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indomethacin (in-doe-meth-a-sin)
Apo-Indomethacin, Indameth, Indocid, Indocin, Indocin I.V, Indocin PDA, Indocin SR, Indochron E-R, Novo-Methacin, Nu-Indo
Classification
Therapeutic: antirheumatics, ductus arteriosus patency adjuncts (IV only), nonsteroidal anti-inflammatory agents
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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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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: PO—DRUG-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 ...