NSAIDS - Acetic Acid Derivatives/Indomethacin and Ketorolac

What is the prototype for the acetic acid derivates subclass of NSAIDS?

• Indomethacin

What other drugs are a part of the acetic acid derivates subclass of NSAIDS?

• Ketorolac

What is the indication for acetic acid derivatives?

• Short term management of pain

• Long term management of pain for things such as → Gouty Arthritis, Rheumatoid Arthritis, Ankylosing Spondylitis

What is the main action of acetic acid derivatives?

• Inhibits prostaglandin synthesis, anti-inflammatory, analgesic, and antipyretic actions

• Blocks COX 1 and COX 2

What are the contraindications for acetic acid derivatives?

• Hypersensitivity

• Past of GI Bleeding

• Renal Impairment

• Pain Following CABG

What are the adverse effects of acetic acid derivatives?

• GI Bleeding

• Anaphylaxis

• Drowsiness/Dizziness

• Rashes

• Fluid Retention

• Hypertension

What are the routes that acetic acid derivatives can be administered?

• PO

• IM

• IV

• Intranasal

What is the normal dosage for ketorolac?

• 10 to 30 mg → Depends on the route!

What is the pregnancy category for acetic acid derivatives?

• B, C, or D → Depends on the drug!

What are the nursing implications for acetic acid derivatives?

• QSEN Alert → GI Pain, Rapid Pulse, and Diaphoresis = GI Perforation!

• Indomethacin → Given PO with food or an antacid

• Ketorolac → First dose should be IV or IM

• Compatibility if given IV!

What patient teaching do acetic acid derivatives require?

• Keep PO meds of out light → To make them less potent

What is the black box warning for acetic acid derivatives?

• Contraindicated for the treatment of pain after coronary artery bypass graft → Open heart surgery!