Am I Having a Heart Attack? Symptoms of Heart Disease
The effects of gravity on seed germination How water moves through the plant How plants reproduce and factors that affect the process The effect of soil components and organic matter on growth of plants. I have tried almost everything to cure my allergies And probably the star of the show is turmeric. Find examples of all of them and understand how they differ. Some researchers have tried to treat colitis by adding more butyrate for substrate, by enema. An average pound 70 kilogram adult will breathe at an average rate of 14 breaths per minute at rest. Pneumonia is inflammation of the lungs caused by fungi, bacteria, or viruses.
Examine phototropism, the study of why plants grow towards light. Where are there more stomata, the top or bottom of a leaf? Is there a relationship between seed shape and the method of seed dispersal? What are the effects of ant mound soil on the growth or bean seeds?
What are the effects of dryer lint on plant growth and soil? How do different types of wood absorb water? Which wood is the hardest and why? Does the density of wood affect the time for a flame to burn through to the other side? Can pigments from lichens be extracted for dyes? An analysis of the pH of saliva of students at your school. What esters are common in basic flavors? Will artificial sweeteners replace sugar?
DNA extraction techniques from beef liver. Comparison of the Effects of Inorganic Catalysts and Enzymes on Peroxide Decomposition How do different conditions affect the speed at which fruit and vegetables ripen What effects do different amounts of exercise have on the production of carbon dioxide in humans?
Compare the amount of protein in different brands of milk. Is there a difference between plant and animal DNA? Do different varieties of the same fruit have the same level of vitamin C? How can we extract DNA from onions? A study of the percentage of DNA by weight in different species Factors affecting the enzyme's reaction rates How can we test for the presence of starch? Illustrate how a sewage plant could produce natural gas Can you reproduce the effects of the commercially produced Pomona's Universal Pectin with homemade citrus pectin?
Paper Chromatography, what colored dyes are found in powdered drink mix and markers? How is calcium involved in muscle function and metabolism? Is there an inheritance pattern in mitochondrial DNA? Effects of temperature on viscosity of oil, chemical reactions, Brownian movement, burning of different materials.
Everyday activities that illustrate chemical principles Chemical reactions that produce energy or that require energy Testing of consumer products- glues, stain removers, antiseptics, mouthwash, detergents, paper towels, making salt water potable, removal of pollutants Effects of sunlight on rubber, ink, paper Illustrate how hydrogen gas might be stored efficiently using carbon nanotubes Demonstrate how liquid methanol could be made from natural gas Effects of increased concentrations on the rate of chemical reactions Compare the pH levels in mouths of various animals and humans at different times in the day Compare the surface tension of various liquids Dealing with chemical spills from industry.
Are there better ways to mitigate the problem? How Does Surface Temperature Above the Boiling Point Affect the Rate of Evaporation of Certain Alcohols Analyzing snow and rain for pollutants; samples from different locations Effects of temperature on density of gases Understand how different physical properties and chemical agents affect microwave superheating of water Build your own small liquid air generator.
Show how pure nitrogen, oxygen, and other gases can be removed from the liquid air by a process known as fractional distillation Effects of salt and other contaminants on rate of rusting Growing crystals- factors that affect the rate and the size Can you obtain water from ink, vinegar, milk? What effects do different amounts of exercise have on the production of carbon dioxide in humans? Analyze soil samples for their components, ability to hold moisture, fertility and pH Does the amount of particle pollution vary with distance from a road, with location, with height.
Determine types of particles found in pollution fallout Catalysts- how they work and why; commercial applicants and problems Determine the effect of different brands of detergents on surface tension Fire extinguishers-principles of operation and factors affecting their efficient use How do acids react with different metals under varying conditions Identify different metals by the color of flame when they burn Can you devise and experiment that will list metals in order of their activity, from the most potassium to the least active ore gold Electroplating- the principles, how different metals can be used and the practical applications Chemical Change and the factors that affect the rate such as heat.
Factors affecting the making of glass. The effects of salts on the freezing point of water and other liquids. Techniques of fractional distillation of oil samples. Testing the mineral concentrations in hard and soft water. Investigation of pH variations of soils. Can negative ions anions can be separated and analyzed with exchange resins.
