Question

A patient has osteoarthritis and has been instructed to take nonsteroidal anti-inflammatory medication. The patient wants to know if it is okay to take over-the-counter medication for a cold. The patient has been experiencing many adverse effects to the nonsteroidal anti-inflammatory medication.

a.       What are the most common adverse reactions of nonsteroidal anti-inflammatory agents?

b.      What are the key considerations in using anti-inflammatory agents with older adults?

c.       What are the important nursing considerations and teaching needs for this patient when taking an over-the-counter salicylate

Answer 1

a: The most common adverse reactions of nonsteroidal anti-inflammatory agents are: the acidity, stomach ulcers, hepatic or liver toxicity then nephrotoxicity means the kidney problems on the long term usage of the NSAIDs.

b) The key considerations in using anti-inflammatory agents with older adults are:

Dose adjustment is highly required as there is reduced hepatic as well as renal activity in case of older patients

Means they have lesser hepatic metabolism as well as low hepatic clearance .

Hence if dose is not reduced or adjusted as per the individual case ther may be chances of the toxicity

c) The salicylates may cause the ulcerogenic effects, acidity

and the most important is the blood clotting is impaired as the salicylates have the anti-palelet aggregator action like in case of ASPRIN

Hence the nursing intervention is to avoid these medications in those cases where the platelet action is highly require.

e.g. In case of dengue salicylates are nor recommended and if it is taken as the OTC it may cause the serious problem in this case.