Adverse Drug Reaction to Celecoxib: Case Study
Preceptor: Christopher Stetler DO
Family Practice
Daris Rice
KCOM OMS IV
Class of 2015
January 19, 2015
Abstract
An Adverse event is defined as any undesirable event that a patient experiences while taking a medication. This includes many things, such as a motor vehicle collision or falling down the stairs. An Adverse event is different from an Adverse Drug Reaction (ADR). An Adverse Drug Reaction, as defined by the Medicines and Healthcare Products Regulatory Agency, is a response to a medicinal product that is noxious or unintended1. These adverse reactions may be an already known side effect or a new side effect not previously recognized. ADRs are very burdensome to the patient’s wellbeing, they increase healthcare cost, and roughly half of the reactions may be preventable.
Introduction
The following case report discusses a Type B ADR to Celecoxib of a 54 year-old female and the events that led to the diagnosis and treatment. Celecoxib is a non-steroidal anti-inflammatory medicine that inhibits the production of prostaglandins by inhibiting cyclooxygenase-2. This drug is indicated for acute pain, primary dysmenorrhea, ankylosing spondylitis, osteoarthritis, and rheumatoid arthritis.3 The patient had been prescribed a therapeutic dose of Celecoxib for osteoarthritis and was tolerating the medicine up until the ADR. Although the diagnosis was discovered, there were challenges that led to the delay in
Are there any contraindications for this drug? Hypersensitivity, cross-sensitivity with other NSAID’s such as aspirin, history of allergic reactions, asthma, advanced renal disease, hepatic dysfunctions, perioperative pain.
When treated with more than a single dose, patients were administered one dose per week. To minimize infusion reactions, patients received intravenous methylprednisolone, oral acetaminophen and diphenhydramine 30 min prior to RTX infusions. All patients were closely monitored for at least 24 h after RTX infusion for observation of infusion reactions. Immunosuppressive agents and/or oral prednisolone used at the time of rituximab treatment were continued until clinical response was demonstrated in the form of remission or decreased
| A subject in a clinical research trial experiences a serious, unanticipated adverse drug experience. How should the investigator proceed, with respect to the IRB, after the discovery of the adverse event occurrence?
Last QDRR in 5/30/17 indicates that patient is free from poly-pharmacy but he is not free of potential drug interaction:
CONSTRUCTED RESPONSE 1. What was the one child policy, and what made China's government want to put it into action? The one child policy was a policy started in 1980 to help with China's rapidly growing population. The policy stated that a family could only have one child and that you would be punished if you didn't follow.
HISTORY OF PRESENT ILLNESS: This patient is a 57 yr. old, Cuban woman with a long history of rheumatoid arthritis. She has received methotrexate on a weekly basis as an outpatient for many years, approximately 2 weeks ago she developed a respiratory infection for which she received antibiotics and completed that course of antibiotics. She developed some ulcerations of her mouth and was instructed to discontinue the
This newsletter is designed to help practising pharmacists understand the application of the basis sciences to practice concerning adalimumab. Lots of practical advice is based on pharmaceutical sciences but once you enter practice it can be hard to remember or find out the basis of why we advise patients in specific ways or why you or other health professionals should handle medicines in certain ways.
You see your best friend laughing with your other friend, sharing cherished moments and having a blast. She then comes up to you and starts off the conversation with how ugly your other friend looked today. You get that feeling of nausea wondering if that's how she spoke about you behind your back. When someone is being two-faced you can´t even think to trust them anymore. The town of Maycomb suffered not only the sickness of prejudice but also the disheartening of hypocrisy. Maycomb was left with a lack of sympathy along with the absence of tolerance and considering one´s feelings. In Harper Lee´s To Kill A Mockingbird, hypocrisy is a major factor in why people have problems in the town, especially concerning the prosecution of Tom Robinson, Scout´s third-grade teacher, and the harsh conversation in Aunt Alexandra's missionary society meeting.
It is, therefore, critical to educate and encourage ADR self-reporting among nurses to manage patient safety and improve patient outcomes. Diligent and standardized reporting of ADRs ensures efficient and safe use of medications. Once the adverse drug reactions are detected and reported, the multidisciplinary team can examine, evaluate and implement effective clinical processes to prevent reoccurrences. The patient health outcomes are thus improved, as measures taken significantly reduce risks associated with medication use.
Mr Wesley is a 56 year old man who has been taking warfarin to prevent clotting as a side effect of chronic atrial fibrillation. He was prescribed the antibiotic cefixime, a 3rd generation cephalosporin to treat his lower urinary tract infection. Not only did he not fully complete the course of antibiotics, he also drank several glasses of wine in one night at a party. Mr Wesley was taken to A&E for a swollen and painful knee that was found to be bleeding internally; his International Normalised Ratio was 5.6. He was told to stop taking warfarin until his International Normalised Ratio has decreased below 5.
Celebrex is a no steroidal anti-inflammatory drug, which relieves inflammation (pain and swelling). It is used to treat arthritis, acute pain, and menstrual pain and discomfort. The pain and swelling relief provided by this medication helps you perform more of your normal daily activities. Celebrex works by blocking the your body’s enzyme that makes prostaglandins, by decreasing prostaglandins it helps to reduce inflammation.
Adverse reactions to drugs are common and almost any drug can cause an adverse reaction.
Adverse reactions to this medication are migraine, speech disorders, rhinitis, sinusitis, hyperglycemia, elevated liver function, elevated serum creatinine level, pancytopenia, bronchitis, dyspnea, toxic epidermal necrolysis, anaphylaxis, elevated creatine kinase, generalized pain, and infection. Nursing considerations with this medication is to have the patient swallow the whole tablet and not to chew. Watch for aspiration while watching the patient take the medication. Educate the patient about the medication and inform them to notify a physician if bleeding
The drug I am prescribed is methylprednisolone. It is considered a steroid and is commonly used to treat inflammation and severe allergies. It is more commonly known as Medrol or Meprolone (Jones & Bartlett Learning, p.703). It inhibits neutrophil accumulation (p.704). Some side effects
Big business has a constructive influence on America. Large corporations contribute much more to a country’s economic well being than smaller ones. Bigger corporations are more productive, pay higher salaries and hourly, generate more jobs, and are more successful in international markets. However, not everyone believes that big business has a positive impact for the US. Some hold to the opinion that big business will never be as effective as small businesses. However, as J. D. Harrison, who covers startups, small business and entrepreneurship for the Washington Post, states that even though people believe that small business is the backbone of our nation, yet “companies with more than 500 workers employed about 45 percent of the workforce yet contributed 65 percent of the jobs created since 1990” (The Washington Post, 2013). This is not to discredit the influence of small business in the US. In fact, they are an essential part of our society. Small business have created and maintained thousands of jobs in the last half century. But we will focus on big business in this discussion. What is the history of big business in the US, and what were the fruitful results, as well harmful ones? What about the political side of big business, and finally, are there ethical associations when it comes to large corporations?