DRUG DATA

CLASSIFICATION

MECHANISM OF ACTION > aspirin-like drug that has analgesic, antipyretic and antiinflammatory activities. These activities appear to be due to its ability to inhibit cyclooxygenase & also antagonize certain effects of prostalgadins Pharmacokinetics: Absorption: well absorbed Distribution: wide Metabolism: liver Excretion: kidneys (50%) liver (20%) Half-life: 2-4 hours Onset: unknown Peak: 2-4 hours Duration: unknown

INDICATION

CONTRAINDICATION

ADVERSE REACTIONS

NURSING RESPONSIBILITIES

Generic Name: mefenamic acid Trade Name: Acidan, Analcid, Aprostal, Biostan, Calibral, Dolfenal, Dolmetine, Escandar, Fenexan, Gardan, Gisfen, harpinac, Istan, Mecid-A, Mefenax, Ponstan, Proxyl, Revalon, Selmac, Spegic, Totagesic. Tyhostan, Zapan Minimum Dose: 250 mg 1 tab TID PO Maximum Dose: 500 mg 1 tab TID PO Contents: mefenamic acid Availability and Color: Capsule/Tablet: 250 mg, 500 mg Route: PO Source: Brener, T., Rita, M.D., Nursing 2007 Drug Handbook. th Philadelphia (27 ed.) Lippincott Williams & Wilkins, p. 22-23

Pharmacologic: CNS drugs Therapeutic: NSAIDs Pregnancy Category: rd C ; D in 3 trimester

> relief of pain including muscular, rheumatic, traumatic, dental, postoperative and postpartum pain, headache migraine, fever and dysmenorrhea

> contraindicated in pts hypersensitivity to drug or other NSAIDs > contraindicated in those who have experienced asthma, urticaria or allergic-type reactions after taking aspirin > contraindicated in pts with acute active ulceration or chronic inflammation of either upper or lower GI tract Precaution: > use cautiously in pts with history of ulcers or GI bleeding, asthma, epilepsy, kidney or liver disease Drug Interaction: > Drug-drug. ACE inhibitors: May decrease antihypertensive effects. Monitor BP. Aspirin: May increase risk of ulcers. Diuretics: May reduce the natriuretic effect of furosemide and thiazides in some pts. Methotrexate: May inhibit methotrexate accumulation in rabbit kidney slices. > Drug-herb. Dong quia, fever few, garlic, ginger, horse chest nut, red clover: May increase risk in bleeding. > Drug-lifestyle. Long term alcohol use, smoking: May cause gastric irritation or bleeding.

CNS dizziness, headache, nervousness, tremors CV congestive heart failure, hypertension, tachycardia, sycope GI gas pain, diarrhea/ constipation, vomiting, dyspepsia, peptic ulceration, nausea Metabolic weight changes Respiratory asthma, dyspnea Skin rash, alopecia, photosensitivity, pruritus Urogenital Cystitis, dysuria, hematuria, interstitial nephritis, oliguria/polyuria, renal failure

Before > Assess pts pain before therapy: location, duration, frequency, precipitating and aggravating factors > Tell pt to report history of allergic reactions to NSAIDs before starting therapy > Prepare food to intake with drug > Assess if the pt has taken drug that may decrease the medications effectiveness > Inform patient need and importance of the drug to him/her During > Administer with food or milk to decrease gastric symptoms > Do not increase dose without physicians order > Administer drug with full glass of water to enhance absorption > Do not crush, dissolve or chew capsules/tablets > Caution in pts with history of peptic ulcer or GI bleeding, epilepsy or liver disease > Observe 15 Rs of drug administration After > Instruct pt not to take drug for more than 7 days >Advise pt to immediately report persistence or failure to relieve pain > Tell pt to report occurrence of drug induced adverse reactions > Teach pt that all NSAIDs, including mefenamic acid, may harm the liver > Discuss in detail all aspects of the drug therapy: reason for taking the drug & expected results