Can light energy influence chemical reactions? A study of acidity in different types and brands of milk Effects of temperature on viscosity of oil, chemical reactions, Brownian movement, burning of different materials. Testing of consumer products- glues, stain removers, antiseptics, mouthwash, detergents, paper towels, making salt water potable, removal of pollutants Effects of sunlight on rubber, ink, paper Effects of increased concentrations on the rate of chemical reactions.
Dealing with chemical spills from the industry. Effects of salt and other contaminants on rate of rusting Growing crystals- factors that affect the rate and the size Can you obtain water from ink, vinegar, milk? How do acids react with different metals under varying conditions Identify different metals by the color of flame when they burn Can you devise and experiment that will list metals in order of their activity, from the most potassium to the least active ore gold Electroplating-the principles, how different metals can be used and the practical applications Calcium magnesium acetate CMA as a deicer Effects of drying times on the properties of glue mixtures Effect of chlorine bleach on fabric strength Chemical reactions that consume versus produce energy Factors affecting an enzyme's reaction rate What household material will put out fire the fastest?
What type of metal, steel, copper, or bronze, will rust faster? Which hair coloring product has the greatest amount of lead acetate?
Back To Category List. Which is the Best? How can a computer be used as a time clock to keep track of time worked. Determining which computer is the fastest for different kinds of programs. Which factors most affect the operating speed of a computer? Can a computer can be used as an educational tool?
Demonstrate how internet data can be used to predict the weather patterns in your home town. Create a program that gives people information based on their birthday.
Which WWW search engine produces the most accurate results? Show how computer programs can simulate astronomical events. How do web pages work? Do computers or computer monitors generate radio signals? Examine the effect of magnetic fields on recording mediums tapes, disks, etc.
Create a program that simulates intelligence, responding to a user based on what the user inputs into the program. Can a computer program affect childrens' learning ability? Demonstrate how examinations can be administered by computer and simultaneously graded. Develop and demonstrate a program to predict a comet's orbital path. Develop an advanced computer program designed to solve one of several problems in the mathematics of probability. Develop a computer program designed to solve one of several problems in advanced mathematics.
Create a program which teaches the user a set of technical facts thorough the use of branched programmed learning methods. How does the C programming language work? Develop a program which will determine the feasibility of takeoff and flight for an aircraft. Develop a program to solve mathematical formulas. Develop a program to recognize animal tracks based on their shape. Can a computer program predict the future population of nations based on past population statistics?
Develop a medical program to identify common childhood illnesses based on the symptoms exhibited. How Safe Is Your Data? Aid for finding the centroid of two dimensional rectangular shapes. Computer-aided design and simulation of digital circuits. Microcomputer programs for the blind. A study of solar flares through the sudden enhancement of atmospherics The identification of elements in the solar and stellar spectra Crystal growth rates versus solution strengths, temperature, etc Observations of experimentally induced seismic waves Is there a relation between sunspot cycles and earthquakes Observations of geomorphic factors in the local areas Fossil studies in limestone and other rocks Sunlight- how do different surfaces affect the amount of sunlight reflected and absorbed?
Design a method of measuring how much sunshine is available each day. A study of phosphorescence as a tool for geologists Do major earthquakes set off other fault areas in other parts of the world?
Does the depth have any effect on other possible resulting quakes? Frost formation- what must the temperature be to form first; what are the effects of humidity? What is the make-up of frost and dew? How does water compare to land and what effect does this have on the weather? What factors affect the cooling of land? Build a snow and rain monitor. Perhaps light from an infrared light emitting diode could used to detect the reflections off the rain drops and snow flakes Build Your Own Seismometer and demonstrate how it works.
Observations of fluctuations in stream flow following rain Study of air tides: Study and record varying levels over the year in a body of water; account for differences and the results on the surrounding environment How much is formed on a square meter for a period of time; account for variations Does wind travel at same speeds and in same directions at different heights? What must the temperature be to form first; what are the effects of humidity?
Which effects the rate of evaporation most- temperature, humidity, wind speed or other factors? Can you measure the speed and force of raindrops? Could you simulate the effect of rain?
Does fresh water hold heat longer than salt water? How do different surfaces affect the amount of sunlight reflected and absorbed? Can you collect the amounts of water in the air at different temperatures? What is the difference between direct sun and in the shade? Is the difference constant? Weather records- Design and build an automatic recording weather device. Test it over a period of time. What happens to hair during periods of changing humidity? Record length of days and nights over a period of time; what effects do the changes have on things like household plants, pets, etc.
