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INTRODUCTION

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fenoprofen (fen-oh-proe-fen)

Nalfon

Classification

Therapeutic: nonopioid analgesics

Pharmacologic: propionic acid derivatives

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Indications
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Rheumatoid arthritis. Osteoarthritis. Mild-to-moderate pain.

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Action
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Inhibits prostaglandin synthesis. Therapeutic Effects: Suppression of pain and inflammation.

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Adverse Reactions/Side Effects
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CNS: confusion, dizziness, drowsiness, headache. EENT: blurred vision, hearing loss, tinnitus. CV: edema, palpitations. GI: GI BLEEDING, HEPATITIS, dyspepsia, abdominal pain, constipation, diarrhea, discomfort, nausea, vomiting. GU: cystitis, dysuria, hematuria, renal failure. Derm: pruritus, rashes, sweating. Hemat: prolonged bleeding time. Neuro: tremor. Misc: ALLERGIC REACTIONS, INCLUDING ANAPHYLAXIS.

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PHYSICAL THERAPY IMPLICATIONS

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Examination and Evaluation
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  • Monitor signs of GI bleeding, including abdominal pain, vomiting blood, blood in stools, or black, tarry stools. Report these signs to the physician immediately.

  • Be alert for signs of drug-induced hepatitis, including anorexia, abdominal pain, severe nausea and vomiting, yellow skin or eyes, skin rashes, flu-like symptoms, and muscle/joint pain. Report these signs to the physician immediately.

  • Monitor signs of allergic reactions and anaphylaxis, including pulmonary symptoms (laryngeal edema, wheezing, cough, dyspnea) or skin reactions (rash, pruritus, urticaria). Notify physician immediately if these reactions occur.

  • Assess pain and other variables (range of motion, muscle strength) to document whether this drug is successful in helping manage the patient's pain and decreasing impairments.

  • Assess blood pressure (BP) periodically and compare to normal values (See Appendix F). NSAIDs can increase BP in certain patients.

  • Assess for signs of prolonged bleeding time such as bleeding gums, nosebleeds, and unusual or excessive bruising. Notify physician if these signs occur.

  • Assess peripheral edema using girth measurements, volume displacement, and measurement of pitting edema (See Appendix N). Report increased swelling in feet and ankles or a sudden increase in body weight due to fluid retention.

  • Monitor signs of kidney dysfunction such as painful urination or blood in the urine. Report signs of renal failure immediately, including decreased urine output, increased BP, muscle cramps/twitching, edema/weight gain from fluid retention, yellowish brown skin, and confusion that progresses to seizures and coma.

  • Assess dizziness and drowsiness that might affect gait, balance, and other functional activities (see Appendix C). Report balance problems and functional limitations to the physician, and caution the patient and family/caregivers to guard against falls and trauma.

  • Monitor and report confusion, agitation, or other psychic disturbances.

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Interventions
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  • Implement appropriate manual therapy techniques, physical agents, and therapeutic exercises to reduce pain and decrease the need for fenoprofen and other NSAIDs.

  • If treating arthritic conditions, recommend orthotic and assistive devices as needed to reduce pain, improve function, and augment the effects of drug therapy.

  • Use caution with any physical interventions that could increase bleeding, including wound d√©bridement, chest percussion, joint mobilization, and application of local heat.

  • Help patient explore other nonpharmacologic methods to reduce chronic pain such as relaxation techniques, exercise, ...

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