CELECOXIB

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(cel-e-cox’ib)
Celebrex
Classifications: central nervous system agent, analgesic, nsaid, cyclooxygenase-2 inhibitor, antipyretic
Pregnancy Category: C first and second trimesters; D third trimester

NURSING IMPLICATIONS

Assessment & Drug Effects

• Therapeutic effectiveness is indicated by relief of joint pain.
• Lab tests: Periodically monitor Hct and Hgb, liver functions, BUN and creatinine, and serum electrolytes.
• Monitor closely lithium levels when the two drugs are given concurrently.
• Monitor closely PT/INR when used concurrently with warfarin.
• Monitor for fluid retention and edema especially in those with a history of hypertension or CHF.

Patient & Family Education

• Avoid using celecoxib during the third trimester of pregnancy.
• Promptly report any of the following: unexplained weight gain, edema, skin rash.
• Stop taking celecoxib and promptly report to physician if any of the following occurs: S&S of liver dysfunction including nausea, fatigue, lethargy, itching, jaundice, abdominal pain, and flulike symptoms; S&S of GI ulceration including black, tarry stools and upper GI distress.
• Do not breast feed while taking this drug.

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• ENOXAPARIN (e-nox’a-pa-rin) Lovenox Classifications: blood formers, coagulators, and anticoagulants; low molecular weight heparin Pregnancy Category: B NURSING IMPLICATIONS Assessment & Drug Effects Lab tests: Baseline coagulation studies; periodic CBC, platelet count, urine and stool for occult blood. Monitor platelet count closely. Withhold drug and notify physician if platelet
• AMOXICILLIN (a-mox-i-sill’in) Amoxil, Apo-Amoxi , Larotid, Novamoxin, Polymox, Sumox, Trimox, Utimox, Wymox, DisperMox Classifications: antiinfective; antibiotic; aminopenicillin Prototype: Ampicillin Pregnancy Category: B NURSING IMPLICATIONS Assessment & Drug Effects Determine previous hypersensitivity reactions to penicillins, cephalosporins, and other allergens prior to therapy. Lab tests: Baseline C&S tests prior to initiation of
• ESOMEPRAZOLE MAGNESIUM (e-so-me’pra-zole) Nexium Classifications: gastrointestinal agent; proton pump inhibitor Prototype: Omeprazole Pregnancy Category: B NURSING IMPLICATIONS Assessment & Drug Effects Monitor for S&S of adverse CNS effects (vertigo, agitation, depression) especially in severely ill patients. Monitor phenytoin levels with concurrent use. Monitor INR/PT with concurrent
• AZITHROMYCIN (a-zi-thro-mye’sin) Zithromax Classifications: antiinfective; macrolide antibiotic Prototype: Erythromycin Pregnancy Category: B NURSING IMPLICATIONS Assessment & Drug Effects Monitor for and report loose stools or diarrhea, since pseudomembranous colitis (see Appendix F) must be ruled out. Monitor PT and INR closely with concurrent warfarin use. Patient & Family Education Direct sunlight
• DOBUTAMINE HYDROCHLORIDE (doe-byoo’ta-meen) Dobutrex Classifications: autonomic nervous system agent; beta-adrenergic agonist; catecholamine Prototype: Isoproterenol Pregnancy Category: C NURSING IMPLICATIONS Assessment & Drug Effects Correct hypovolemia by administration of appropriate volume expanders prior to initiation of therapy. Monitor therapeutic effectiveness. At any given dosage level, drug takes 10–20 min to produce