Can you measure how much dew is formed in a square meter. How does the temperature change during the day? What time is usually the warmest? Can you construct your own thermometer to keep your own records. Observations of experimentally-induced seismic waves A study of small scale wind currents around buildings A study of solar flares through sudden enhancement of atmospherics The effects of solar activity on radio propagation Build a "tornado in a box" to show how tornadoes form Demonstrate how clouds form via condensation around particulate matter.
Explain how fog forms and build a device that produces fog. Which affects evaporation the most.. Build and demonstrate a weather station with rain gauge and wind indicators.
What is wind chill and what effect does it have on inanimate objects? Explain why the sky is blue and then sometimes changes color. Demonstrate how moisture or dust in the air can change apparent color of the atmosphere. Can you demonstrate how an undersea earthquake produces a tsunami? Build a working model that demonstrates the cause of earthquakes.
Demonstrate which holds heat the longest, water or soil. Will different types of salt grow different kinds of crystals? Is there a relation between sunspot cycles and earthquake? What is the accuracy of Web-based Weather forecasting services? Build a working model of a device that indicates how level a surface is.
Perhaps it would make different tones when a bubble moved in a tube. Designing a strong bridge, an energy efficient home Comparing insulative properties of various natural and commercial insulators. Which are the best? Find the maximum speed in fiber optic links How does weight and shape affect the rate at which an object sinks? How can I build a home-made thermos bottle?
What is the most efficient design for a windmill? Which type of barrier is most effective in reducing highway noise? Design and construct a simple device to demonstrate hovercraft principles What is the effect of dampening on a shock absorber?
What is the strength of dome shaped eggshells as demonstrated by their weight bearing capacity? Is it to build a working water clock? Which style of roof truss is the strongest? Which building design is best in withstanding an earthquake?
Demonstrate how an AM radio detector can be constructed out of scrap materials and explain the function of the various components. Build a working model of a body temperature monitor and alarm. Might be great for hikers worried about hypothermia Can a small sensory robot be built for use on pavements and highways which will automatically search for and indicate when pavement or highway cracks of a certain size are found so they can be repaired?
Build a freeze alarm. The device would sound an alarm when the temperature dropped below 32 degrees F. Design A Electrically Driven Micrometer Why do the inside of cars get so hot in the sun and what are ways to reduce the heat? Is it possible to reduce noise by adding certain types of noise? What are the effects on dry wall thickness on sound transmission? Is it possible to eliminate foundation by temperature variation?
Is is possible to make a clothes dryer more efficient by using an air-to-air heat exchanger? Invent an electronic water usage monitor that could be easily attached to a shower head to help the user conserve water Build a wind energy monitor. The output signal from a simple wind speed meter anemometer would be fed to a computer that would calculate and plot the potential energy per unit area each day. Such a system might be useful to help define locations for wind energy farms. Design considerations for "Solar Heated" homes Design considerations for "Solar-Cell" powered homes What are the best designs for propellers for wind generators?
Production of electrical energy from mechanical sources Which substance is best to use in blocking floodwaters? Develop a shower water temperature monitor. Such a device might help conserve energy Study of efficient home insulation. Which is the best? Illustrate a working model of an electrodeless sulfur lamp. Show how such lamps could save energy in home, office and street lighting needs The effect of landscaping and architecture on energy consumption.
What are the annual variations in the ecology of a body of water The study of the impact of pollution on an ecosystem A study of water pollution from feed lot farms Make your own aerogel cubes.
Describe some uses for this new material Illustrate how glass foam might be used to make strong building materials with high insulation properties Tracing chemical e.
DDT concentrations in successive food chain levels Ozone destruction experiments A study of air purification methods Come up with some non-chemical methods of purifying water.
Build a lawn moisture sensor. Tells you when it is time to water the lawn. Saveswater by not allowing sprinkler to turn on of the lawn is moist enough Demonstrate how sea wave action could be used to produce fresh water from sea water using reverse osmoses Build an energy monitor that displays gas and electricity usage.
Unit connected to the power and gas meters. Maybe place the display next to the thermostat. Displays real time usage as well as weekly and monthly totals Efficient methods of breaking down crude oil in seawater Experimenting with microbial degradation of petroleum Experimenting with biodegradability Can Centrifugal Filtration Be Used to Remove Particles from Water Efficiently and Economically Find and ink that would decompose for recycling paper Rain- can you measure the speed and force of raindrops?
