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MECHANISM OF ACTION > thought to inhibit prostaglandin synthesis, impending cyclooxygenase -2 (COX -2), to produce antiinflammatory, analgesic, and antipyretic effects. Pharmacokinetics: Absorption: well absorbed Distribution: bound to plasma proteins Metabolism: liver Excretion: urine Half-life: 11 hours Onset: unknown Peak: 3 hours Duration: unknown





Generic Name: celecoxib Trade Name: Celebrex, Celcoxx, Flamar Minimum Dose: 100 mg 1 cap BID PO Maximum Dose: 400 mg 2 caps BID PO Contents: celecoxib Availability and Color: Capsules: 100 mg, 200 mg Route: PO

Pharmacologic: CNS drugs Therapeutic: NSAIDs Pregnancy Category: rd C ; D in 3 trimester

> acute or chronic use in the treatment of the signs and symptoms of osteoarthritis, rheumatoid arthritis > postsurgical/ dental pain and acute pain of osteoarthritis > acute pain including primary dysmenorrhea > familial adenomatous polyposis (FAP) > an adjunct to usual care (e.g., endoscopic surveillance and surgery)

> contraindicated in pts hypersensitivity to drug, sulphonamides, aspirin or other NSAIDs > contraindicated in those with severe hepatic impairment and in the treatments of perioperative pain after coronary artery bypass graft surgery > avoid use in the 3 trimester of pregnancy Precaution: > use cautiously in pts with history of ulcers or GI bleeding, advance renal disease, dehydration, anemia, symptomatic liver disease, hypertension, edema, heart failure or asthma and in poor CYP2C9 metabolizers Drug Interaction: > Drug-drug. ACE inhibitors: May decrease antihypertensive effects. Monitor BP. Aluminun and Magnesium containing antacids: May decrease celecoxib level. Aspirin: May increase risk of ulcers; lower aspirin dosage can be safe to reduce risk of CV events. > Drug-herb. Dong quia, fever few, garlic, ginger, horse chest nut, red clover: May increase risk in bleeding. White willow: Herb and drug contain similar components. > Drug-lifestyle. Long term alcohol use, smoking: May cause gastric irritation or bleeding.

CNS dizziness, headache, insomnia CV peripheral edema EENT pharyngitis, rhinitis, sinusitis GI abdominal pain, diarrhea, dyspepsia, flatulence, nausea Metabolic hyperchloremia Musculoskeletal back pain Respiratory URT infection Skin rash, toxic epidermal necrolysis, StevenJohnsons Syndrome, erythema, multiforme, exfoliate dermatitis Other accidental injury

Before > Tell pt to report history of allergic reactions to aspirin or other NSAIDs > Assess for appropriateness of therapy of pain: rheumatoid arthritis, osteoarthritis, & inflammation of joints > Prepare food or milk to intake with drug > Assess if the pt has taken drug that may decrease the medication effectiveness > Inform patient need and importance of the drug to him/her During > Administer with food or milk to decrease gastric symptoms > Do not increase dose without physicians order > Administer drug with full glass of water to enhance absorption > Do not crush, dissolve or chew capsules > Observe 15 Rs of drug administration After > Teach pt that drug must be continued for prescribed time to be effective > Instruct pt to promptly report signs of GI bleeding such as blood in vomit, urine or stool > Teach pt that all NSAIDs, including celecoxib, may harm the liver > Advise pt to stop therapy and notify prescriber if he/she experiences signs and symptoms of liver toxicity (nausea, fatigue, lethargy) > Inform pt that it may take several days before he feels consistent pain relief.

Source: Brener, T., Rita, M.D., Nursing 2007 Drug Handbook. th Philadelphia (27 ed.) Lippincott Williams & Wilkins, p. 374-376