Indocin (Indomethacin) Special considerations: Health Square: "Indocin should be taken with food or an antacid, and with a full glass of water. Never take on an empty stomach. Take this medication exactly as prescribed by your doctor. If you are using Indocin for arthritis, it should be taken regularly. If you are taking the liquid form of this medicine, shake the bottle well before each use. Indocin SR capsules should be swallowed whole, not crushed or broken. Do not lie down for about 20 to 30 minutes after taking Indocin. This helps prevent irritation that could lead to trouble in swallowing. If you are using the suppository form of this medicine: If the suppository is too soft to insert, hold it under cool water or chill it before removing the wrapper Remove the foil wrapper and moisten your rectal area with cool tap water. Lie down your side and use your finger to push the suppository well up into the rectum. Hold your buttocks together for a few seconds. Indocin suppositories should be kept inside the rectum for at least 1 hour so that all of the medicine can be absorbed by your body. Take the forgotten dose as soon as you remember. If it is time for your next dose, skip the one you missed and return to your regular schedule. Never take a double dose. The liquid and suppository forms of Indocin may be stored at room temperature. Keep both forms from extreme heat, and protect the liquid from freezing."
http://www.healthsqr.com/newrx/IND1209.HTM

Indocin (Indomethacin) Used for treatment of PDA: Neonatology: "When using Indomethacin for treatment of PDA, give doses 12-24 hours apart with close monitoring of urine output. Use 3 doses for 1st course, 1-3 doses for second course. If anuria or severe oliguria, subsequent doses should be delayed or cancelled and surgical intervention should be considered.Metabolized and excreted by the liver and kidneys. Half-life is approximately 30 hours, with a range of 15-50 hours. Pharmacokinetics are quite variable in newborns. Monitor: Platelets, BUN, Creatinine daily. Action Inhibitor of prostaglandin synthesis, probably by suppressing production of PGE1 which is thought to be the main relaxant of the ductus. Probably only effective in premature infants of less than 35 weeks gestation (including postnatal age).Toxicity: Transient decrease in urine output in some patients, usually not lasting more than 48 hrs. Indomethacin is bound tightly to albumin and may displace bilirubin. Platelet function may be altered by inhibition of prostaglandin synthesis. Hyponatremia. Vasoconstrictor; decreases renal and GI blood flow. Reduction of cerebral blood flow associated with rapid infusion."
http://www.neonatology.org/ref/meds/med54.html

Indocin (Indomethacin) drug interactions: Focus on Arthritis: "Indomethacin should be avoided by patients with a history of asthma attacks, hives, or other allergic reactions to aspirin or other NSAIDs. Rare but severe allergic reactions have been reported in such individuals. It also should be avoided by patients with peptic ulcer disease or poor kidney function, since this medication can aggravate both conditions. Indomethacin is generally used with caution in patients taking blood thinning medications (anticoagulants), such as warfarin (Coumadin), because of increased risk of bleeding. Patients taking lithium can develop toxic blood lithium levels. Patients also taking cyclosporine (Sandimmune) can develop kidney toxicity. Use of Indomethacin in children has not been adequately studied. Indomethacin is not habit forming. NSAIDs should be discontinued prior to elective surgery because of a mild interference with clotting that is characteristic of this group of medicines. Indomethacin is best discontinued at least three days in advance of the procedure. Indomethacin suppositories should be avoided by patients with a history of recent rectal bleeding or inflammation. Persons who have more than 3 alcoholic beverages per day are at increased risk of developing stomach ulcers when taking indomethacin or other NSAIDs. PREGNANCY: Indomethacin is generally avoided during pregnancy."
http://www.focusonarthritis.com/script/main/Art.asp?li=MNI&ArticleKey=766&page=2