Use of solar energy- design and construct solar cookers, solar panels, etc. An analysis of exhaust emissions of cars as related to the size of cars and tune-up conditions How Carbon Dioxide Affects the Temperature of Air An analysis of carbon monoxide, oxides of nitrogen, and hydrocarbons in our ambient air. How much air space maximizes insulation in various materials? Design, construction, and testing of a mechanical method of separating solid waste for recycling.
The effect of air pollution on algae, protozoa, fish, insects or mosses and lichens What type of materials are strongest when they interact with acid rain? Which material filters water the best? The effect of air pollution on algae, protozoa, fish, insects or mosses and lichens Does the amount of particle pollution vary with distance from a road, with location, with height.
Determine types of particles found in pollution fallout Exploring methods of controlling erosion Is air in your house the same temperature at floor level and near the ceiling? How could you spread heat more evenly through the house? Can magnetism be used to remove minerals from "hard" water? Research and demonstrate methods of pasteurizing or purifying water using only sunlight as the source of heat.
Is there a relationship between well water contamination and animal pens? How effective is lettuce as a bioassay medium for determining the toxicity of water contaminants? What effect does water turbidity have on dissolved oxygen? What are the effects of biodegradable wastes on dissolved oxygen? From which direction does our area receive the most particulate air pollution? Does carbon dioxide contribute to warming in a closed environment?
What aerosols are in the air and does air quality affect asthma rates? Research and experiment with different plants to see if any of them can be used as an indicator of air pollution. What are the effects on plant life when detergents are added to the soil? Examine and compare the biodegradability of different soap powders. Compare the effects of Polyacrylamide vs. Polyacrylate on soil erosion.
Which types of paper decompose the most rapidly when buried? What effect would an oil spill have on plant life? Demonstrate the greenhouse effect by measuring the temperature within a light trap box covered with glass or plastic. Does the pH of rainwater vary from place to place in our community?
How does air pollution affect the growth of algae? What are the effects of carbon dioxide on land plant life? What about water plant life? Are macroinvertebrates indicators of stream health? Can biomass be used to generate electricity by creating methane gas? Can soil besides a roadway be a health hazard?
What are the best grasses to use to reduce the amount of soil in runoff? How to different fabrics compare as barriers against UV radiation? Is is possible to use recycled newspaper to fertilize plants? Which enzyme works best to reduce grease in a grease trap? The mathematics of snowflakes Infinity comes in different "sizes". What does this mean? How can it be explained? Compare the mean, median and range of heights for males and females in your class. How will this compare to a class one year older?
Demonstrate the bell shaped curved for random distribution Does a sphere hold a volume greater than the apparent volume of a cylinder? Research, explain and demonstrate the use of fractals. Determine how the size of a statistical sample affects its accuracy. What equalities of lengths and angles are sufficient to prove two sets of four points quadrilaterals or quadrangles Build models showing that parallelograms with the same base and height have the same areas.
Is there a 3-dimensional analogue? This can lead to a purely visual proof of the Pythagorean theorem, using a physical model based on dissections. Consider tiling the plane using shapes of the same size. What's possible and what isn't?
In particular it can be shown that any 4-sided shape can tile the plane. What about 5 sides? Make sketches in a geometry program Sketchpad, Cabri, or using Kali Investigate compass and straight-edge constructions - showing what's possible and discussing what's not. Investigate constructions using origami paper folding. Can you construct all figures that are constructed with ruler and compass?
Can you construct more figures? What is the fewest number of colors needed to color any map if the rule is that no two countries with a common border can have the same color. Why is the proof interesting? What if Mars is also divided into areas so that these areas are owned by different countries on earth. They too are colored by the same rule but the areas there must be colored by the color of the country they belong to.
How many colors are now needed? Polyominoes are shapes made by connecting certain numbers of equal-sized squares together. How many different ones can be made from 2 squares?
Investigate the shapes that polynominoes can make. Investigate the creation of secret codes ciphers. Find out where they are used today! Look at their history. Build your own using prime numbers. Find out all you can about the Catalan Numbers, 1, 1, 2, 5, 14, 42, Build models to illustrate asymptotic results such as Stirling's formula or the prime number theorem.
