- Body system
- Pain
- Name stem
- -profen, -fenac
- Drug cards
- 3 in this guide
Drugs in this class
Other examples: Naproxen, Celecoxib, Diclofenac, Meloxicam, Indomethacin.
How NSAIDs and acetaminophen work
NSAIDs inhibit cyclooxygenase (COX-1 and/or COX-2), lowering prostaglandins. Celecoxib is COX-2 selective. Acetaminophen acts centrally and has little anti-inflammatory effect.
Uses
- Mild to moderate pain
- Fever
- Arthritis and musculoskeletal inflammation
- Dysmenorrhea
- Opioid-sparing multimodal pain control
Adverse effects
- GI ulcers and bleeding
- Kidney injury and fluid retention
- Hypertension and cardiovascular events
- Bleeding (platelet effect of nonselective NSAIDs)
- Liver injury (acetaminophen overdose)
Nursing considerations
- Assess for GI bleeding, kidney function and blood pressure.
- Avoid NSAIDs in kidney disease, heart failure, active ulcers and late pregnancy.
- Track total daily acetaminophen from all products.
Patient teaching
- Take NSAIDs with food.
- Do not combine different NSAIDs.
- Read labels for hidden acetaminophen.
NSAIDs and acetaminophen NCLEX practice questions
Answer each question to see the rationale.
3 questions. Choose an answer to see the rationale.
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Which finding in a patient taking ibuprofen daily should be reported?
Show answer
Answer D: Black, tarry stools Black, tarry stools suggest upper GI bleeding, a serious NSAID complication.
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What is the antidote for acetaminophen overdose?
Show answer
Answer A: Acetylcysteine Acetylcysteine replenishes glutathione and protects the liver after acetaminophen overdose.
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What is the maximum total duration of ketorolac therapy?
Show answer
Answer A: 5 days Ketorolac (all routes combined) is limited to 5 days because of the risk of GI bleeding and kidney injury.
Frequently asked questions
What are NSAIDs and acetaminophen?
NSAIDs relieve pain, fever and inflammation but can cause GI bleeding, kidney injury and cardiovascular events. Acetaminophen relieves pain and fever without these risks but can injure the liver.
How do NSAIDs and acetaminophen work?
NSAIDs inhibit cyclooxygenase (COX-1 and/or COX-2), lowering prostaglandins. Celecoxib is COX-2 selective. Acetaminophen acts centrally and has little anti-inflammatory effect.
What are examples of NSAIDs and acetaminophen?
Ibuprofen, Ketorolac, Acetaminophen, Naproxen, Celecoxib, Diclofenac, Meloxicam and Indomethacin.
What are the nursing considerations for NSAIDs and acetaminophen?
Assess for GI bleeding, kidney function and blood pressure. Avoid NSAIDs in kidney disease, heart failure, active ulcers and late pregnancy.