How to write a medication case study solved: Osteoarthritis, Celebrex, & Ibuprofen

Case study: 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.

SOLUTION TO CASE STUDY

1. What is the first-line therapy for osteoarthritis and the mechanism of action?

Osteoarthritis is characterized by the thinning of the articular cartilage and the thickening of the bone. Patients suffering from osteoarthritis may experience extreme pain on or after movement and stiffness in the morning or evening after strenuous activity. The first-line therapy for osteoarthritis is the use of acetaminophen, which is effective in the treatment of both intermittent and mild symptoms (Zhu et al., 2018). If the drug does not prove effective or the symptoms get worse, it is recommended to use nonsteroidal anti-inflammatory drugs (NSAIDs) to help relieve the pain. There is overwhelming evidence pointing to the inhibition of cyclooxygenase enzyme as the main mechanism of NSAIDs’ analgesic, antipyretic, and anti-inflammatory properties.

2. Sally expresses concern about the recent news about heart problems and celecoxib (Celebrex). What information should be included in a teaching plan to help her understand taking celecoxib and the benefits and risks?

The use of Celebrex in the management of osteoarthritis has been associated with heart problems based on previous studies. The studies indicate that individuals who use Celebrex are more likely to develop heart problems than those who do not take the drug. Some of the heart issues that have been linked to the use of the drug include heart attacks, strokes, and even death related to cardiovascular disease (Hong et al., 2020). It is important to use therapy to understand the level of effect that the use of a drug has had on an individual. Some signs to look for include inflammations, pain, and swellings on the joints.

A nurse should assess whether the patient is allergic to nonsteroidal anti-inflammatory drugs (NSAIDs) or sulfonamide drugs. Any patient who exhibits these signs should not be allowed to take Celebrex. The nurse should also be keen to note any skin rashes during the period. Celebrex has various side effects on patients that need to be included in the patient teaching plan on drug use. Some common ones include hypertension, diarrhea, abdominal pain, increase in liver enzymes, peripheral edema, and gastroesophageal reflux disease, among others (Hong et al., 2020). Despite the dangers listed, there are many benefits that patients may gain by using Celebrex to manage osteoarthritis. It is effective in relieving stiffness and pain. Also, it gets rid of swellings resulting from osteoarthritis and rheumatoid arthritis.

3. Ibuprofen and celecoxib are both nonsteroidal anti-inflammatory drugs. Explain how they are similar and different.

Both drugs are considered nonsteroidal anti-inflammatory drugs (NSAIDs), and they also exist in generic forms. The typical treatment for both drugs can vary from a few weeks to months or even years for other patients. Both drugs can help in treating conditions such as osteoarthritis, rheumatoid arthritis, and primary dysmenorrhea (Isola et al., 2019). Celebrex is considered to be a COX-2 in inhibitor, while Ibuprofen is not. Celebrex can be administered in a liquid form for children, while Ibuprofen can exist in the form of capsules, chewable, liquids, and even drops. Celebrex is commendable for patients two years and older, while Ibuprofen can be administered from the age of 6 months and older. Celebrex is normally easier on the stomach as it does not block COX-1 and COX-2 and thus a lower risk of a patient suffering from ulcers, unlike the case of Ibuprofen.

References

Chow, Y. Y., & Chin, K. Y. (2020). The Role of Inflammation in the Pathogenesis of Osteoarthritis. Mediators of Inflammation, 2020, 8293921. https://doi.org/10.1155/2020/8293921

Hong, W., Chen, Y., You, K., Tan, S., Wu, F., Tao, J., … & Li, Y. X. (2020). Celebrex adjuvant therapy on coronavirus disease 2019: An experimental study. Frontiers in Pharmacology, 11, 561674. https://doi.org/10.3389/fphar.2020.561674

Isola, G., Matarese, M., Ramaglia, L., Cicciù, M., & Matarese, G. (2019). Evaluation of the efficacy of celecoxib and Ibuprofen on postoperative pain, swelling, and mouth opening after surgical removal of impacted third molars: A randomized, controlled clinical trial. International Journal of Oral and Maxillofacial Surgery, 48(10), 1348-1354. https://doi.org/10.1016/j.ijom.2019.02.006

Zhu, X., Wu, D., Sang, L., Wang, Y., Shen, Y., Zhuang, X., … & Jiang, L. (2018). Comparative effectiveness of glucosamine, chondroitin, acetaminophen or celecoxib for the treatment of knee and/or hip osteoarthritis: A network meta-analysis. Clin Exp Rheumatol, 36(4), 595-602. https://pubmed.ncbi.nlm.nih.gov/29465368/

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