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INTRODUCTION

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naproxen (na-prox-en)

Aleve, Anaprox, Anaprox DS,

Image not available.Apo-Napro-Na, Apo-Napro-Na DS, Image not available.Apo-Naproxen, EC-Naprosyn, Naprelan, Napron X, Naprosyn, Image not available.Naprosyn-E, Image not available.Naprosyn-SR, Image not available.Naxen, Image not available.Novo-Naprox, Image not available.Novo-Naprox Sodium DS, Image not available.Nu-Naprox, Image not available.Synflex, Image not available.Synflex DS

Classification

Therapeutic: nonopioid analgesics, nonsteroidal anti-inflammatory agents, antipyretics

Pharmacologic: propionic acid derivatives

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Indications
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Mild-to-moderate pain. Dysmenorrhea. Fever. Inflammatory disorders, including Rheumatoid arthritis (adults and children), Osteoarthritis.

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Action
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Inhibits prostaglandin synthesis. Therapeutic Effects: Decreased pain. Reduction of fever. Suppression of inflammation.

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Adverse Reactions/Side Effects
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CNS: dizziness, drowsiness, headache. EENT: tinnitus, visual disturbances. Resp: dyspnea. CV: edema, palpitations, tachycardia. GI: DRUG-INDUCED HEPATITIS, GI BLEEDING, constipation, dyspepsia, nausea, anorexia, diarrhea, discomfort, flatulence, vomiting. GU: cystitis, hematuria, renal failure. Derm: photosensitivity, rashes, sweating, pseudoporphyria (12% incidence in children with juvenile rheumatoid arthritis—discontinue therapy if this occurs). Hemat: blood dyscrasias, prolonged bleeding time. Misc: ALLERGIC REACTIONS, INCLUDING ANAPHYLAXIS AND STEVENS-JOHNSON SYNDROME.

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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). Be especially alert for exfoliation, dermatitis, and other severe skin reactions that might indicate serious hypersensitivity reactions such as Stevens-Johnson syndrome. 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 heart rate, ECG, and heart sounds, especially during exercise (See Appendices G, H). Report rapid heart rate (tachycardia) or symptoms of other arrhythmias such as palpitations, chest discomfort, shortness of breath, fainting, and fatigue/weakness.

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

  • Be alert for signs of prolonged bleeding time such as bleeding gums, nosebleeds, and unusual or excessive bruising. Report these signs to the physician.

  • 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.

  • Monitor unusual weakness and fatigue that might be due to anemia, or other symptoms such as fever, sore throat, mucosal ...

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