There is a well-known device for illustrating the binomial distribution. Marbles are dropped through the top and encounter a number of pins before dropping into cells where they are distributed according to the binomial distribution. By changing the position of the pins one should be able to get other kinds of distributions bimodal, skewed, approximately rectangular, etc.
Use Monte Carlo methods to find areas or to estimate pi. Rather than using random numbers, throw a bunch of small objects onto the required area and count the numbers of objects inside the area as a fraction of the total in the rectangular frame. Look at the ways different bases are used in our culture and how they have been used in other cultures.
Look at how other cultures have written their number systems. Demonstrate how to add using the Mayan base 20, maybe compare to trying to add with Roman numerals is it even possible? Explore the history and use of the Abacus There are several methods of counting and calculating using your fingers and hands. Some of these methods are still in common usage.
Explore the mathematics behind one of them. Find out all you can about the Fibonacci Numbers - In particular, where do they arise in nature? What is the Golden Mean? Study its appearance in art, architecture, biology, and geometry, and its connection with continued fractions, Fibonacci numbers. What else can you find out?
If that's not enough, do squares, pentagonal numbers, hexagonal numbers, etc. Venture into the third and even the fourth dimensions.
Use your computer to draw fractals based on simple equations such as Julia sets and Mandelbrot sets. Find examples of all of them and understand how they differ. Is there an algorithm for getting out of 2-dimensional mazes? Look at the history of mazes some are extraordinary.
The clearance of Naproxen is 0. The plasma half-life of the Naproxen anion in humans ranges from 12 to 17 hours. The corresponding half-lives of both Naproxen's metabolites and conjugates are shorter than 12 hours, and their rates of excretion have been found to coincide closely with the rate of Naproxen disappearance from the plasma.
The terminal half-life appears to be similar in pediatric and adult patients. Pharmacokinetic studies of Naproxen were not performed in pediatric patients younger than 5 years of age.
Pharmacokinetic parameters appear to be similar following administration of Naproxen suspension or tablets in pediatric patients. Unbound trough Naproxen concentrations in elderly subjects have been reported to range from 0.
The clinical significance of this finding is unclear, although it is possible that the increase in free Naproxen concentration could be associated with an increase in the rate of adverse events per a given dosage in some elderly patients. Naproxen pharmacokinetics has not been determined in subjects with hepatic insufficiency. Chronic alcoholic liver disease and probably other diseases with decreased or abnormal plasma proteins albumin reduce the total plasma concentration of Naproxen, but the plasma concentration of unbound Naproxen is increased.
Caution is advised when high doses are required and some adjustment of dosage may be required in these patients. It is prudent to use the lowest effective dose. Naproxen pharmacokinetics has not been determined in subjects with renal insufficiency.
Given that Naproxen, its metabolites and conjugates are primarily excreted by the kidney, the potential exists for Naproxen metabolites to accumulate in the presence of renal insufficiency. Elimination of Naproxen is decreased in patients with severe renal impairment. The clinical significance of this interaction is not known. Naproxen has been studied in patients with rheumatoid arthritis, osteoarthritis, juvenile arthritis, ankylosing spondylitis, tendonitis and bursitis, and acute gout. Improvement in patients treated for rheumatoid arthritis was demonstrated by a reduction in joint swelling, a reduction in duration of morning stiffness, a reduction in disease activity as assessed by both the investigator and patient, and by increased mobility as demonstrated by a reduction in walking time.
Generally, response to Naproxen has not been found to be dependent on age, sex, severity or duration of rheumatoid arthritis. In patients with osteoarthritis, the therapeutic action of Naproxen has been shown by a reduction in joint pain or tenderness, an increase in range of motion in knee joints, increased mobility as demonstrated by a reduction in walking time, and improvement in capacity to perform activities of daily living impaired by the disease.
Nineteen patients in the mg group terminated prematurely because of adverse events. Most of these adverse events were gastrointestinal events.
In clinical studies in patients with rheumatoid arthritis, osteoarthritis, and juvenile arthritis, Naproxen has been shown to be comparable to aspirin and indomethacin in controlling the aforementioned measures of disease activity, but the frequency and severity of the milder gastrointestinal adverse effects nausea, dyspepsia, heartburn and nervous system adverse effects tinnitus, dizziness, lightheadedness were less in Naproxen-treated patients than in those treated with aspirin or indomethacin.
