NSAIDs (Non-Steroidal Anti-Inflammatory Drugs)

Definition

NSAIDs are a class of medications that inhibit cyclooxygenase (COX-1 and COX-2) enzymes, reducing prostaglandin production. They provide analgesic, anti-inflammatory, and antipyretic effects.

Common NSAIDs

• Ibuprofen (Motrin, Advil)
• Naproxen (Aleve, Naprosyn)
• Ketorolac (Toradol) - IV/IM
• Diclofenac
• Indomethacin
• Celecoxib (Celebrex) - selective COX-2
• Aspirin (low-dose for cardioprotection)

Indications

Mild to moderate pain, inflammation, fever, arthritis, dysmenorrhea, cardiovascular protection (aspirin).

Side Effects

• GI bleeding and ulcers (most common serious adverse effect)
• Renal toxicity (especially in dehydrated or elderly patients)
• Cardiovascular risk (MI, stroke with long-term use)
• Hypertension
• Platelet dysfunction
• Bronchospasm (aspirin-sensitive asthma)

Contraindications

• Active GI bleeding or peptic ulcer
• Severe renal impairment
• Heart failure
• Third trimester pregnancy (premature closure of ductus arteriosus)
• Children with viral illness (aspirin only - Reye syndrome)

Nursing Considerations

• Administer with food to reduce GI upset.
• Monitor for GI bleeding (dark stools, hematemesis).
• Assess renal function and hydration.
• Use lowest effective dose for shortest duration.
• Avoid combining multiple NSAIDs.
• Teach about drug interactions (warfarin, SSRIs, lithium).

NCLEX Relevance

GI bleeding, renal toxicity, and Reye syndrome in children are top test points.