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Sun Aug 13 03:41:44 BST 2006

Complications with diclofenac are largely related to
(1) Allergic and anaphylactic reactions - they might vary according
with local incidence of allergic reactions to this drug. Severe
reactions are uncommon, but mild ones are often seen.
(2) Renal damage in patients who are already volume-depleted and/ or
have mild subclinical renal impairment
(3) Reduced platelet aggregation in patients who are already
hypocoagulated or who have any unsuspected underlying coagulation
defect - take care with von Willebrand disease and with patients on
oral anticoagulation...
(4) Deflagration of gastric mucosal lesions in patients with previous
peptic disease.

If you have these 4 possibilities in mind, and you think you can
control all of them to a certain extent, you can use the drug and
comprehend very well its limitations.

I will tell you that I have seen  a 32 yo patient die right in front
of all the team some years ago, who was only suffering of urolithiasis
and wanted something to relieve his pain. After a diclofenac injection
he underwent anaphylactic reaction and arrested. After three hours of
ressuscitation maneuvers, coming back twice and arresting again, he
was declared dead.

Sure this might happen with any drug...but PLEASE TAKE CARE all the
time, and be aware of all problems that might arise from NSAIDS in
acute emergency patients especially when the doctor hasn´t had enough
time to listen and investigate  all the details of the patient´s
anamnesis. THINK before prescribing it, and make sure  all the risks
involved are inferior to the possible benefits.

My two cents.

claudia

On 8/11/06, Leontdog at aol.com <Leontdog at aol.com> wrote:
> yea...I had an "allergic" response to 3 doses of Diclofenac PO...went into
> ARF with Creatinine reaching 3.9 within a week...have to add that I was
> taking
> Benicar daily as well...renal function returned to normal within another
> week
> (2  weeks off Diclofenac).....as a Critical Care nurse...scared me.....sworn
> off  NSAIDS and back to good 'ole tylenol as needed.
>
> Nancy King RN, ANP-C
> Decatur, Ga.
> US
> --
> trauma-list : TRAUMA.ORG
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