Indocin (Indomethacin) dosages: Nurses PDR: "Capsules, Oral Suspension Moderate to severe arthritis, osteoarthritis, ankylosing spondylitis. Adults, initial: 25 mg b.i.d.-t.i.d.; may be increased by 25-50 mg at weekly intervals, according to condition and, if tolerated, until satisfactory response is obtained. With persistent night pain or morning stiffness, a maximum of 100 mg of the total daily dose can be given at bedtime. Maximum daily dosage: 150-200 mg. In acute flares of chronic rheumatoid arthritis, the dose may need to be increased by 25-50 mg/day until the acute phase is under control. Acute gouty arthritis. Adults, initial: 50 mg t.i.d. until pain is tolerable; then, reduce dosage rapidly until drug is withdrawn. Pain relief usually occurs within 2-4 hr, tenderness and heat subside in 24-36 hr, and swelling disappears in 3-4 days. Acute painful shoulder (bursitis/tendinitis). 75-150 mg/day in three to four divided doses for 1-2 weeks. Sustained-Release Capsules Antirheumatic, anti-inflammatory. Adults: 75 mg, of which 25 mg is released immediately, 1-2 times/day. Suppositories Anti-inflammatory, antirheumatic, antigout. Adults: 50 mg up to q.i.d. Pediatric: 1.5-2.5 mg/kg/day in three to four divided doses (up to a maximum of 4 mg/kg or 250-300 mg/day, whichever is less). IV Only Patent ductus arteriosus. 3 IV doses, depending on age of the infant, are given at 12-24-hr intervals. Infants less than 2 days: first dose, 0.2 mg/kg, followed by two doses of 0.1 mg/kg each; infants 2-7 days: three doses of 0.2 mg/kg each; infants more than 7 days: first dose, 0.2 mg/kg, followed by two doses of 0.25 mg/kg each. If patent ductus arteriosus reopens, a second course of one to three doses may be given. Surgery may be required if there is no response after two courses of therapy."
http://www.nursespdr.com/members/database/ndrhtml/indomethacin.html

Treatment of Indocin (Indomethacin) for headaches: Headaches.org: "Indomethacin (Indocin) is an analgesic. It is classified as a non-steroidal antiinflammatory drug. These are commonly referred to as NSAIDS. Other NSAIDS are also used as analgesics. Indomethacin can be used as a pain reliever or analgesic. It can also be used as a treatment for arthritis, fever or other conditions where inflammation plays a role in creating the symptoms."http://www.headaches.org/topicsheets/indocin.html

Idocin ( Indomethacin) is listed as a drug that will cause hair loss.: Health Library: "Next time your doctor prescribes any drug for you, ask if it will cause hair loss. You doctor may not realize this side effect. You can ask him or her to look it up in the Physicians' Desk Reference, which lists the side effects of all prescription medications. If the drug is linked to reversible alopecia, ask if another can be substituted. And just to make sure your physician has given you accurate information, when you get the prescription filled, ask your pharmacist as well: penicillamine, auranofin (Ridaura), indomethacin (i\Indocin), naproxen (Naprosyn), sulindac (Clinoril), and methotrexate (Folex)"
http://www.health-library.com/library/health/part7.htm

Side effects of Indocin (Indomethacin): RxList: "Gastrointestinal- nausea with or without vomiting, dyspepsia (including indigestion, heartburn and epigastric pain), diarrhea, abdominal distress or pain, constipation. Less than 1% anorexia, bloating, (includes distension), flatulence, peptic ulcer, gastroenteritis, rectal bleeding, proctitis, single or multiple ulceratins; including perforation and hemorrhage of the esophagus, stomach, duodenum, or small and large intestines, intestinal ulceration associated with stenosis and obstruction, gastrointestinal bleeding without obvious ulcer formation and perforation of pre-existing signoid lesions (diverticulum, carcinoma, etc.), development of ulcerative colitis, and regional ileitis, ulcerative stomatitis, toxic hepatitis and jaundice (some fatal cases have been reported)."
http://www.rxlist.com/cgi/generic/indometh_ad.htm

