Drug Name Mechanism Of Action Indication / Contraindication Adverse Effect Nursing Responsibilities

DRUG NAME

GENERIC: MEFENAMIC ACID BRAND: PONSTEL CLASS: NONSTEROIDAL ANTIINFLAMMATORY DRUG (NSAID) DOSAGE: 500 mg. ROUTE: ORAL

MECHANISM OF ACTION

Mefenamic acid binds the prostaglandin synthetase receptors COX-1 and COX2, inhibiting the action of prostaglandin synthetase. As these receptors have a role as a major mediator of inflammation and/or a role for prostanoid signaling in activity-dependent plasticity, the symptoms of pain are temporarily reduced.

INDICATION / CONTRAINDICATION INDICATIONs: Short-term relief of mild to moderate pain when therapy will not exceed 1 week. CONTRAINDICATION: Hypersensitivity to drug; GI inflammation or ulceration. Safety in children <1 y, during pregnancy (category C), or lactation is not established.

ADVERSE EFFECT

CNS: Anxiety, asthenia, confusion, depression, dream abnormalities, drowsiness, insomnia, malaise, nervousness, paresthesia, somnolence, tremors, vertigo HEMATOLOGIC: Prolonged prothrombim time, severe autoimmune haemolytic anemia (longterm use), leukopenia, eosinophilia, agranulocytosis, thrombocytopenic porpura, megaloblastic anemia, pancytopenia, bone marrow hypoplasia. CV: Congestive heart failure, hypertension, tachycardia, syncope GI: Abdominal pain, constipation, diarrhea, dyspepsia, flatulence, gross bleeding/perforation, heartburn, nausea, GI ulcers (gastric/duodenal),

NURSING RESPONSIBILITIES

BEFORE: Dx: a. Check doctor’s order. b. Assess pain score. c. Assess for history of ellergies to NSAIDs. Tx: a. Supervise patients at risk for developing severe diarrhea and vomiting for dehydration and electrolyte imbalance. b. Notify Physician when persistent GI discomfort, sore throat, fever or malaise occurs. EDx: a. Educate patient regarding desired and adverse effects. b. Educate patient that prolonged use of drug may damage liver. DURING: Dx: a. Assess mental status for worsening of depression, anxiety, social functioning, confusion and nervousness.

vomiting, abnormal renal function, anemia, dizziness, edema, elevated liver enzymes, headaches, increased bleeding time, pruritus, rashes, tinnitus GU: Dysuria, renal impairment DERM: Alopecia, photosensitivity, pruritus, sweat RESP: Dyspnea, hemoptysis, pharyngitis

b. Monitor mood changes. c. Monitor for other adverse effects. Tx: a. Give drug with food, milk or antacids. b. Do no increase or double the dose, follow exactly as prescribed and indicated. EDx: a. Tell patient to take the drug with full glass of water and do not break, chew or crush capsule and tablet. AFTER: Dx: a. Assess knowledge/teach patient appropriate use, interventions to reduce side effects, and adverse symptoms to report. b. Monitor for effectiveness as exhibited by a decrease in symptoms. c. Monitor for side effects. Tx: a. Remember that a lot of these drugs can cause dizziness in the first few weeks of taking so take safety precautions. b. Provide safety measures (e.g. adequate lighting,

raised side rails, etc.) to prevent injuries. c. Provide comfort measures (e.g. voiding before dosing, taking food with drug, etc.) to help patient tolerate drug effects. EDx: a. Instruct discontinuation of medication if adverse effect occurs. b. Advise patient to avoid alcohol intake. c. Instruct patient to verbalize feelings and concerns.