In patients with ankylosing spondylitis, Naproxen has been shown to decrease night pain, morning stiffness and pain at rest. In double-blind studies the drug was shown to be as effective as aspirin, but with fewer side effects. In patients with acute gout, a favorable response to Naproxen was shown by significant clearing of inflammatory changes e. Naproxen has been studied in patients with mild to moderate pain secondary to postoperative, orthopedic, postpartum episiotomy and uterine contraction pain and dysmenorrhea.
Onset of pain relief can begin within 1 hour in patients taking Naproxen. Analgesic effect was shown by such measures as reduction of pain intensity scores, increase in pain relief scores, decrease in numbers of patients requiring additional analgesic medication, and delay in time to remedication.
The analgesic effect has been found to last for up to 12 hours. Whether Naproxen has a "steroid-sparing" effect has not been adequately studied. When added to the regimen of patients receiving gold salts, Naproxen did result in greater improvement. Its use in combination with salicylates is not recommended because there is evidence that aspirin increases the rate of excretion of Naproxen and data are inadequate to demonstrate that Naproxen and aspirin produce greater improvement over that achieved with aspirin alone.
In addition, as with other NSAIDs, the combination may result in higher frequency of adverse events than demonstrated for either product alone. In 51 Cr blood loss and gastroscopy studies with normal volunteers, daily administration of mg of Naproxen has been demonstrated to cause statistically significantly less gastric bleeding and erosion than mg of aspirin.
The hepatic and renal tolerability of long-term Naproxen administration was studied in two double-blind clinical trials involving patients. Of the patients studied, 98 patients were age 65 and older and 10 of the 98 patients were age 75 and older. Naproxen was administered at doses of mg twice daily or mg twice daily for up to 6 months. Transient abnormalities of laboratory tests assessing hepatic and renal function were noted in some patients, although there were no differences noted in the occurrence of abnormal values among different age groups.
Carefully consider the potential benefits and risks of Naproxen Suspension and other treatment options before deciding to use Naproxen Suspension. Naproxen Suspension is recommended for juvenile rheumatoid arthritis in order to obtain the maximum dosage flexibility based on the patient's weight.
Clinical trials of several COX-2 selective and nonselective NSAIDs of up to three years duration have shown an increased risk of serious cardiovascular CV thrombotic events, including myocardial infarction MI , and stroke, which can be fatal.
However, patients with known CV disease or risk factors had a higher absolute incidence of excess serious CV thrombotic events, due to their increased baseline rate. Some observational studies found that this increased risk of serious CV thrombotic events began as early as the first weeks of treatment.
The increase in CV thrombotic risk has been observed most consistently at higher doses. To minimize the potential risk for an adverse CV event in NSAID-treated patients, use the lowest effective dose for the shortest duration possible. Physicians and patients should remain alert for the development of such events, throughout the entire treatment course, even in the absence of previous CV symptoms.
Patients should be informed about the symptoms of serious CV events and the steps to take if they occur. There is no consistent evidence that concurrent use of aspirin mitigates the increased risk of serious CV thrombotic events associated with NSAID use.
Observational studies conducted in the Danish National Registry have demonstrated that patients treated with NSAIDs in the post-MI period were at increased risk of reinfarction, CV-related death, and all-cause mortality beginning in the first week of treatment. Although the absolute rate of death declined somewhat after the first year post-MI, the increased relative risk of death in NSAID users persisted over at least the next 4 years of follow-up.
Avoid the use of Naproxen Suspension in patients with a recent MI unless the benefits are expected to outweigh the risk of recurrent CV thrombotic events. If Naproxen Suspension is used in patients with a recent MI, monitor patients for signs of cardiac ischemia. NSAIDs, including Naproxen, can cause serious gastrointestinal GI adverse events including inflammation, bleeding, ulceration, and perforation of the esophagus, stomach, small intestine, or large intestine, which can be fatal.
These serious adverse events can occur at any time, with or without warning symptoms, in patients treated with NSAIDs. However, even short-term therapy is not without risk. Other factors that increase the risk of GI bleeding in patients treated with NSAIDs include longer duration of NSAID therapy; concomitant use of oral corticosteroids, aspirin, anticoagulants, or selective serotonin reuptake inhibitors SSRIs , smoking, use of alcohol, older age, and poor general health status.
