What all healthcare providers should know about ibuprofen. 5 info tips
Ibuprofen can actually elevate the blood pressure so this is something that super important to realize that whether an individual has not been diagnosed with hypertension or if an individual has been that diagnosis of hypertension if they sit still can raise their blood pressure either way now and also it has been shown besides that it also has been shown that
Can actually affect the antihypertensive drugs their efficiency or their effectiveness except for calcium channel blockers well the higher the dose of the ibuprofen the more likely that will affect the blood pressure ibuprofen increases the risk for a gi bleed now ibuprofen can disrupt and reduce the production of prostaglandins within the stomach prostaglandins
Provide protection against mucosal damage specifically in the stomach with these changes this increases the risk for a gastric ulcer or basically take a hole in the stomach it makes it much easier to develop now signs of a gi bleed include seeing black tarry stools coffee ground stools dizziness low hemoglobin those are all things that are may be signs or symptoms
Of a gi bleed let’s go over a nursing scenario to make this more realistic a patient comes in the er with unexplained dizziness and shortness of breath their vital signs are heart rate 110 blood pressure 95 10 98 point 4 respirations 22 and oxygen 91% they state that they have been having dark tarry stools for the last week they have also been feeling very weak and
Fatigued labs are drawn iv fluids are started and 2 liters of nasal cannula oxygen is started they do feel some water and lot of improvement after these interventions however the er doctor decides to go ahead and get in a cold stool and all get four times i be as a gi bleed is highly suspected when labs are turned the hemoglobin is at six point five the previous
Hemoglobin from four months ago was at twelve point seven the rest of their labs including the renal function are normal they do not have any chronic conditions that they can remember their medalists include sir tecton milligrams ibuprofen 600 milligrams as needed and flonase daily the patient missed it taking more ibuprofen recently because of increased back pain the
Ibuprofen is then discontinued by the er doctor the gi doctor has been consulted and four times trip has been started now this is a very realistic scenario hopefully this makes sense and kind of puts it all together i wanted to make sure to do this so that makes sense and we’ll do that in a few other examples info tip number three now this kind of goes along with
The previous tip and this is one that most people know but you take appropriate with food this basically helps to avoid the stomach upset that often happens when you take out your program so just remember to tell your patients that they should take any kind of inset with food another quick fact ibuprofen should not be taken if you have kidney disease individuals
Who have canoes ease or who are at risk to develop kidney disease should not take ibuprofen nsaids can actually worsen the real function this is important to recognize especially when you’re doing a med reconciliation if you’re a nurse or if you’re a provider who is looking at you talking with the patient and they have renal failure all of a sudden looking at the
Med list and trying to determine if there’s any specific med that may be contributing now even if nsaid is not the exact reason before the kidney failure it can definitely set that kidney failure kind of tip it over the edge and so we want to make sure to be catching things that could potentially make it worse now let’s go on to a scenario let’s read this scenario
Here your patients labs in their home meds you see that they’re on i think open and that their gfr study at creighton 2.3 and bonus 34 you review the patient’s previous labs for two months ago their gfr was 62 creatinine 1.2 121 you call the on-call provider to notify them of this the i-pro fitness held girlfriend may not be the only cost for the renal failure
However can definitely be contributing to the renal failure so this is important because this actually requires you as the nurse to know a few things and things first of all it requires you to be able to recognize these labs very quickly or at least have an idea of what the normals are most hospital lab reports will give highlight of abnormals in red but i have
Seen some systems where that’s just not the case the other thing is that you have an idea that the ibuprofen may be contributing to the kidney failure even if it’s not the main cause you need to be able to recognize that this patient is in kidney failure a lot of times what i like to do is if they someone does have renal function that is abnormal i like to go to
Previous labs and i always check to see where they’ve been running either way they probably should not be on it and said if that’s the case if they have renal failure but it’s just good to get a baseline reference so when you’re calling the phone call provider you’re aware of this mark re infarction risk now i beep ropin and most incense can actually increase your
Risk for a heart attack well people are surprised to hear this in 2005 the fda warned that basically nsaids can increase your risk to have a heart attack it also increased your risk to have a stroke as well now a heart attack can happen fairly quickly even when started even if you’re not on incense for very long so even if you’re only using it for short-term
Use if you you could even happen within the span of two weeks to three weeks or so so you know the biggest thing is to take into consideration if the individual has a history of myocardial infarction or cardiovascular disease or history of strokes obviously these people you would want to avoid and sense in because that increases their risk even more to end up
Developing one of these two things there are some incense that are considered safer so i’m just uh ds is shown but there still the jury’s still out on that arrghh for instance naproxen is actually considered well for the studies safer than diclofenac and ibuprofen this that’s what some things are some studies are showing now this may be confusing to some people
Though because aspirin is also an nsaid but it does not have the same risks it actually is given to prevent things like stroke and heart attack so let’s go ahead and move on to a patient scenario your patient is having a headache they are in the hospital for chest pain that is likely due to a non stemi you do not see any peer in medications on there a bar for
Headache or pain your patient tells you that a problem is only thing that works for them you call the on-call provider to your custom profile the provider tells you after reviewing and asking some questions that they will not order any incense as this can increase the risk for a heart attack they decide to order acetaminophen instead so let’s talk about this this
Is actually something when i used to be on call that i was quite okay this happened quite a bit actually and so a lot of times the the two things that main things you need to know here whether your provider or a nurse on the floor calling for this patient is that number one that nsaids first of all can make increase your risk for stroke and heart attack and then
Number two also knowing what the nsaids are a lot of people do not know the different kinds of insets they just a lot of times will correlate things like naproxen or ibuprofen but they don’t think of anything else so here is a list for you of some of the more common some or not these are some of the insets that you should be aware of well this concludes this video
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Transcribed from video
Ibuprofen By Med Made EZ