Medications to avoid while taking Indocin (Indomethacin): Web MD: "Other prescription and over-the-counter drugs may increase the effects of indomethacin and cause dangerous side effects. Tell your doctor if you are taking any of the following drugs: other nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Motrin, Rufen, others), ketoprofen (Orudis, Orudis KT, Oruvail), or naproxen (Naprosyn, Aleve, Anaprox) other commonly used NSAIDs, including diclofenac (Voltaren, Cataflam), etodolac (Lodine), fenoprofen (Nalfon), flurbiprofen (Ansaid), indomethacin (Indocin), ketorolac (Toradol), nabumetone (Relafen), oxaprozin (Daypro), Indomethacin (Indocin), sulindac (Clinoril), or tolmetin (Tolectin); aspirin and other salicylates (forms of aspirin) such as salsalate (Disalcid), choline salicylate, and magnesium salicylate (watch the aspirin content of other over-the-counter products such as cough, cold, and allergy medicines); diuretics (water pills) such as hydrochlorothiazide (HCTZ, Hydrodiuril, others), chlorothiazide (Diuril, others), chlorthalidone (Thalitone), bumetanide (Bumex), ethacrynic acid (Edecrin), furosemide (Lasix), spironolactone (Aldactone), and amiloride (Midamor); anticoagulants such as warfarin (Coumadin); steroids such as prednisone (Deltasone); alcohol, oral antidiabetic drugs such as glipizide (Glucotrol) and glyburide (Micronase, Diabeta; lithium (Eskalith, Lithobid, others); cyclosporine (Sandimmune, Neoral); or bismuth subsalicylate in drugs such as Pepto-Bismol. Indomethacin can also decrease the effects of other drugs, such as angiotensin- converting-enzyme (ACE) inhibitors, used to treat high blood pressure and other conditions, such as benazepril (Lotensin) and captopril (Capoten); other commonly used ACE inhibitors, including enalapril (Vasotec), fosinopril (Monopril), lisinopril (Prinivil, Zestril), moexipril (Univasc), quinapril (Accupril), and ramipril (Altace); and beta-blockers, used to treat high blood pressure and other conditions, such as acebutolol (Sectral), metoprolol (Lopressor), propranolol (Inderal), atenolol (Tenormin), and carteolol (Cartrol). Drugs other than those listed here may also interact with indomethacin. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines. "
http://my.webmd.com/content/article/4046.859

Indocin (Indomethacin) rectal suppository: Walgreens Pharmacy: "Possible Side Effects: side effects, that may go away during treatment, include dizziness, lightheadedness, drowsiness, burning feeling or discomfort in rectum, rectal itching, or headache. if they continue or are bothersome, check with your doctor. check with your doctor as soon as possible if you experience blurred vision, ringing in ears, swelling of hands or ankles, fever, sore throat, vomiting material that looks like coffee grounds, blood in stool or vomit, or stomach pain. contact your doctor immediately if you experience seizures; swelling of hands, face, lips, eyes, throat, or tongue; difficulty swallowing or breathing; or hoarseness. if you notice other effects not listed above contact your doctor, nurse, or pharmacist. vomit that looks like coffee grounds. If you notice other effects not listed above contact your doctor, nurse, or pharmacist."
http://www.walgreens.com/library/finddrug/druginfo.jhtml?_DARGS=%2Flibrary%2Ffinddrug%2Fdruginfo.jhtml.1_A&_DAV=7492

Gifts:

Nurses' Station:"The idea for the Nurses' Station Catalog was conceived in 1989. After searching the marketplace in response to customer inquiries, it became obvious that there were no catalogs of this type serving the nursing profession. To be sure, there were several catalogs offering nurse's uniforms and a smattering of professional items. But there weren't any catalogs at the time offering a range of gifts, clothing, professional items, name badges, shoes and scrubs for nurses. It took two years of hard work to gather samples and put a together a catalog of the most unique and high-quality items for nurses. As a result, the first Nurses' Station Catalog was published in the Spring of 1991."
Nurses Station P.O. Box 388 Centerbrook, CT 06409-03881

Quick Nursing Links: About this site, Associations, Nursing A To Z, Nursing Entrepreneurs, Nurse-Owned Businesses, Chat Rooms, Directories, Education, Continuing (CEUs), Email, Employment, Jobs, Recruiters, Gift Ideas, Nursing Homes, Humor, Medical Jokes, Journals Legal Nurse Consulting (Medical), Nursing Professions Nursing Schools, Shortages, Short Staffing, Nursing Students, Unions, Uniforms and Scrubs, Traveling Nurses, Travel Nursing Agencies, Website Evaluation