Drawing

Generic Name
Brand Name
Classification

Mefenamic Acid
Ponstan Forte
Non Steroidal Anti Inflammatory Drug (NSAID)
Blocks a substance in the body called cyclo oxygenase (COX) which is
involved in the production of prostaglandins. Prostaglandins are produced in
Action
response to injury and certain diseases causing pain, swelling and inflammation.
Mefenamic acid blocks the production of prostaglandins therefore effective at
reducing inflammation and pain.
Dosage
500 mg PRN
Dysmenorrhea, Menorrhagia, Theumatoid arthritis, Juvenile arthritis, Osteoarthritis,
Indication
Muscular pain, pain and inflammation due to accidents, toothache, headache, pain
following childbirth and pain following surgery.
People who are taking aspirin or other NSAIDs, Peptic ulcer of bleeding in the gut,
Contraindicatio
Inflammatory bowel disease, Severe heart failure, Kidney Failure, Third trimester of
n
pregnancy.
Should not be used in combination with painkilling doses of aspirin or any other
NSAID taken by mouth as this increases the risk of side effects on the stomach
and intestines.
Drug
Selective inhibitors of COX-2 such as celecoxib or etoricoxib should also be
Interaction
avoided for the same reason.
Increased risk of ulceration or bleeding in the gut if mefenamic acid is taken with
corticosteroids such as prednisolone.
Disturbances of the gut such as indigestion, diarrhoea, constipation, nausea,
vomiting or abdominal pain.
Headache.
Visual disturbances.
Sensation of spinning (vertigo).
Sensation of ringing, or other noise in the ears (tinnitus).
Side Effects and Increased blood pressure.
Adverse Effects Awareness of your heartbeat (palpitations).
Depression.
Hallucinations.
Inflammation of the pancreas (pancreatitis).
Allergic reactions such as severe skin rashes, swelling of the lips, tongue and
throat (angioedema) or narrowing of the airways (bronchospasm).
Kidney, liver or blood disorders.
Nursing
1. Assess pain and limitation of movement following the administration.

Responsibilities

2. Assess fever and associated signs like tachycardia and chills.

3. Monitor periodically in prolonged high dose therapy to assess for GI blood
loss.
4. Instruct to take medication exactly as prescribed.
5. Instruct to take with full glass of water and to remain in an upright position for 1
30 minutes.
6. Advise patient that this may cause drowsiness and blurred vision.
7. Advise patient to avoid concurrent use of alcohol to minimize possible gastric
irritation.
8. Inform patient that most NSAIDs prolong bleeding time due to suppressed
platelet aggregation.
9. Caution patient to avoid taking acetaminophen, salicylates to prevent analgesic
nephropathy.
10. Advise patient to notify health care professional before treatment or surgery or
when adverse effects occur.

Brain Tumor
- Is a localized intracranial lesion that occupies
space within the skull resulting to:

Increased intracranial pressure and

cerebral edema

Seizure activity and focal neurologic

signs
Hydrocephalus
Altered pituitary function

o
o
Tumor
o A mass of tissue that is formed by an
accumulation of abnormal cells
o Normally, cells die and replaced by new
cells. With cancer and other tumors,
something disrupts this cycle. Tumor
cells grow and dont die. As this process
goes on, the tumor continues to grow as
more and more cells are added to the
mass.
Types
o Primary brain tumors
Originate from cells and
structures within the brain
Begin when normal cells
acquire errors or mutations in
their DNA
These mutations allow cells to
grow and divide at increased
rates and to continue living
when healthy cells die
o Secondary brain tumors (Metastatic)
Develop from structures outside
the brain
When cancer begins elsewhere
and spreads to the brain
Breast cancer, colon cancer,
kidney cancer, lung cancer,
melanoma
Symptoms
o Headaches
o Nausea and vomiting
o Vision problems
o Difficulty with balance
o Speech difficulties
o Behaviour changes
o Seizures
o Hearing problems

Acoustic neuromas (schwannomas)

o Develop on the nerves that control balance and
hearing leading from your inner ear to your
brain.
Pituitary adenomas
o Develop in the pituitary gland at the base of the
brain.
Medulloblastomas
o These are the most common cancerous brain
tumors in children. A medulloblastoma starts in
the lower back part of the brain and tends to
spread through the spinal fluid.
Germ cell tumors
o Germ cell tumors may develop during childhood
where the testicles or ovaries will form. But
sometimes germ cell tumors move to other parts
of the body, such as the brain.
Craniopharyngiomas
o These rare, noncancerous tumors start near the
brain's pituitary gland, which secretes hormones
that control many body functions.
-

Causes
o Possible causes may include genetics,
defective immune system, heredity,
viruses and head injury

Gliomas
o These tumors begin in the brain or spinal cord
Meningiomas

Arises from the membranes that surround your

brain and spinal cord (meninges). Most
meningiomas are noncancerous.

Risk Factors
o Age
Common in older adults
o Exposure to radiation
Increased risk of brain tumors
o Family history of brain tumors
Increased risk of brain tumors
Diagnosis
o Neurological exam
Indicates the areas of the central
nervous sytem involve
Assist in the precise localization
of the lesion
o Imaging tests
MRI and CT scan
Detection of smaller lesions in
the brain stem and pituitary
regions
o Biopsy
To remove the brain tumor and
determine if it is cancerous or
benign
Treatment
Surgery

Location is accessible, remove as much

as possible
Small and easy to remove, complete
removal
Cannot be separated or located near
sensitive areas, surgery is risky
Radiation Therapy
Treat cancer that has spread to the body
Radiosurgery
Uses multiple beams of radiation
treatment to kill the tumor cells in a very
small area
Chemotherapy
Temozolomide (Temodar)
Targeted Drug Therapy
Bevacizumab (Avastin)
Stops the formation of new blood
vessels, cutting off blood supply to a
tumor and killing the tumor cells
Contraindications
o Hypersensitivity
o Pregnancy (critical to fetus)
Side effects
o Hypertension, hypotension
o Hemoptysis
o GI perforation
o Nephrotic syndrome
o Proteinuria
o Bleeding
o Impaired wound healing
Rehabilitation after treatment
Physical Therapy
Occupational Therapy
Speech Therapy

Nursing Management
o Teaching patient to direct food and
fluids toward unaffected side
o Eating at upright position, offering
semisoft diet and having suction readily
available
o Neurologic checks
o Monitor vital signs
o Reorient to persons and surroundings
o Assistance to self care
o Prevention to injury