Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
DRUG CLASS AND MECHANISM: Indomethacin is a
nonsteroidal
anti-inflammatory drug (NSAID) that reduces fever, pain and inflammation. It is
similar to ibuprofen (Motrin) and naproxen (Naprosyn, Aleve). Indomethacin works
by reducing the production of prostaglandins. Prostaglandins are chemicals that
the body produces to cause fever and pain that are associated with inflammation.
Indomethacin blocks the enzymes that make prostaglandins (cyclooxygenase 1 and
2) and thereby reduces the levels of prostaglandins. As a result, fever, pain
and inflammation are reduced. Indomethacin is available in a sustained (slow)
release form (Indocin-SR). The FDA first approved indomethacin in January 1965.
PRESCRIPTION: Yes
GENERIC AVAILABLE: Yes
PREPARATIONS:
Capsules: 25 and 50 mg;
Capsules, sustained release: 75 mg;
Suspension: 25 mg/ml;
Suppositories: 50 mg.
STORAGE: Capsules should be kept at room temperature 15-30 C (59-86
F). Oral suspension and suppositories should be kept below 30 C (86 F). The oral
suspension should not be frozen.
DOSING: The recommended dose for adults is 50-200 mg per day split
into 2-3 doses. Indomethacin should be taken with food in order to reduce
abdominal discomfort.
DRUG INTERACTIONS:Cholestyramine (Questran) and colestipol (Colestid)
may decrease the absorption of indomethacin by binding to indomethacin in the
intestine and preventing absorption into the body. Indomethacin and other NSAIDs
may decrease the elimination of lithium
(Eskalith, Lithobid) by the kidneys and, therefore, increase
the blood level of lithium, which could lead to lithium toxicity.
Indomethacin
may reduce the blood pressure-lowering effects of drugs that are given to
reduce
blood pressure. This may occur because prostaglandins play a role in the
regulation of blood pressure. When indomethacin is used in combination with
aminoglycoside antibiotics (for example, gentamicin) the blood levels of the
aminoglycoside may increase, presumably because the elimination of
aminoglycoside from the body is reduced. This may lead to aminoglycoside-related
side effects.
Individuals taking oral blood thinners or anticoagulants [for example,
warfarin (Coumadin)] should avoid indomethacin because indomethacin also thins the blood,
and excessive blood thinning may lead to bleeding.
PREGNANCY: Use during pregnancy has not been adequately studied.
Indomethacin may have adverse effects on the fetus.
NURSING MOTHERS: Indomethacin is excreted in
breast milk and therefore
should be avoided by nursing mothers.
Rheumatoid arthritis is an autoimmune disease that causes chronic inflammation of the joints, the tissue around the joints, as well as other organs in the body. Because it can affect multiple other organs of the body, rheumatoid arthritis is referred to as a systemic illness and is sometimes called rheumatoid disease.
Gout is a condition that results from crystals of uric acid depositing in tissues of the body. Gout is a condition that can lead to abnormally elevated levels of uric acid in the
blood, recurring attacks of joint inflammation (arthritis), deposits of
hard lumps of uric acid in and around the joints, and decreased kidney
function and kidney stones.
Bursitis of the hip results when the fluid-filled sac (bursa) near the hip becomes inflamed due to localized soft tissue trauma or strain. Symptoms include stiffness and pain around the hip joint. If the hip bursa is not infected, hip bursitis can be treated with ice compresses, rest, and antiinflammatory and pain medications.
Ankle pain is commonly due to a sprain or tendinitis. The severity of ankle sprains ranges from mild (which can resolve within 24 hours) to severe (which can require surgical repair). Tendinitis of the ankle can be caused by trauma or inflammation.
Osteoarthritis is a type of arthritis caused by inflammation, breakdown, and eventual loss of
cartilage in the joints. Also known as degenerative arthritis. Osteoarthritis
can be caused by aging, heredity, and injury from trauma or disease.
Arthritis is inflammation of one or more joints. When joints are inflamed they can develop stiffness, warmth, swelling, redness and pain. There are over 100 types of
arthritis including osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, lupus, gout,
and pseudogout.
Stool color is generally brown. When stool color changes, often, an individual becomes concerned. The presence of the bilirubin in bile is generally responsible for stool color. Bilirubin concentration can vary bile color from light yellow to almost black in color. Changes in bilirubin can cause stool to turn green, gray, or clay-like in color. Intestinal bleeding may turn stool black, tarry, red, maroon, or smelly stool. Medication and food may also affect stool color.