Most postmarketing reports of fatal GI events occurred in elderly or debilitated patients. In addition, rare, sometimes fatal, cases of severe hepatic injury, including fulminant hepatitis, liver necrosis and hepatic failure have been reported. Inform patients of the warning signs and symptoms of hepatotoxicity e. If clinical signs and symptoms consistent with liver disease develop, or if systemic manifestations occur e. NSAIDs, including Naproxen Suspension, can lead to new onset of hypertension or worsening of pre-existing hypertension, either of which may contribute to the increased incidence of CV events.
The Coxib and traditional NSAID Trialists' Collaboration meta-analysis of randomized controlled trials demonstrated an approximately two-fold increase in hospitalizations for heart failure in COX-2 selective-treated patients and nonselective NSAID-treated patients compared to placebo-treated patients.
Use of Naproxen may blunt the CV effects of several therapeutic agents used to treat these medical conditions [e. Avoid the use of Naproxen Suspension in patients with severe heart failure unless the benefits are expected to outweigh the risk of worsening heart failure. If Naproxen Suspension is used in patients with severe heart failure, monitor patients for signs of worsening heart failure.
Each 5 mL of Naproxen Suspension contains 39 mg of sodium. This should be considered in patients whose overall intake of sodium must be severely restricted. Renal toxicity has also been seen in patients in whom renal prostaglandins have a compensatory role in the maintenance of renal perfusion.
In these patients, administration of an NSAID may cause a dose-dependent reduction in prostaglandin formation and, secondarily, in renal blood flow, which may precipitate overt renal decompensation. Patients at greatest risk of this reaction are those with impaired renal function, dehydration, hypovolemia, heart failure, liver dysfunction, those taking diuretics and ACE inhibitors or ARBs, and the elderly.
No information is available from controlled clinical studies regarding the use of Naproxen Suspension in patients with advanced renal disease. The renal effects of Naproxen Suspension may hasten the progression of renal dysfunction in patients with pre-existing renal disease.
Correct volume status in dehydrated or hypovolemic patients prior to initiating Naproxen Suspension. Avoid the use of Naproxen Suspension in patients with advanced renal disease unless the benefits are expected to outweigh the risk of worsening renal function.
If Naproxen Suspension is used in patients with advanced renal disease, monitor patients for signs of worsening renal function. Increases in serum potassium concentration, including hyperkalemia, have been reported with use of NSAIDs, even in some patients without renal impairment.
In patients with normal renal function, these effects have been attributed to a hyporeninemic-hypoaldosteronism state. When Naproxen Suspension is used in patients with preexisting asthma without known aspirin sensitivity , monitor patients for changes in the signs and symptoms of asthma. These serious events may occur without warning. Inform patients about the signs and symptoms of serious skin reactions and to discontinue use of Naproxen Suspension at the first appearance of skin rash or any other sign of hypersensitivity.
Naproxen may cause premature closure of the fetal ductus arteriosus. This may be due to occult or gross blood loss, fluid retention, or an incompletely described effect on erythropoiesis. If a patient treated with Naproxen Suspension has any signs or symptoms of anemia, monitor hemoglobin or hematocrit. Co-morbid conditions such as coagulation disorders, or concomitant use of warfarin, other anticoagulants, antiplatelet agents e.
Naproxen Suspension should not be used concomitantly with other Naproxen-containing products since they all circulate in the plasma as the Naproxen anion.
Naproxen Suspension cannot be expected to substitute for corticosteroids or to treat corticosteroid insufficiency. Abrupt discontinuation of corticosteroids may lead to disease exacerbation. Patients on prolonged corticosteroid therapy should have their therapy tapered slowly if a decision is made to discontinue corticosteroids and the patient should be observed closely for any evidence of adverse effects, including adrenal insufficiency and exacerbation of symptoms of arthritis.
Patients with initial hemoglobin values of 10 g or less who are to receive long-term therapy should have hemoglobin values determined periodically. Because of adverse eye findings in animal studies with drugs of this class, it is recommended that ophthalmic studies be carried out if any change or disturbance in vision occurs.
Advise the patient to read the FDA-approved patient labeling Medication Guide that accompanies each prescription dispensed. Inform patients, families, or their caregivers of the following information before initiating therapy with Naproxen Suspension and periodically during the course of ongoing therapy. Advise patients to be alert for the symptoms of cardiovascular thrombotic events, including chest pain, shortness of breath, weakness, or slurring of speech, and to report any of these symptoms to their healthcare provider immediately see WARNINGS; Cardiovascular Thrombotic Events.
