GERVACIO, Siergs Smith P.

BSN IV

Patients Name: Teresita Daraman

Sex:
Female
Name of Drug
Generic Name:

Classification
Pharmacologic:

celecoxib

COX-2 inhibitors

Brand Name:
CeleBREX
Celcox
Celemax
Celebix
Patients Dose:
200 mg cap PO BID

Therapeutic:
antirheumatics, nonsteroidal
anti-inflammatory agents

Maximum Dose:
400 mg/day

Diagnosis: Staghorn Calculus, Left

Age: 56 years old
Mechanism of Action
Action:
Inhibits the enzyme COX-2.
This enzyme is required for
the synthesis of
prostaglandins. Has analgesic,
anti-inflammatory,
and antipyretic properties.
Therapeutic
Effects: Decreased pain and
inflammation caused by
arthritis or spondylitis.
Decreased pain.
Pharmacokinetics:

Indication
General:

Absorption: Bioavailability
unknown.
Distribution: 97% bound to
plasma proteins; extensive
tissue distribution.
Metabolism and Excretion:
Mostly metabolized
by the hepatic CYP2C9
isoenzyme; <3% excreted
unchanged in urine and feces.

Management of acute pain

Relief of signs and

symptoms of
osteoarthritis, rheumatoid
arthritis, ankylosing
spondylitis, and juvenile
rheumatoid arthritis.
Management of acute pain
including
primary dysmenorrhea.
Patients Indication:

Date of Admission: January 23, 2016

Height/Weight: 39.5 kg/5 ft.
Contraindication
Hypersensitivity; Cross
sensitivity may exist with
other NSAIDs, including
aspirin; History of allergictype reactions to
sulfonamides; History of
asthma, urticaria, or
allergic-type reactions to
aspirin or other NSAIDs;
Advanced renal disease;
Severe hepatic dysfunction
Precautions:
Cardiovascular disease or
risk factors for
cardiovascular disease;
Pre-existing renal disease,
heart failure, liver
dysfunction,
concurrent diuretic, or ACE
inhibitor; Hypertension or
fluid retention;
Renal insufficiency;
Serious dehydration

Side Effects
CNS: dizziness, headache,
insomnia.
CV: MYOCARDIAL
INFARCTION, STROKE,
THROMBOSIS, edema.
GI: GI BLEEDING,
abdominal pain, diarrhea,
dyspepsia, flatulence,
nausea.
Derm: EXFOLIATIVE
DERMATITIS, STEVENSJOHNSON SYNDROME,
TOXIC EPIDERMAL
NECROLYSIS,
rash.

Minimum Dose:
Route: PO
100 mg
Pregnancy Category:

Onset: 24 48 hr

Category C

Peak: unknown

Availability:

Drug Interactions:
May increase effectiveness
of ACE inhibitors, thiazide
diuretics, and furosemide.
Fluconazole increase levels
(use lowest recommended
dosage). May increase risk
of bleeding with
warfarin and aspirin. May
increase serum lithium
levels. Does not inhibit the
cardio protective effect of
low-dose aspirin.

Duration: 24 48 hr

Capsules

Half-Life: 11 hr

Route:
PO

Source:
Daviss Drug Guide
for Nurses p. 283 - 284

Source:
Daviss Drug Guide for Nurses
p. 283 - 284

Source:
Daviss Drug Guide for
Nurses p. 283 - 284

Source:
Daviss Drug Guide for
Nurses p. 283 - 284

Source:
Daviss Drug Guide for
Nurses p. 283 - 284

Source:
Daviss Drug Guide for
Nurses p. 283 - 284

Nursing Responsibilities
Before:

Observe the 10Rs of drug

administration

Ask for drug allergies

Administer the prescribed

dosage

Assess PQRST of pain

Do not confuse with Celexa

(citalopram) or
Cerebyx(fosphenytoin).

During:

May be administered
without regard to meals.

Capsules may be opened

and sprinkled on applesauce
and ingested immediately
with water.

Instruct patient to take

celecoxib exactly as
directed.

Do not take more than

prescribed dose.

Use lowest effective dose

for shortest period of time.
After:

Advise patient to notify

health care professional
promptly if signs or
symptoms of GI toxicity,
skin rash, unexplained
weight gain, edema, or
chest pain occurs.

Patients should discontinue

celecoxib and notify health
care professional if signs
and symptoms of
hepatotoxicity occur.

Increasing doses does not

appear to increase
effectiveness.

Assess patient for skin rash

frequently during therapy.

Documentation
Source:
Daviss Drug Guide for Nurses p. 283
- 284