Nursing In Ghana

Celecoxib (Celebrex)

Description

Celecoxib (Celebrex) is a non-opioid analgesic used for the management of acute pain and acute and long-term treatment of signs and symptoms of rheumatoid arthritis and osteoarthritis

Generic Name

celecoxib

(sell ah cocks’ ib)

Brand Name

Celebrex

Drug classes

  • NSAID
  • Analgesic (nonopioid)
  • Specific COX-2 enzyme blocker

Therapeutic actions

Analgesic and anti-inflammatory activities related to inhibition of the COX-2 enzyme, which is activated in inflammation to cause the signs and symptoms associated with inflammation; does not affect the COX-1 enzyme, which protects the lining of the GI tract and has blood clotting and renal functions.

Indications

  • Acute and long-term treatment of signs and symptoms of rheumatoid arthritis and osteoarthritis
  • Reduction of the number of colorectal polyps in familial adenomatous polyposis (FAP)
  • Management of acute pain
  • Treatment of primary dysmenorrhea

Contraindications and cautions

  • Contraindicated with allergies to sulfonamides, celecoxib, NSAIDs, or aspirin; significant renal impairment; pregnancy (third trimester); lactation.
  • Use cautiously with impaired hearing, hepatic, and CV conditions.
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Available forms

Capsules—100, 200 mg

Dosages

ADULTS

  • Initially, 100 mg PO bid; may increase to 200 mg/day PO bid as needed.
  • Acute pain, dysmenorrhea: 400 mg, then 200 mg PO bid.
  • FAP: 400 mg PO bid.

PEDIATRIC PATIENTS

Safety and efficacy have not been established.

PATIENTS WITH HEPATIC IMPAIRMENT

Reduce dosage by 50%.

Adverse effects

  • CNS: Headache, dizziness, somnolence, insomnia, fatigue, tiredness, dizziness, tinnitus, ophthamologic effects
  • Dermatologic: Rash, pruritus, sweating, dry mucous membranes, stomatitis
  • GI: Nausea, abdominal pain, dyspepsia, flatulence, GI bleed
  • Hematologic: Neutropenia, eosinophilia, leukopenia, pancytopenia, thrombocytopenia, agranulocytosis, granulocytopenia, aplastic anemia, decreased hemoglobin or hematocrit, bone marrow depression,menorrhagia
  • Other: Peripheral edema, anaphylactoid reactions to anaphylactic shock.
Interactions

Drug-drug

  • Increased risk of bleeding if taken concurrently with warfarin. Monitor patient closely and reduce warfarin dose as appropriate
  • Increased lithium levels and toxicity
  • Increased risk of GI bleeding with long-term alcohol use, smoking

Nursing considerations

Name confusion has occurred between Celebrex (celecoxib), Celexa (citalopram), Xanax (alprazolam), and Cerebyx (fosphenytoin); use caution.

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Interventions

  • Administer drug with food or after meals if GI upset occurs.
  • Establish safety measures if CNS, visual disturbances occur.
  • Arrange for periodic ophthalmologic examination during long-term therapy.
  • WARNING: If overdose occurs, institute emergency procedures—gastric lavage, induction of emesis, supportive therapy.
  • Provide further comfort measures to reduce pain (eg, positioning, environmental control), and to reduce inflammation (eg, warmth, positioning, rest).

Patient teaching points

  • Take drug with food or meals if GI upset occurs.
  • Take only the prescribed dosage.
  • You may experience these side effects: Dizziness, drowsiness (avoid driving or the use of dangerous machinery while using this drug).
  • Report sore throat, fever, rash, itching, weight gain, swelling in ankles or fingers; changes in vision.
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