Common drugs for arthritis and connective tissue disease

Dosage: vares depending on which drug is being used

Purpose: relieves chronic pain by inhibiting prostaglandin synthesis

Nursing Implications: observe for fluid retention, increased blood pressure, and changes in renal function

tionales: Most NSAID's cause sodium retention, which can lead to edema, hypertension, renal damage, and heart failure. Drugs should be used with caution in older adults

Monitor electrolyte and CBC values; most NSAID's cause increased sodium levels and can cause bone marrow suppression

Observe for CNS changes (dizziness, confussion); most NSAID's can cause CNS effects, especially in older adults

• Dosage: 200mg orally daily
• Purpose: an antimalarial agent that helps decrease inflammation and slow disease process

Nursing implications: instruct patient to have frequent (every 6-12 months) ophthalmologic examination

Rationale: drug can cause retinal damage

Purpose: supresses bone marrow to reduce immune response

Nursing implications:Monitor for side effects and toxic effects, including buat not limited to nausea/vomiting, bone marrow suppression, and increased liver enzymes

instruct patient to avoid crowds and people with infections such as influenza, if ill seek medical attention

Rationale: the side effects ans toxic effects of these drugs can be devastating

immune suppression increases the risk of infection

Purpose: decreases inflammatory and immune response by decreasing WBC count

• Nursing implications: observe for cushingoid changes, buffalo hump, moon face, striae, acne, thin skin, bruising, fluid retention, and increased blood pressure.
• Monitor electrolyte and glucose levels. Monitor weight.

Rationale: these changes are expected and tend to be dose related changes diminish as dose decreases

chronic steroid therapy can cause sodium or fluid retention, potassium depletion, and elevated glucose level

• Nursing implications cont: observe for long-term effects of chronic steroid therapy, such as osteoporosis, attaracts, hypertension diabetes, and impaited healing
• Rationale: these complications may need to be treated with other drugs or modalities

Teach patient to increase dietaty calcium and vitamin D and take supplement

instruct patient to avoid crowds and persons with infections such as influenza

Rationale: drug suppress immune system (lymphocytes) and increases risk of infection or decreased healing

Purpose: decreases inflammation and slows disease process

Nursing implications: check for sulfa allergy or kidney or liver disease

teach patient to drink adequate fluids

teach men that the drug can lower sperm count

Rationales: drug is a sulfa medication that has potential renal/liver toxicities

failure to drink fluids may cause formation of urine crystals

low sperm count may interfere with ability to conceive

Purpose: decreases inflammation by inhibiting an enzyme

Nursing implcations: teach patient to have prescribed laboratory test, usually every 6-8 weeks

avoid alcohol while taking drug

Rationales: increased liver enzymes and decreased bloood count have been reported

alcohol can increase liver enzymes

Purpose: Neutralize biological activity of either TNF or IL to decrease immune response

Nursing implications: do not give BRMs if patient has a serious infection, TB, or MS

Rationale: drugs may exacerbate infections, MS, or lupus

• teach patient to report site reaction
• refrigerate to prevent decomposition
• report chest pain
• difficulty breathing during infusion
• monitor blood pressure
• monitor WBC count
• report cough, dizziness, and sore throat
• monitor for dyspnea, wheezing, flushing, itching
• observe for infusion reaction

Do not refrigerate it is the only BRM that you do not refrigerate