DRUG NAME DRUG CLASSIFICATION MECHANISM OF DRUG INDICATION CONTRAINDICTION DRUG SIDE EFFECTS ADVERSE EFFECT NURSING RESPONSIBILITIES

ACTION INTERACTIONS

Elecoxib  Pharmacologic Selectively To relieve Allergic ACE inhibitors, This drug may Pregnancy when using
class: NSAID inhibits the signs and reaction (such angiotensin II raise the chance of Drug increases risk of NSAIDs like
 Therapeutic enzymatic activity symptom as anaphylaxis receptor heart and blood premature closure of celecoxib:
 Children age 2 and class: of s of or angioedema) antagonists, beta vessel side effects the fetal ductus 1. Avoid in Recent
over weighing more Analgesic, cyclooxygenase-2 osteo- to aspirin, blockers: like heart attack arterisus if given MI: Patients with a
than 25 kg (55 lb). anti- (COX2), the arthritis other NSAIDs, Decreased and stroke. If during the third recent myocardial
100 inflammatory, enzyme needed or sulfonamide antihypertensive these happen, trimester of infarction (MI)
mg twice daily. antirheumatic to convert derivatives or effect of these they can be pregnancy. should avoid
 Children age 2 and arachidonic acid history of drugs, increased deadly. The risk of Drug should be NSAIDs due to an
over weighing 10 to to prostaglandin. aspirininduced risk of these side effects avoided in pregnant increased risk of
25 kg (22 to 55 lb). 50 Prostaglandins nasal polyps renal failure in may be greater if women starting at 30 reinfarction. If
 Children younger are responsible with patients who are your child has weeks necessary, closely
than 2 years of age— for mediating the bronchospasm; elderly, have heart disease or of gestation and monitor for signs
Use and dose must inflammatory hypersensitivity existing renal risks for heart onward. of cardiac
be determined by response and to dysfunction, or are disease. However, Lactation ischemia.
your doctor. causing local celecoxib or its volume-depleted the risk may also Drug maybe present in 2. Caution in Heart
vasodilation, components; anticoagulants be raised in people breast milk in low Failure: NSAIDs,
swelling, and treatment of such as warfarin, who do not have concentrations. including celecoxib,
pain. pain after antiplatelet drugs heart disease or Patient should check should not be
Prostaglandins coronary artery such as aspirin risks for heart with prescriber before given to patients
also play a role in bypass graft and other disease. The risk of breastfeeding. with severe heart
peripheral pain surgery salicylates, these health Reproduction failure, as it can
transmission to corticosteroids, problems can Drug may delay or exacerbate the
the selective serotonin happen as soon as prevent rupture of condition. Monitor
spinal cord. By reuptake the first weeks of ovarian follicles, which for worsening
inhibiting COX-2 inhibitors: using this drug and may result in infertility heart failure if use
activity and Increased risk of GI may be greater that is reversible once is unavoidable.
prostaglandin ulceration and with higher doses drug therapy has 3. Risk of GI
production, this other GI or with long-term been discontinued. Bleeding: Exercise
reduces complications, use. Do not give Drug may have to be extreme caution in
inflammatory increased risk of this drug to your withheld in women patients with a
symptoms and bleeding child right before who are having history of GI
relieves pain. cyclosporine: or after bypass difficulty conceiving or bleeding or ulcer
Increased risk of heart surgery. who are being tested disease, as NSAIDs
cyclosporine- This drug may for infertility. increase the risk of
induced raise the chance of GI bleeding and
nephrotoxicity severe and ulceration. Limit
CYP2C9 inducers sometimes deadly use to the shortest
such as rifampin: stomach or bowel possible duration
Possibly decreased problems like and be alert to
effectiveness of ulcers or bleeding. warning signs.
celecoxib The risk is greater 4. Cardiovascular
CYP2C9 inhibitors in older people, Thrombotic
such as and in people who Events: NSAIDs
fluconazole: have had stomach increase the risk of
Possibly increased or bowel ulcers or serious
risk of bleeding before. cardiovascular
celecoxib toxicity These problems events, such as MI
YP2D6 substrates: may occur without and stroke.
Possibly enhance warning signs. Monitor patients
the exposure and for warning signs
toxicity of and discontinue
these drugs celecoxib if
digoxin: Increased symptoms arise.
risk of digitalis 5. Hypertension
toxicity Monitoring: Use
furosemide, celecoxib
thiazide diuretics: cautiously in
Reduced diuretic patients with
effects of these hypertension and
drugs, increased closely monitor
risk of renal failure blood pressure
lithium: Possibly throughout
elevated blood treatment.
lithium level 6. Pediatric Use: Be
methotrexate: cautious when
Increased risk of using celecoxib in
methotrexate children with
toxicity systemic onset
(neutropenia, juvenile
renal dysfunction, rheumatoid
thrombocytopenia) arthritis due to the
pemetrexed: potential for
Increased risk of serious adverse
myelosuppression, reactions.
GI and renal 7. CYP2C9 Poor
toxicity Metabolizers:
Exercise caution in
patients known to
be poor CYP2C9
metabolizers, and
consider starting at
lower dosages,
especially in
patients with
juvenile
rheumatoid
arthritis.
8. Bone Marrow
Suppression: In
patients with bone
marrow
suppression, such
as those
undergoing
antineoplastic
therapy, monitor
laboratory results
 and assess for
infection, as
celecoxib's anti-
inflammatory
properties can
mask signs and
symptoms.
9. Less Common GI
Reactions: Monitor
for less common
but serious adverse
GI reactions,
especially in elderly
patients or those
on long-term
celecoxib therapy.
10. Liver and Renal
Function: Regularly
monitor liver
enzymes, BUN, and
serum creatinine
levels, as celecoxib
may affect hepatic
and renal function.
11. Anemia: Monitor
CBC for decreased
hemoglobin and
hematocrit levels,
as celecoxib can
worsen anemia.
12. Skin Reactions:
Check for skin rash
or hypersensitivity
reactions, as
celecoxib may
cause serious skin
issues, even in
patients with no
previous sensitivity
to sulfur.
13. Avoid
Combination with
Nonaspirin
NSAIDs: Do not
combine celecoxib
with nonaspirin
NSAIDs, regardless
of the dose, as it
may mask signs of
infection.
.