blood flow and reversible lead to hearing loss reversible renal swelling of the impairment, lips and tongue especially in

sodium only. Or, 100 mg P.O. daily or b.i.d. extendedrelease diclofenac sodium only. Rheumatoid arthritis Adults: 50 mg P.O. t.i.d. or q.i.d., or 75 mg P.O. b.i.d. diclofenac potassium or delayedrelease diclofenac sodium only. Or, 100 mg P.O. daily or b.i.d. extendedrelease diclofenac sodium only, or 50

in patients with history of peptic ulcer disease, hepatic dysfunction, cardiac disease, hypertensio n, fluid retention, or impaired renal function.

tinnitus GI abdominal distention abdominal pain or cramps bleeding constipation diarrhea flatulence indigestion melena nausea peptic ulceration taste disorder bloody diarrhea appetite change colitis GU nephrotic syndrome acute renal failure fluid retention interstitial nephritis oliguria papillary necrosis proteinuria

patients with renal or heart failure or liver dysfunction, in elderly patients, and in those taking diuretics. Monitor these patients closely. Liver function test values may increase during therapy. Monitor transaminase, especially ALT, levels periodically in patients undergoing long-term therapy. Make first transaminase measurement no later than 8 weeks after therapy begins. Because of their antipyretic and anti-

to 100 mg diclofenac sodium P.R. at bedtime as substitute for last P.O. dose of the day. Don't exceed 150 mg daily. Analgesia, primary dysmenorrh ea Adults: 50 mg diclofenac potassium P.O. t.i.d. For some patients, the first dose on the 1st day may be 100 mg, followed by 50 mg for the second and third doses; maximum dose for 1st

Hepatic jaundice hepatitis hepatotoxicity Metabolic hypoglycemia hyperglycemia Musculoskele tal back leg or joint pain Respiratory asthma Skin StevensJohnson syndrome allergic purpura alopecia bullous eruption dermatitis eczema photosensitivity reactions pruritus rash urticaria Other anaphylactoid reactions anaphylaxis

inflammatory actions, NSAIDs may mask the signs and symptoms of infection. Alert: NSAI Ds may increase the risk of potentially fatal cardiovascular thrombotic events, MI, and stroke. Serious GI toxicity, including peptic ulcers and bleeding, can occur in patient taking NSAIDs, despite lack of symptoms. Look alikesound alike: Don't confuse diclofenac with Diflucan. Patient Teaching Tell patient

day is 200 mg. Don't exceed 150 mg daily after the 1st day.

angioedema

to take drug with milk, meals, or antacids to minimize GI distress. Instruct patient not to crush, break, or chew entericcoated tablets. Advise patient not to take this drug with any other diclofenaccontaining products (such as Arthrotec). Teach patient signs and symptoms of GI bleeding, including blood in vomit, urine, or stool; coffeeground vomit; and black, tarry stool. Tell him to notify prescriber immediately if any of these

occurs. Teach patient the signs and symptoms of damage to the liver, including nausea, fatigue, lethargy, itching, yellowed skin or eyes, right upper quadrant tenderness, and flulike symptoms. Tell patient to contact prescriber immediately if these symptoms occur. Advise patient to avoid drinking alcohol or taking aspirin during drug therapy. Tell patient to wear sunscreen or

protective clothing because drug may cause sensitivity to sunlight. Warn patient to avoid hazardous activities that require alertness until it is known whether the drug causes CNS symptoms. Tell pregnant woman to avoid use of drug during last trimester. Advise patient that use of OTC NSAIDs and diclofenac may increase the risk of GI toxicity.