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INTRODUCTION

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indomethacin (in-doe-meth-a-sin)

Image not available.Apo-Indomethacin, Image not available.Indameth, Image not available.Indocid, Indocin, Indocin I.V, Image not available.Indocin PDA, Indocin SR, Indochron E-R, Image not available.Novo-Methacin, Image not available.Nu-Indo

Classification

Therapeutic: antirheumatics, ductus arteriosus patency adjuncts (IV only), nonsteroidal anti-inflammatory agents

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Indications
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PO: Inflammatory disorders, including Rheumatoid arthritis, gouty arthritis, osteoarthritis , ankylosing spondylitis. Generally reserved for patients who do not respond to less toxic agents. IV: Alternative to surgery in the management of patent ductus arteriosus in premature neonates.

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Action
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Inhibits prostaglandin synthesis. Therapeutic Effects: PO—Suppression of pain and inflammation. IV—Closure of patent ductus arteriosus (PDA).

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Adverse Reactions/Side Effects
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CNS: dizziness, drowsiness, headache, psychic disturbances. EENT: blurred vision, tinnitus. CV: hypertension, edema. GI: PODRUG-INDUCED HEPATITIS, GI BLEEDING, constipation, dyspepsia, nausea, vomiting, discomfort, necrotizing enterocolitis. GU: cystitis, hematuria, renal failure. Derm: rashes. F and E: hyperkalemia IV: dilutional hyponatremia IV: hypoglycemia. Hemat: thrombocytopenia, blood dyscrasias, prolonged bleeding time. Local: phlebitis at IV site. 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 and promote hypertension in certain patients.

  • 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.

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

  • Report any unusual weakness and fatigue that might be due to anemia.

  • Monitor symptoms of high plasma potassium levels (hyperkalemia), including bradycardia, fatigue, weakness, numbness, and tingling. Notify physician because severe cases can lead to life-threatening arrhythmias and paralysis.

  • Monitor signs of hypoglycemia, especially during and after exercise. Common neuromuscular symptoms include anxiety; restlessness; tingling in hands, feet, lips, or tongue; chills; cold sweats; confusion; difficulty in concentration; drowsiness; nightmares or trouble sleeping; excessive hunger; headache; irritability; nervousness; tremor; weakness; unsteady gait. Report persistent or repeated episodes of hypoglycemia to the physician.

  • Monitor signs of kidney dysfunction such as ...

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