McKenna's Pharmacology for Nursing, 2e

C H A P T E R 1 6  Anti-inflammatory, antiarthritis and related agents 247

TABLE 16.2

DRUGS IN FOCUS Non-steroidal anti-inflammatory drugs (NSAIDs) and related agents

Drug name

Dosage/route

Usual indications

NSAIDs Propionic acids flurbiprofen (Ocufen, Strepfen)

Ophthalmic solution: 1 drop (gtt) q 30 minutes beginning 2 hours after surgery Lozenge: dissolve one loz every 3–6 hours Adult: 400–800 mg PO t.d.s. to q.i.d. Paediatric: 30–40 mg/kg per day PO in three to four divided doses for arthritis; 5–10 mg/kg PO q 6–8 hours for fever 100–200 mg PO/day or one suppository rectally at night Adult: 250–500 mg PO b.d.; do not give >200 mg q 12 hours for geriatric people Paediatric: 10 mg/kg per day PO in two divided doses for juvenile arthritis; do not give OTC versions to children <12 years without consulting healthcare provider

Long-term management of arthritis; topically to manage pain after eye surgery in adults; relief of severe sore throat

Treatment of pain, arthritis, dysmenorrhoea, juvenile arthritis

ibuprofen (Advil, Brufen, others)

ketoprofen (Orudis)

Short-term management of pain; long- term management of arthritis (SR form); ophthalmic form to relieve ocular itching

naproxen (Naprosyn)

Treatment of pain, arthritis, dysmenorrhoea, juvenile arthritis

tiaprofenic acid (Surgam)

Adult: 300–600 mg PO daily

Management of rheumatoid arthritis and osteoarthritis

Acetic acids diclofenac (Voltaren, Clonac, Dinac)

75–150 mg/day PO or PR

Treatment of acute and chronic pain associated with inflammatory conditions in adults Relief of moderate to severe pain in PO, topical and PR forms; closure of patent ductus arteriosus in premature infants (given IV) Short-term management of pain in adults; topically to relieve ocular itching

indomethacin (Arthrexin, Indocin)

50–200 mg/day PO or PR. PDA in premature neonate: 0.1–0.25 mg/kg q 12–24 hours × three doses 10 mg PO q 4–6 hours, or 30–60 mg IM, switching to oral form as soon as possible, or 30 mg IV as a single dose Ophthalmic: 1 gtt to affected eye q.i.d.; reduce dose with renal impairment and in people >65 years

ketorolac (Toradol)

sulindac (Aclin)

150–200 mg PO b.d.

Treatment of various inflammatory conditions in adults

Fenamates mefenamic acid (Ponstan)

500 mg PO, then 250 mg PO q 6 hours as needed

Short-term treatment of pain in adults and children >14 years; primary dysmenorrhoea

Oxicam derivative meloxicam (Mobic)

Adult: 7.5 mg/day PO to a maximum of 15 mg/day Paediatric: 0.125 mg/kg per day PO to a maximum of 7.5 mg/day

Treatment of osteoarthritis, rheumatoid arthritis and juvenile arthritis

piroxicam (Feldene)

20 mg/day PO as a single dose

Treatment of acute and chronic arthritis in adults

Cyclooxygenase-2 inhibitors celecoxib (Celebrex)

Initially: 100–200 mg PO b.d.; acute pain 400 mg PO then 200 mg PO b.d. for familial adenomatous polyposis (FAP)

Treatment of acute and chronic arthritis in adults; acute pain; primary

dysmenorrhoea; reduction of the number of colorectal polyps in FAP; ankylosing spondylitis Continued on following page