Diclofenac Sodium
Trade name:
Diclofenac
sodium: Voltaren, Rufenal, Novo-Difenac (CAN), Nu-Diclo
(CAN), ,
Voltaren Ophtha (CAN), Voltaren-XR
Diclofenac potassium: Cataflam,
Voltaren Rapid (CAN)
Drug classes
•
Analgesic (non-narcotic) Antipyretic
•
Anti-inflammatory agent
•
Nonsteroidal
anti-inflammatory drug (NSAID)
Pregnancy: (Category B /D if used in 3rd trimester or near
delivery.]
Action: Inhibits prostaglandin
synthetase to cause antipyretic and anti Inflammatory effects; the
exact mechanism is unknown.
Uses:
× Rheumatoid arthritis × Osteoarthritis.
× Acute or long-term treatment of mild to moderate pain, including
dysmenorrheal
× Ankylating spondylitis
× Other musculoskeletal diseases.
× Dental pain
× Strains & sprains.
Dose by mouth, 75–150 mg daily
in 2–3 divided doses
By deep intramuscular
injection into the gluteal muscle, acute exacerbations of pain and postoperative pain, 75 mg once daily (twice
daily in severe cases) for max. Of 2 days Ureteric colic, 75 mg then a further
75 mg after 30 minutes if necessary
by intravenous infusion (in hospital setting), 75 mg repeated if
necessary after 4–6 hours for max. 2 days
Prevention
of postoperative pain, initially after surgery 25–50 mg over 15–60
minutes then
5 mg/hour for max.
2 days by rectum in suppositories, 75–150 mg
daily in divided doses
Max. Total daily dose by any route
150 mg
Child 1–12 years, juvenile arthritis, by mouth or by
rectum, 1–3 mg/kg daily in divided doses (25 mg e/c tablets, 12.5 mg and 25 mg
suppositories only) Contraindications:
1- Children less than14 years of age.
2- Lactation.
3- Hypersensitivity (asthma, rashes, rhinitis).
4- Uses with caution in patients with a history of GI disease &
reduced renal functions.
Side effects:
× CNS: Headache, dizziness, somnolence,
insomnia, fatigue, tiredness, dizziness, tinnitus, ophthalmologic effects
× GI: Nausea, dyspepsia, GI pain,
diarrhea, vomiting, constipation, flatulence
× Hematologic: Bleeding, platelet
inhibition with higher doses
× GU: Dysuria, renal impairment
× Dermatologic: Rash, pruritus,
sweating, dry mucous membranes, stomatitis
× Other: Peripheral edema,
anaphylactoid reactions to fatal anaphylactic shock Nursing considerations:
§ Give on full stomach to avoid GIT irritation.
§ When given IM, Give it deep into a large muscle because drug is
very irritant.
§ Note any history of allergic responses to aspirin or
nonsteroidal anti-inflammatory agents. {NS.AID.}
§ Note the age of the client.
§ Determine if patient is taking oral hypoglycemic or insulin and
document it.
§ Take these agents with milk or meal or antacids as prescribed.
§ Encourage patient to take drug regularly.
§ Report signs of GI irritation, sore throat, fever, rash,
itching, weight gain, swelling in ankles or fingers, changes in vision; black,
tarry stools, tinnitus, and rashes – etc.
§ Dizziness, drowsiness can occur (avoid driving or using
dangerous machinery while on this drug).
If the client has Diabetes Mellitus, explain the possible in increasing
hypoglycemic effect of the drugs, to test urine & blood for glucose. To adjust
dose of these agents.
