Ibuprofen Uses, Dosage, Side Effects

Ibuprofen

(eye-byoo′proe-fen)

Advil, Amersol A, Caldolor, Children’s Motrin, Ibuprin, Junior Strength Motrin Caplets, Motrin, Nuprin, Pediaprofen, Pamprin-IB, Rufen, Trendar

Classifications: ANALGESIC, NONSTEROIDAL ANTI-INFLAMMATORY DRUG (NSAID) (COX-1 AND COX-2 INHIBITOR); ANTIPYRETIC

Therapeutic: ANALGESIC, NSAID; ANTI-INFLAMMATORY; ANTIPYRETIC

Pregnancy Category: C

AVAILABILITY

Tablet; chewable tablet; suspension; drops; solution for injection

ACTION & THERAPEUTIC EFFECT

(COX-1 and COX-2) NSAID inhibitor with nonsteroidal anti-inflammatory activity that blocks prostaglandin synthesis. Its activity also includes modulation of T-cell function, inhibition of inflammatory cell chemotaxis, decreased release of superoxide radicals, or increased scavenging of these compounds at inflammatory sites. Has nonsteroidal anti-inflammatory, analgesic, and antipyretic effects. Inhibits platelet aggregation and prolongs bleeding time.

USES

Chronic, symptomatic rheumatoid arthritis and osteoarthritis; relief of mild to moderate pain; primary dysmenorrhea; reduction of fever.

UNLABELED USES

Gout, juvenile rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, vascular headache.

CONTRAINDICATIONS

Patient in whom urticaria, severe rhinitis, bronchospasm, angioedema, nasal polyps are precipitated by aspirin or other NSAIDs; active peptic ulcer, bleeding abnormalities; perioperative pain related to CABG surgery.

CAUTIOUS USE

History of GI ulceration; diabetes mellitus, impaired hepatic or renal function, chronic renal failure; hypertension, history of coronary artery disease, angina, MI; cardiac decompensation; patients with SLE; older adults; pregnancy (category C). Safe use in children younger than 6 mo not established.

Ibuprofen Uses, Dosage, Side Effects

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ROUTE & DOSAGE

Inflammatory Disease

Adult: PO 400–800 mg t.i.d. or q.i.d. (max: 3200 mg/day)

Child: POWeight less than 20 kg: Up to 400 mg/day in divided doses; weight 20–30 kg: Up to 600 mg/day in divided doses; weight 30–40 kg: Up to 800 mg/ day in divided doses

Dysmenorrhea

Adult: PO 400 mg q4–6h up to 1200 mg/day

Mild to Moderate Pain

Adult: PO 400 mg q4–6h up to 1200 mg/day IV 400 mg q4–6h prn or 100–200 mg q4h prn

Fever

Adult: PO 200–400 mg t.i.d. or q.i.d. (max: 1200 mg/day)

Child (6 mo–12 y): PO 5–10 mg/ kg q4–6h up to 40 mg/kg/day

ADMINISTRATION

Oral

• Give on an empty stomach, 1 h before or 2 h after meals. May be taken with meals or milk if GI intolerance occurs.
• Ensure that chewable tablets are chewed or crushed before being swallowed.
• Note: Tablet may be crushed if patient is unable to swallow it whole and mixed with food or liquid before swallowing.
• Store in tightly closed, light-resistant container unless otherwise directed by manufacturer.

Intravenous

Patients should be well hydrated before IV infusion to prevent renal damage.

PREPARE: Infusion: Dilute required dose with NS, D5W or LR to a final concentration of 4 mg/mL or less.

ADMINISTER: Infusion: Infuse over at least 30 min.

ADVERSE EFFECTS (≥1%)

CNS: Headache, dizziness, light-headedness, anxiety, emotional lability, fatigue, malaise, drowsiness, confusion, depression, aseptic meningitis. CV: Hypertension, palpitation, congestive heart failure (patient with marginal cardiac function); thrombotic events (MI, stroke); peripheral edema. Special Senses: Amblyopia (blurred vision, decreased visual acuity, scotomas, changes in color vision); nystagmus, visual-field defects; tinnitus, impaired hearing. GI: Dry mouth, gingival ulcerations, dyspepsia, heartburn, nausea, vomiting, anorexia, diarrhea, constipation, bloating, flatulence, epigastric or abdominal discomfort or pain, GI ulceration, occult blood loss. Hematologic: Thrombocytopenia, neutropenia, hemolytic or aplastic anemia, leukopenia; decreased Hgb, Hct; transitory rise in AST, ALT, serum alkaline phosphatase; rise in (Ivy) bleeding time. GU: Acute renal failure, polyuria, azotemia, cystitis, hematuria, nephrotoxicity, decreased creatinine clearance. Skin: Maculopapular and vesicobullous skin eruptions, erythema multiforme, pruritus, rectal itching, acne. Body as a Whole: Fluid retention with edema, Stevens-Johnson syndrome, toxic hepatitis, hypersensitivity reactions, anaphylaxis, bronchospasm, serum sickness, SLE, angioedema.

INTERACTIONS

Drug: ORAL ANTICOAGULANTS, heparin may prolong bleeding time; may increase lithium and methotrexate toxicity. Herbal: Feverfew, garlic, ginger, ginkgo may increase bleeding potential.

PHARMACOKINETICS

Absorption: 80% from GI tract (oral product). Onset: 1 h (antipyretic). Peak: 1–2 h. Duration: 6–8 h. Metabolism: In liver. Elimination: Primarily in urine; some biliary excretion. Half-Life: 2–4 h.

NURSING IMPLICATIONS

Black Box Warning

Ibuprofen has been associated with increased risk of serious, potentially fatal GI bleeding and cardiovascular events (e.g., MI & CVA); risk may increase with duration of use and may be greater in the older adult and those with risk factors for CV disease.

Assessment & Drug Effects

• Monitor for and report promptly S&S of CV thrombotic events (i.e., angina, MI, TIA, or stroke).
• Observe patients with history of cardiac decompensation closely for evidence of fluid retention and edema.
• Monitor for and report promptly S&S of GI ulceration or bleeding. Significant GI bleeding may occur without prior warning.
• Auditory and ophthalmologic examinations are recommended in patients receiving prolonged or high-dose therapy.
• Note: Symptoms of acute toxicity in children include apnea, cyanosis, response only to painful stimuli, dizziness, and nystagmus.
• Monitor lab tests: Baseline and periodic Hgb, renal function tests, LFTs.

Patient & Family Education

• Stop taking drug and report promptly to prescriber if you experience chest pain, shortness of breath, weakness, slurring of speech, or other signs of a cardiac or neurologic problem.
• Notify prescriber immediately of passage of dark tarry stools, “coffee ground” emesis, frankly bloody emesis, or other GI distress, as well as blood or protein in urine, and onset of skin rash, pruritus, jaundice.
• Do not drive or engage in other potentially hazardous activities until response to the drug is known.
• Do not self-medicate with ibuprofen if taking prescribed drugs or being treated for a serious condition without consulting prescriber.
• Do not give to children younger than 3 mo or for longer than 2 days without consulting prescriber.
• Do not take aspirin concurrently with ibuprofen.
• Avoid alcohol and NSAIDs unless otherwise advised by prescriber. Concurrent use may increase risk of GI ulceration and bleeding tendencies.

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Ditulis oleh Unknown pada tanggal Sunday, October 11, 2015