Question

A patient is talking is taking the NSAID, indomethacin for treatment of pericarditis. The nurse will teach the patients watch for witch adverse effect ?

Answer 1

INDOCIN (indomethacin) is a nonsteroidal anti-inflammatory drug which reversibly inhibits cyclooxygenase-1 and 2 (COX-1 and 2) enzymes, resulting in decreased formation of prostaglandin precursors; it has antipyretic, analgesic, and anti-inflammatory properties.

Adverse effects include:

Cardiovascular effects: The drug can cause an increased risk of serious cardiovascular thrombotic events, including myocardial infarction (MI) and stroke, which can be fatal. This risk may occur early in treatment and may increase with duration of use. Precautions to be carried out includes:Monitor blood pressure; use with caution in patients with hypertension. May cause sodium and fluid retention, use with caution in patients with edema. Avoid use in heart failure. Avoid use in patients with recent Myocardial infarction unless benefits outweigh risk of cardiovascular thrombotic events. Use the lowest effective dose for the shortest duration of time, consistent with individual patient goals, to reduce risk of cardiovascular events; alternate therapies should be considered for patients at high risk.

CNS effects include drowsiness, dizziness, blurred vision, and other neurologic effects, which may impair physical or mental abilities; patients must be cautioned about performing tasks that require mental alertness (eg, operating machinery, driving). Headache may occur; cessation of therapy required if headache persists after dosage reduction.

Gastrointestinal effects: NSAIDs cause increased risk of serious GI inflammation, ulceration, bleeding, and perforation; elderly patients and patients with history of peptic ulcer disease and/or GI bleeding are at greater risk for serious GI events. These events may occur at any time during therapy and without warning. Advice the client to take drug with food or milk to avoid ulceration.

Other effects include hepatotoxicity, anaphylactic reactions,hyperkalemia , prolonged bleeding time and renal toxicity.