Advise patients to report symptoms of ulcerations and bleeding, including epigastric pain, dyspepsia, melena, and hematemesis to their health care provider. Advise patients to be alert for the symptoms of congestive heart failure including shortness of breath, unexplained weight gain, or edema and to contact their healthcare provider if such symptoms occur see WARNINGS; Heart Failure and Edema.
Inform patients of the signs of an anaphylactic reaction e. Alert patients that NSAIDs may be present in "over the counter" medications for treatment of colds, fever, or insomnia. Caution should be exercised by patients whose activities require alertness if they experience drowsiness, dizziness, vertigo or depression during therapy with Naproxen. The pharmacological activity of Naproxen in reducing inflammation, and possibly fever, may diminish the utility of diagnostic signs in detecting infections.
See Table 1 for clinically significant drug interactions with Naproxen. No evidence of tumorigenicity was found. Studies to evaluate the mutagenic potential of Naproxen Suspension have not been completed. Studies to evaluate the impact of Naproxen on male or female fertility have not been completed.
Use of NSAIDs, including Naproxen Suspension, during the third trimester of pregnancy increases the risk of premature closure of the fetal ductus arteriosus. Data from observational studies regarding potential embryofetal risks of NSAID use in women in the first or second trimesters of pregnancy are inconclusive. In the general U. In animal reproduction studies in rats, rabbit, and mice no evidence of teratogenicity or fetal harm when Naproxen was administered during the period of organogenesis at doses 0.
Based on animal data, prostaglandins have been shown to have an important role in endometrial vascular permeability, blastocyst implantation, and decidualization. In animal studies, administration of prostaglandin synthesis inhibitors such as Naproxen, resulted in increased pre- and post-implantation loss.
There is some evidence to suggest that when inhibitors of prostaglandin synthesis are used to delay preterm labor there is an increased risk of neonatal complications such as necrotizing enterocolitis, patent ductus arteriosus and intracranial hemorrhage. Naproxen treatment given in late pregnancy to delay parturition has been associated with persistent pulmonary hypertension, renal dysfunction and abnormal prostaglandin E levels in preterm infants.
Because of the known effects of nonsteroidal antiinflammatory drugs on the fetal cardiovascular system closure of ductus arteriosus , use during pregnancy particularly starting at 30 weeks of gestation, or third trimester should be avoided.
In animal studies, administration of prostaglandin synthesis inhibitors such as Naproxen, resulted in increased preand post-implantation loss. There are no studies on the effects of Naproxen Suspension during labor or delivery. In animal studies, NSAIDS, including Naproxen, inhibit prostaglandin synthesis, cause delayed parturition, and increase the incidence of stillbirth.
The developmental and health benefits of breastfeeding should be considered along with the mother's clinical need for Naproxen Suspension and any potential adverse effects on the breastfed infant from the Naproxen Suspension or from the underlying maternal condition. Based on the mechanism of action, the use of prostaglandin-mediated NSAIDs, including Naproxen Suspension, may delay or prevent rupture of ovarian follicles, which has been associated with reversible infertility in some women.
Published animal studies have shown that administration of prostaglandin synthesis inhibitors has the potential to disrupt prostaglandin- mediated follicular rupture required for ovulation. Consider withdrawal of NSAIDs, including Naproxen Suspension, in women who have difficulties conceiving or who are undergoing investigation of infertility.. Safety and effectiveness in pediatric patients below the age of 2 years have not been established. There are no adequate effectiveness or dose-response data for other pediatric conditions, but the experience in juvenile arthritis and other use experience have established that single doses of 2.
Studies indicate that although total plasma concentration of Naproxen is unchanged, the unbound plasma fraction of Naproxen is increased in the elderly. Caution is advised when high doses are required and some adjustment of dosage may be required in elderly patients.
As with other drugs used in the elderly, it is prudent to use the lowest effective dose. Experience indicates that geriatric patients may be particularly sensitive to certain adverse effects of nonsteroidal anti-inflammatory drugs.
Elderly or debilitated patients seem to tolerate peptic ulceration or bleeding less well when these events do occur. Naproxen is known to be substantially excreted by the kidney, and the risk of toxic reactions to this drug may be greater in patients with impaired renal function.
Because elderly patients are more likely to have decreased renal function, care should be taken in dose selection, and it may be useful to monitor renal function.