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Pharmacology > Anti inflammatory and anti arthritis Chapter 16 > Flashcards

Anti inflammatory and anti arthritis Chapter 16 Flashcards

1
Q

What are Anti-inflammatory agents block or alter inflammatory process

A
  • NSAIDs
  • Salicylates
  • Anti-arthritis
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2
Q

What are other anti-inflammatory agents?

A
  • Steroids
  • Antihistamines-block release of histamine in response to antigen
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3
Q

How do prostaglandins work?

A
  • Mediate pain-sensitizing pain receptors
  • Induce inflammation by vasodilatation
  • Fever-influences hypothalamic response to pathogens
  • GI-inhibits acid secretion
  • Renal protection-perfusion/function
  • Involved in regulating platelet aggregation
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4
Q

What is ibuprofen (Motrin, Advil)?

A

Nonsteroidal ant- inflammatory drugs(Nsaids)

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5
Q

What is therapeutic actions of ibuprofen (Motrin, Advil)?

A

NSAID
NSAIDs block two enzymes needed for prostaglandin synthesis and
inflammation response
* COX-1–> needed for blood clotting, stomach protection, sodium/water balance in
kidney
* COX-2 –>active when more prostaglandin needed, thought to block vasodilation

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6
Q

What are indications of ibuprofen (Motrin, Advil)?

A

Strong anti-inflammatory; analgesic effects(relieving pain); anti-pyretic(relieving fever)

Treatment of pain, arthritis, dysmenorrhea, juvenile arthritis

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7
Q

What is adverse effects of ibuprofen (Motrin, Advil)?

A

NSAID
-Bleeding, stomach ulcers, fluid retention

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8
Q

What are contras of ibuprofen (Motrin, Advil)?

A

NSAID
Allergy to salicylates, NSAIDs
* celecoxib (Celebrex) cross sensitivity with sulfonamides

  • Cardiac disease and HTN (varying effects of the prostaglandins and increased risk of heart attack and stroke; )
  • Bleeding disorders  GI, hemophilia, thrombocytopenia (Could make bleeding worse
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9
Q

What are Cautions of ibuprofen (Motrin, Advil)?

A

NSAID
* Pregnancy/lactation
* Renal/hepatic disease

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10
Q

What are drug to drug interactions of ibuprofen (Motrin, Advil)?

A

NSAID
* Decrease diuretic effect when taken with
loop diuretics
* Decrease HTN effect when combined with
beta blockers
* Caution with lithium
* Potentiate opioids

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11
Q

What is acetylsalicylic acid (ASA, Aspirin, Ecotrin)

A

SALICYLATES

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12
Q

What is therapeutic actions of acetylsalicylic acid (ASA, Aspirin, Ecotrin)

A

Salicylates
Inhibits synthesis of prostaglandins

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13
Q

What are indications of acetylsalicylic acid (ASA, Aspirin, Ecotrin)?

A

Salicylates
* Antipyretic (acts on hypothalamus)
* Analgesic
* Anti-inflammatory
* Inhibits platelets aggregation

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14
Q

What are pharmacokinetics of acetylsalicylic acid (ASA, Aspirin, Ecotrin)?

A

Salicylates
Absorbed quickly

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15
Q

What are adverse effects of acetylsalicylic acid (ASA, Aspirin, Ecotrin)?

A

Salicylates
Ototoxicity/ Tinnitus
* GI: nausea, heartburn, epigastric discomfort
* Bleeding
* Salicylism

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16
Q

What are contras/cautions of acetylsalicylic acid (ASA, Aspirin, Ecotrin)?

A

Salicylates
* Allergy to salicylates, NSAIDs or tartrazine
* Bleeding abnormalities
* Impaired renal function
* Surgery within one week
* Viral influenza/chickenpox in children/adolescents (Reyes syndrome)
* Pregnancy/lactation

17
Q

What are drug to drug acetylsalicylic acid (ASA, Aspirin, Ecotrin)?

A

Salicylates
Anti-coags use

18
Q

What is therapeutic actions of Acetaminophen(Tylenol)?

A

Acts on hypothalamus

hypothalamus to cause sweating and vasodilation; this in turn causes the release of heat and lowers fever.

19
Q

What is indications of Acetaminophen(Tylenol)?

A

Mild to moderate pain relief and reduction of fever

20
Q

What is antidote to Acetaminophen toxicity?

A

acetylcysteine (Acetadote) PO or IV

21
Q

What are adverse effects of Acetaminophen toxicity?

A

Hepatotoxicity

22
Q

What is contra to Acetaminophen toxicity?

A

Allergy to acetaminophen

23
Q

What is cautions to Acetaminophen toxicity?

A

Pregnancy/lactation
Hepatic dysfunction/chronic ETOH

24
Q

What is etanercept(Enbrel)?

A

Disease modifying anti rheumatic drugs

25
Q

What is therapeutic actions of etanercept(Enbrel)?

A

Disease modifying anti rheumatic drugs

  • Neutralizes immune system
  • Goal is to depress overactive immune system, decrease
    inflammation, stop disease progression
26
Q

What are indications of etanercept(Enbrel)?

And pharmacokinetics

A

Disease modifying anti rheumatic drugs

RA, plaque psoriasis
SQ injection

27
Q

What are adverse effects etanercept(Enbrel)?

A

Disease modifying anti rheumatic drugs

Black box warning  Fatal
infections; lymphomas/ other
cancers

28
Q

What are contras of etanercept(Enbrel)?

A

Disease modifying anti rheumatic drugs

*Allergy

  • Active infection(because they block the body’s immune/inflammatory response and serious reactions could occur)
  • Pregnancy/lactation
29
Q

What are cautions of etanercept(Enbrel)?

A

Disease modifying anti rheumatic drugs

  • Liver/renal disease
  • Bone marrow suppression (follow
    labs)
  • Various CNS effects
  • Monitor for worsening of
    demyelinating disorders (MS)
30
Q

What are drug to drug of etanercept(Enbrel)?

A

Disease modifying anti rheumatic drugs
No live vaccines

31
Q

What to assess with ANTI-INFLAMMATORY, ANTI ARTHRITIS, DMARDS??

A

Co-morbidities
* Allergies
* Pain
* Ability to perform ADLs
* Baseline labs
* Medication use

32
Q

Nursing diagnosis with
ANTI-INFLAMMATORY, ANTI ARTHRITIS, DMARDS??

A
  • Risk for bleeding (NSAIDs,
    salicylates)
  • Acute pain r/t GI effects
  • Risk for infection (DMARDs)
33
Q

Nursing implementation with ANTI-INFLAMMATORY, ANTI ARTHRITIS, DMARDS??

A
  • Teach signs of GI bleeding
  • Administration:
  • With food (↓ GI distress)
  • Salicylates NOT to be given to children
  • Do not crush/chew enteric coated tablets
  • Monitor laboratory results:
  • Renal and hepatic function
  • PLTs, HCT, WBC
34
Q

What is additional considerations with ANTI-INFLAMMATORY, ANTI ARTHRITIS, DMARDS??

A
  • Older adults/children more susceptible to
    adverse effects
  • Pregnancy  acetaminophen

Pharmacology (39 decks)

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