Bursitis is inflammation of a bursa. A bursa is a tiny fluid-filled sac that functions as a gliding surface to reduce friction between tissues of the body. There are 160 bursae in the body. The major bursae are located adjacent to the tendons near the large joints, such as the shoulders, elbows, hips, and knees.
Ankylosing spondylitis is a type of arthritis that causes chronic inflammation of the spine. The tendency to develop ankylosing spondylitis is genetically inherited.
Psoriatic arthritis is a disease that causes skin and joint inflammation. Symptoms include painful, stiff, and swollen joints, tendinitis, and organ inflammation. Treatment involves antiinflammatory medications and exercise.
Shoulder bursitis is inflammation of the shoulder bursa. Bursitis may be caused by injury, infection, or a rheumatic condition. Symptoms include pain, swelling, tenderness, and pain with movement of the shoulder joint. Treatment may involve ice compresses, rest, and antiinflammatory medications and depends on whether there is an infection.
Bursitis of the knee results when any of the three fluid-filled sacs (bursae) become inflamed due to injury or strain. Symptoms include pain, swelling, warmth, tenderness, and redness. Treatment of knee bursitis depends on whether infection is involved. If the knee bursa is not infected, knee bursitis may be treated with ice compresses, rest, and antiinflammatory and pain medications.
Pericarditis is the inflammation of the pericardial sac that surrounds the heart. The causes of pericarditis include injury from heart attack, heart surgery, trauma; viral or fungal infection, HIV, tumors, mixed connective tissue disease, metabolic disease, medication reactions, or idiopathic. Treatment for pericarditis is generally medication, however, sometimes surgery is necessary.
Diabetes insipidus is a condition in which the patient has frequent urination. Symptoms of diabetes insipidus include irritable, listless, fever, vomiting, or diarrhea due to the loss of large volumes of urine. There are three types of diabetes insipidus, central, nephrogenic, dipsogenic, and gestational. Treatment depends upon the type of diabetes insipidus.
Reactive arthritis is a chronic, systemic rheumatic disease characterized by three conditions, including conjunctivitis, joint inflammation, and genital, urinary or gastrointestinal system inflammation. Inflammation leads to pain, swelling, warmth, redness, and stiffness of the affected joints. Non-joint areas may experience irritation and pain. Treatment for reactive arthritis depends on which area of the body is affected. Joint inflammation is treated with antiinflammatory medications.
Nonsteroidal antiinflammatory drugs (NSAIDs) are prescribed medications for the treatment of inflammatory conditions. Examples of NSAIDs include aspirin, ibuprofen, naproxen, and more. One common side effect of NSAIDs is peptic ulcer (ulcers of the esophagus, stomach, or duodenum). Side effects, drug interactions, warnings and precautions, and patient safety information should be reviewed prior to taking NSAIDs.
Calcific bursitis is the calcification of the bursa caused by chronic inflammation of the bursa. Calcific bursitis most commonly occurs in the shoulder. Calcific bursitis treatment includes medication for inflammation, ice, immobilization, cortisone injections, and occasionally surgical removal of the inflamed bursa.
Weber-Christian disease is a rare inflammatory disease that affects the body's fat tissues. It's also known as relapsing febrile nodular panniculitis syndrome and idiopathic lobular panniculitis. The disorder appears on the skin as red or purple tender, raised lumps. The thighs and lower legs are the most frequently affected areas. Other symptoms may include nausea, vomiting, weight loss, joint pain, and abdominal pain. Though there is no cure for the disease, inflammation may be treated with various antiinflammatory medications.
Reactive arthritis is a chronic form of arthritis featuring
the following three conditions: (1) inflamed joints, (2)
inflammation of the eyes (conjunctivitis), and (3) inflammation of the
genital, urinary, or gastrointestinal systems.
This form of joint inflammation is called "reactive arthritis" because it is
felt to involve an immune system that is "reacting" to
the presence of bacterial infections in the genital, urinary, or
gastrointestinal systems. Accordingly, certain people's immune systems are
genetically primed to react aberrantly when these areas are exposed to
certain bacteria. The aberrant reaction of the immune system leads to
spontaneous inflammation in the joints and eyes. This can be confounding to the patient and the doctor when the infection has long passed at the time of presentation with arthritis or eye inflammation.
Reactive arthritis has, in the past, been referred to as Reiter
syndr...
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