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Generic & Brand Name Generic: Mefenamic acid Brand: Dolfenal

Dose, Strength & Formulation Ordered: mefenamic acid 500 mg 1 tab PRN for pain Timing: PRN

Classification: Central Nervous System agent; analgesic; nsaid; antipyretic Duration: Unknown Other forms: Capsule

Indication/ Mechanism of Action Indications: Mild to moderate pain, inflammation, stiffness, swelling or tenderness caused by surgical procedure. (Lippincott W; 2009) Mechanism of Actions: The analgesic effect of NSAIDs may result from interference with the prostaglandins involved in pain.Prostaglan dins appear to sensitize pain receptors to mechanical

Adverse Effects & Drug Interaction Adverse Effect: CNS:Drowsiness, insomnia, dizziness, nervousness, confusion, headache. GI: Abdominal pain, dyspepsia, epigastric distress, nausea, nephrotoxicity occurs occasionally. Skin:Urticaria, rash, facial edema. BodyWhole:Perspira tion. CV:Palpitation. Respiratory:Dyspne a; acute exacerbation of asthma; bronchoconstriction (in patients sensitive to aspirin). Interaction: Drug to Drug:
Aminoglycosides (eg, tobramycin)

Nursing Responsibilities 1.Assess patients level of pain and inflammation before therapy. (Lippincott W; 2009)

Rationale

Client Teaching 1.Encourage patient to take drug as directed to achieve desired effect. (Lippincott W; 2009) 2. Review methods to prevent or minimize GI upset. (Lippincott W; 2009) 3. Work with patient on long-term therapy to arrange for monitoring of laboratory values, especially BUN,

1.To indicate baseline data and to monitor patient. (Lippincott W; 2009) 2. To detect toxicity. (Lippincott W; 2009)

2. Monitor ophthalmic and auditory function before and periodically during therapy. (Lippincott W; 2009) 3. Monitor CBC, platelet count, and hepatic and renal function studies periodically. (Lippincott W; 2009) 4. Be alert for adverse reactions and drug interactions. (Lippincott W; 2009)

Pregnancy Category: C

3. To detect abnormalities. (Lippincott W; 2009)

The risk of acute

4.To indicate proper precautionary measures and management for possible adverse

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stimulation or to other chemical mediators. NSAIDs inhibit synthesis of prostaglandins peripherally and possibly centrally. Like salicylates, NSAIDs exert an antiinflammatory effect that may result in part from inhibition of prostaglandin synthesis and release during inflammation. (Lippincott W; 2009)

renal failure may be increased. Avoid coadministration. 5. Asses patients and Antacids containing magnesium hydroxide familys knowledge of drug therapy. (Lippincott W; 2009) Antacids containing magnesium hydroxide increase the rate and extent of mefenamic acid 6. Give oral NSAIDs absorption. with 8 oz. (240 ml) of water. Anticoagulants (Lippincott W; 2009) Increased risk of gastric erosion and 7. Have patient sit up bleeding. Use with for 15 to 30 minutes caution and close after taking the drug. monitoring. (Lippincott W; 2009) Smoking and Alcohol 8. Crush tablets or mix with food or The risk of GI fluid. bleeding may be (Lippincott W;2009) increased.

reactions. (Lippincott W; 2009) 5. Proper patient and family education promotes good quality care. (Lippincott W; 2009) 6. To ensure adequate passage into the stomach. (Lippincott W; 2009) 7. To prevent it from lodging in esophagus. (Lippincott W; 2009) 8. To aid in swallowing. (Lippincott W; 2009)

creatinine levels, liver function test result and CBC. (Lippincott W; 2009) 4. Instruct patient to notify prescriber about severe or persistent adverse reaction. (Lippincott W; 2009) 5. Inform patient tof potential drug interaction and how to manage them.

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