Mindanao State University – Iligan Institute of Technology Student: Penaso, Nathanielle Keith S.

Block: 263
COLLEGE OF NURSING

PHARMACOLOGICAL MANAGEMENT

DRUG STUDY

Brand Name: ________Ponstel/Ponstan____________________________Generic Name: __Mefenamic Acid_____________ Drug Classification: Nonsteroidal anti-inflammatory drug______

Dosage, Route & Frequency Drug-Drug & Drug- Side Effects Adverse Reactions
Drug Action Indications Contraindications
Recommended Prescribed Food Interactions (By System) (By System)
Acute pain in adults Mefenamic acid Drug. For relief of mild to Mefenamic Acid is CNS: headache, CNS: Drowsiness,
and adolescents ≥ inhibits the activity of ACE-inhibitors moderate pain in contraindicated in dizziness insomnia, dizziness,
14 years of age, the 500mg 1 cap TID PO the enzymes cyclo- Reports suggest that patients =14 years of patients with known nervousness,
recommended dose is oxygenase I and II, NSAIDs may diminish age, when therapy will hypersensitivity to CV: confusion, headache.
500 mg as an initial resulting in a the antihypertensive not exceed one week mefenamic acid. perforation,congestive
dose followed by 250 decreased formation effect of ACE (7 days). heart,failure, GI: Severe diarrhea,
mg every 6 hours as of precursors of inhibitors. Mefenamic Acid hypertension, ulceration, and
needed, usually not to prostaglandins and Aspirin For treatment of should not be used in tachycardia, syncope bleeding, abdominal
exceed one week. thromboxanes. The Administration of primary patients with cramps, constipation,
dysmenorrhea. preexisting renal Skin: swelling, itching, hepatic toxicity.
resulting decrease in mefenamic acid and
For the treatment of disease. rashes
prostaglandin aspirin is not
primary Skin: Urticaria, rash,
synthesis, by generally GI: abdominal pain,
dysmenorrhea, the Mefenamic Acid is facial edema. Special
prostaglandin recommended constipation, diarrhea,
recommended dose is contraindicated in Senses: Eye irritation,
synthase, is because of the indigestion, gas,
500 mg as an initial patients with acute loss of color vision
responsible for the potential of increased heartburn, nausea, GI
dose followed by 250 active ulceration of (reversible), blurred
therapeutic effects of adverse effects. It can ulcers, vomiting,
mg every 6 hours, either the upper or vision, ear pain.
mefenamic acid. reduce the natriuretic abnormal renal
given orally, starting lower gastrointestinal
Mefenamic acid also effect-of furosemide function, anemia CV: Palpitation.
with the onset of tract.
causes a decrease in and thiazides in some
bleeding and the formation of patients. This Respiratory: Dyspnea;
associated symptoms. thromboxane A2 response has been acute exacerbation of
synthesis, by attributed to inhibition asthma;
thromboxane of renal prostaglandin bronchoconstriction
synthase, thereby synthesis. (in patients sensitive
inhibiting platelet Lithium to aspirin).
aggregation. When NSAIDs and
lithium are
administered
concurrently, subjects
 should be observed
carefully for signs of
lithium toxicity.
Methotrexate
NSAIDs have been
reported to
competitively inhibit
methotrexate
accumulation in rabbit
kidney slices. This
may indicate that they
could enhance the
toxicity of
methotrexate.
Warfarin
The effects of warfarin
and NSAIDs on GI
bleeding are
synergistic, such that
users of both drugs
together have a risk of
serious GI bleeding
higher than users of
either drug alone.

Herbal: Feverfew,
garlic, ginger, ginkgo
increase bleeding
potential.
Responsibilities in the Nursing Process (ADPIE) Responsibilities in the Nursing Process (ADPIE)
Assessment ■ Direct patient to inform the dentist or surgeon before a procedure when taking ibuprofen or
■ Check patient’s history of allergy to NSAIDs such as ibuprofen. If an allergy is present, notify other NSAIDs for a continuous period.
health care provider. ■ Warn female patients not to take NSAIDs 1 to 2 days before menstruation to avoid heavy
■ Obtain a drug and herbal history, and report any possible drug-drug or herb-drug interactions. menstrual flow. If discomfort occurs, acetaminophen is usually prescribed.
NSAIDs can increase the effects of phenytoin (Dilantin), sulfonamides, and warfarin. Most ■ Advise pregnant patients to avoid NSAIDs. Congenital abnormalities may occur when NSAIDS
NSAIDs are highly protein-bound and can displace other highly protein bound drugs like warfarin are taken during early pregnancy, and excess bleeding might occur during delivery.
(Coumadin). ■ Inform patient that it may take several weeks to experience desired drug effect of some
■ Determine medical history. NSAIDs are contraindicated if patient has severe renal or liver NSAIDs and diseasemodifying antirheumatic drugs (DMARDs).
disease, peptic ulcer, or bleeding disorder. ■ Educate patient of the common side effects of NSAIDs. Nausea, vomiting, peripheral edema,
■ Assess patient for GI upset and peripheral edema, which are common side effects of NSAIDs. GI upset, purpura or petechiae, or dizziness might occur. Report occurrences of side effects.
Nursing Diagnoses Diet
■ Risk for injury related to dizziness ■ Advise patient to take NSAIDs with meals or snacks to reduce GI upset.
■ Risk for activity intolerance related to fatigue Cultural Considerations
Planning ■ Recognize that patients from various cultural backgrounds respond to pain and inflammation in
■ The patient’s inflammatory process will subside in 1 to 3 weeks. various ways. In some cultures, the use of drugs to alleviate pain and inflammation is not
Nursing Interventions acceptable. Herbal medicine and acupuncture may be used to alleviate pain.
■ Observe patient for bleeding gums, petechiae, ecchymoses, or black (tarry) stools. Bleeding ■ Be supportive of patient’s methods for pain control. Explain the purpose of medications and
time can be prolonged when NSAIDs are taken, especially with a highly protein-bound drug such their actions and side effects.
as warfarin (anticoagulant). Evaluation
■ Report if patient has GI discomfort. Administer NSAIDs at mealtime or with food to prevent GI ■ Evaluate the effectiveness of the drug therapy, such as a
upset. decrease in pain and in swollen joints and an increase
■ Monitor vital signs and check for peripheral edema, especially in the morning. in mobility.
■ Do not give directions such as “take one blue pill” at a specified time. Instead, provide name
and dosage of medication.
Patient Teaching
■ Inform patient not to take aspirin and acetaminophen with NSAIDs. Taking an NSAID with
aspirin could cause GI upset and possible GI bleeding.
■ Inform patient to avoid alcohol when taking NSAIDs. GI upset or gastric ulcer may result.
■ Alert patient that many herbal products may interact with NSAIDs and could cause bleeding.
Doses of NSAIDs and/or herbs may need to be modified to avoid possible bleeding occurrence
(Herbal Alert 25-1).