A client has been started on a first-generation nonsteroidal anti-inflammatory medication for arthritis pain. The client says, "I remember something about one of these drugs causing heart attacks and strokes. Which drug was that?"
The nurse responds that the drug was celecoxib (Celebrex) but that:
1. Celebrex causes no problems at lower dosages.
2. the client has been prescribed a different medication.
3. the drug has been taken off the market.
4. newer research has proven that the concerns were unfounded.
Correct Answer: 2
Rationale 1: The adverse effects of Celebrex are not dose dependent.
Rationale 2: Celecoxib (Celebrex) is an effective second-generation NSAID but has limited use due to increased risk of myocardial infarction and stroke.
Rationale 3: Celebrex is still available, but its use is limited due to the increased risk of myocardial infarction and stroke.
Rationale 4: Use of Celebrex is limited due to the increased risk of myocardial infarction or stroke.
Global Rationale: Celecoxib (Celebrex) is a second-generation NSAID and is the sole drug remaining in this class in the United States. Other COX-2 inhibitors are still available outside the U.S. The COX-2 inhibitors have been found to increase the risk of serious cardiovascular events, including fatal MI and stroke. These results are not dose dependent.
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