DRUG STUDY: CELECOXIB

Drug Name Drug Classification Mechanism of Action and Drug Action Drug Effects Interactions
Indications (Serious/Common)
Generic Name: Pharmacologic: Mechanism of Action: Pharmacokinetics Side effects (common by Drug – Drug
A: Bioavailability unknown. system):
Celecoxib COX2 inhibitors Inhibits the enzyme COX-2. CYP2C9 inhibitors may increase
This enzyme is required for the D: 97% bound to plasma CNS: dizziness, headache, levels.
Trade Name: Therapeutic: synthesis of prostaglandins. Has proteins; extensive tissue insomnia.
analgesic, anti-inflammatory, distribution. May decrease effectiveness of
Celebrex Antirheumatics, nonsteroidal and antipyretic properties. CV: edema, hypertension. ACE inhibitors, thiazide
Onsenal Anti-inflammatory agents Therapeutic Effects: Decreased M: Mostly metabolized by the GI: abdominal pain, diuretics, and furosemide.
Elyxyb pain and inflammation caused hepatic CYP2C9 isoenzyme; diarrhea, dyspepsia,
Dosage: by arthritis or spondylitis. Half-life: 11 hr flatulence, nausea. Fluconazole increase levels (use
Decreased pain. lowest recommended dosage).
Recommended: PO E: <3% excreted unchanged in Derm: rash.
(Adults): urine and feces. Increase risk of bleeding with
Osteoarthritis—200 mg once anticoagulants, aspirin,
F and E: hyperkalemia.
daily or 100 mg twice daily. clopidogrel, ticagrelor,
Indication(s): Pharmacodynamics
Rheumatoid arthritis—100– prasugrel, corticosteroids,
Route: PO Adverse Reactions
200 mg twice daily
Relief of signs and symptoms of Onset: 24 – 48 hr (Serious, Life threatening) fibrinolytics, SNRIs, or SSRIs.
Ankylosing spondylitis—200
osteoarthritis, rheumatoid Peak: Unknown Life-threatening:
mg once daily or 100 mg
arthritis, ankylosing spondylitis, Duration: 12 – 24 hr CV: hf, myocardial May increase serum lithium
twice daily; dose may be levels. Does not inhibit the
and juvenile rheumatoid Infarction, stroke,
increase after 6 weeks to 400 cardioprotective effect of low-
arthritis. Management of acute thrombosis
mg daily. dose aspirin.
pain including primary GI: GI bleeding
Acute pain, including
dysmenorrhea. Derm: exfoliative
dysmenorrhea— 400 mg
dermatitis, Stevens-Johnson Drug – Food/Herbal
initially, then a 200-mg dose
syndrome, toxic epidermal
if needed on the first day;
Necrolysis

Janeirah Q. Manalundong
Faculty, College of Health Sciences NSG 105: PHARMACOLOGY DRUG STUDY 1
 then 200 mg twice daily as Contraindications:
needed. Patients with active peptic Drug – Laboratory
ulcers, with significant
renal and hepatic May cause increase AST and
impairment ALT levels.

Treatment of Overdose/ Antidote

Janeirah Q. Manalundong
Faculty, College of Health Sciences NSG 105: PHARMACOLOGY DRUG STUDY 2
Nursing Process: Celecoxib

Assessment Nursing Planning Nursing Interventions with Appropriate Patient Evaluation/ Expected
Diagnoses Rationale (Italic) Teaching/Education Outcomes of Care
(Priority Problems)
General
▪ Assess range of motion, degree of ▪ Acute pain The patient will: ▪ Monitor for congestive heart ▪ Instruct patient to take Reduction in joint pain in
swelling, and pain in affected ▪ Impaired physical ▪ Demonstrate failure, fluid retention, celecoxib exactly as directed. patients with
joints before and periodically mobility Do not take more than
complication with hypertension, and renal disease. osteoarthritis.
prescribed dose. Increasing
throughout therapy. lifestyle modification Use cautiously in these patients, doses do not appear to
necessary for successful as drug may cause increased increase effectiveness. Use Reduction in joint
▪ Assess patient for allergy to drug therapy. edema and fluid retention. lowest effective dose for tenderness, pain, and joint
sulfonamides, aspirin, or ▪ Avoid evidence of ▪ Monitor vital signs (especially shortest period of time. swelling in patients with
NSAIDs. Patients with these gastrointestinal pulse and blood pressure) for rheumatoid arthritis and
allergies should not receive bleeding. baseline information and to ▪ Patient should discontinue juvenile rheumatoid
celecoxib and notify health
celecoxib. ▪ Demonstrate knowledge monitor the drug’s possible effect arthritis.
care professional if signs and
of drug action and side of COX I inhibition on renal symptoms of hepatotoxicity
▪ Assess patient for skin rash effects of drug. vasodilation. Decreased pain.
(nausea, fatigue, lethargy,
frequently during therapy. ▪ Monitor intake and output due to pruritus, jaundice, upper
Discontinue at first sign of rash; possible drug interactions that right quadrant tenderness, flu- Decreased pain with
may be life-threatening. Stevens- may decrease function of like symptoms) occur. dysmenorrhea.
Johnson syndrome may develop. reabsorption of water at the loop
Treat symptomatically; may recur of Henle. ▪ Advise patient to notify health
once treatment is stopped. ▪ Monitor for gastrointestinal care professional if
distress such as nausea, diarrhea, pregnancy is planned or
abdominal pain, or flatulence. suspected.
▪ Monitor liver function, CBC,
BUN, serum creatinine, and
serum electrolytes.

Janeirah Q. Manalundong
Faculty, College of Health Sciences NSG 105: PHARMACOLOGY DRUG STUDY 3
 ▪ Monitor lithium levels in patients Side Effects
who are taking lithium. ▪ Advise patient to notify health
Celecoxib may alter established care professional promptly if
signs or symptoms of GI
lithium levels.
toxicity (abdominal pain,
black stools), skin rash,
unexplained weight gain,
edema, or chest pain occurs.

Janeirah Q. Manalundong
Faculty, College of Health Sciences NSG 105: PHARMACOLOGY DRUG STUDY 4