Nursing

Sally is a 50-year-old female who has been a jogger for several years. She has recently been diagnosed with osteoarthritis. She has been taking ibuprofen for 3 months but states that “it does not help” and hurts her stomach. The health care provider prescribes celecoxib (Celebrex) 100 mg orally twice a day.

  1. What is the first-line therapy for osteoarthritis and the mechanism of action?
  2. Sally expresses concern about all the recent news about heart problems and celecoxib (Celebrex). What information should be included in a teaching plan to help her understand about taking celecoxib and the benefits and risks?
  3. Ibuprofen and celecoxib are both nonsteroidal anti-inflammatory drugs. Explain how they are similar and different

Submission Instructions:

  • Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources.

Answer:

Introduction

Osteoarthritis is a common degenerative joint disease that occurs as a result of damage to cartilage, leading to pain, swelling, and stiffness of joints. The primary goals of osteoarthritis management are to relieve pain, improve joint function, and prevent disability. The first-line therapy for osteoarthritis is non-pharmacological, including weight management, exercise, physical therapy, and self-care interventions. However, when non-pharmacological therapy is not effective, pharmacological therapy may be required. Celecoxib (Celebrex) is a nonsteroidal anti-inflammatory drug (NSAID) commonly used for osteoarthritis management. This paper discusses the first-line therapy for osteoarthritis, the mechanism of action of celecoxib, the benefits and risks of using celecoxib, and the similarities and differences between celecoxib and ibuprofen.

First-line therapy for osteoarthritis and the mechanism of action

The first-line therapy for osteoarthritis is non-pharmacological, including weight management, exercise, physical therapy, and self-care interventions. Weight management is essential for people with osteoarthritis since excess weight increases the risk of joint damage and can exacerbate joint pain. Exercise and physical therapy are recommended to help reduce joint pain, improve joint mobility and strength, and prevent disability. Self-care interventions, such as the use of heat or cold packs, can also help reduce joint pain and swelling.

When non-pharmacological therapy is not effective, pharmacological therapy may be required. Celecoxib is a selective cyclooxygenase-2 (COX-2) inhibitor and a non-steroidal anti-inflammatory drug (NSAID) used to treat osteoarthritis. COX-2 is an enzyme responsible for producing prostaglandins, which are inflammatory mediators. Celecoxib selectively inhibits COX-2, reducing the production of prostaglandins and, therefore, reducing inflammation and pain.

Benefits and risks of using celecoxib

Sally expressed concern about the recent news regarding heart problems and celecoxib. It is essential to provide her with information on the benefits and risks of using celecoxib to help her make an informed decision.

Benefits of using celecoxib

Celecoxib is a highly effective medication for osteoarthritis pain relief. In a meta-analysis of randomized controlled trials, celecoxib was found to be significantly more effective in reducing osteoarthritis pain than placebo, and its effects were comparable to those of traditional NSAIDs such as ibuprofen (Bjordal et al., 2018). Additionally, celecoxib has been found to be safer than traditional NSAIDs in terms of gastrointestinal side effects. A systematic review and meta-analysis of randomized controlled trials found that celecoxib was associated with a lower risk of upper gastrointestinal events than traditional NSAIDs (Lanas et al., 2019). Therefore, celecoxib may be a suitable alternative for people who are intolerant to traditional NSAIDs or at high risk of gastrointestinal events.

Risks of using celecoxib

Celecoxib has been associated with an increased risk of cardiovascular events, including heart attacks and strokes. A meta-analysis of randomized controlled trials found that the risk of cardiovascular events was higher with high doses of celecoxib (≥400 mg/day) than with placebo, but not significantly different from that of traditional NSAIDs (Trelle et al., 2011). The risk of cardiovascular events with celecoxib is generally considered low, but it is essential to monitor cardiovascular risk factors, such as blood pressure and cholesterol levels, in people taking celecoxib.

Other potential side effects of celecoxib include gastrointestinal events, such as abdominal pain, diarrhea, and nausea

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