2 - Internal Analgesics / Fever / Antipyretics Flashcards Preview

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Flashcards in 2 - Internal Analgesics / Fever / Antipyretics Deck (78)
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1

When to call MD for > 3 months

Rectal temp > 104 or equivilant

2

Ibuprofen PEDIATRIC OTC Dose

7.5mg /kg / dose

to

MAX 30mg/kg/day

3

Digital Thermometers

GENERALLY THE BEST CHOICE

  • 10-60 seconds for a reaing
  • Can be used for Oral / Rectal / Axillary
  • Use Watersoluble LUBRICATION for rectal
    • not vaseline = too thick

4

Naproxen Dosing

220mg q8-12 hours

first dose can be 220 or 440

 

MAX DOSE = 660mg/day

5

Glucosamine + Chondroitin indications

Indicated to manage pain in Osteoarthritis

for moderate to severe pain

not too much for mild pain

no evidence for effectiveness in RA

6

Osteo Bi-flex

  • Glucosamine + Chondroitin
  • MSM + Bosweilla serrata extract
  • Vitamins + Herbs + Melatonin

7

NSAID Patient Counseling

 

  • Avoid other NSAIDS + ASA + Alcohol
  • Take w/ food or milk
    • minimum full glass of water
  • Notify MD if:
    • weight gain / edema / rash
    • signs of bleeding
  • Do not take for >10 days for PAIN
    • >3 days for fever w/o talking to your doctor

8

Choosing Ibuprofen vs APAP

Ibuprofen has longer duration of action

--> can use overnight / less dosing

BUT - Ibu has side effects including GI distress

9

Can you use Chondroitin / Glucosamine if pregnant?

NO

Also avoid in Kids

10

Oral Fever Temperature

> 99.5

11

Temporal Fever Temperature

for 0-2 months

>100.7

12

Do not take NSAIDS for ___ days

>10 days for PAIN

 

>3 days for FEVER w/o talking to MD

13

Advantage of NAPROXEN > other NSAIDS (ibuprofen)

Longer duration of Action

Up to 12 hours

Can take less frequently

but no anti-pyretic effect

14

Acetaminophen Max Daily Dosage

FDA < 4 Grams a day

Tylenol botles say < 3 grams per day for extra strength

Regular < 3250mg/day

15

How long can an adult use APAP?

<10 days for PAIN

 

<3 days for FEVER

16

Symptoms that EXCLUDE self-treatment

"see doctor"

  • Spots / Rash
  • CANT DRINK FLUIDS
    • refuses fluids / vomiting
  • Fever >3 days w or w/o treatment
  • Diarrhea
  • Stiff neck
  • History of Siezures

17

NSAID Increased risk of adverse effects

  • >60 yrs old
  • Taking oral steroids / warfarin / diuretics
  • ASA sensitivity
  • >3 alcoholic drinks every day while using product
  • History of:
    • bleeding problems
    • stomach problems like heartburn or ulcers
    • CHF / High BP / Heart Disease / Kidney Disease

18

Heart & Stroke Warning for NSAIDS

EXCEPT FOR ASPIRIN (salicylate)

NSAIDS increase risk of heart attack / failure / stroke

patients with risk for CV disease should AVOID NSAIDS

use lowest dose & shortest durations

19

When to use oral antipyretics for ADULTS / Older Children?

Oral temp > 101

and/or fever is ACCOMPANIED by DISCOMFORT

20

Glucosamine

500mg TID 

VERY SLOW ONSET OF ACTION

compared to NSAIDS, takes up to 4-6 months for FULL effects

Appears to be safe short-term

Beware of SHELLFISH ALLERGIES

diabetic patients should monitor glucose-amino sugar

21

Axillary Temperature Measurement

  • Inaccurate due to environmental temperatures  and physiologic factors​
  • Armpit
    • >99.3
  • Fever may shunt blood AWAY from skin, so can be NORMAL when fever is present

22

What to recommend if patient has history of GI upset with ASA or IBU?

Acetaminophen

Enteric Coated Salicylate (if anti-inflammatory needed)

23

Asperin indications

Analgesic (equivilant to APAP)

Antipyretic (equivilant to APAP)

Anti-inflammatory

24

Ibuprofen Pediatric Safety

5-10mg/kg/dose

Boston Uni Fever Study

Looked at GI bleeding / renal failure / anyphylaxis / REYE's

No Difference in risk for SERIOUS adverse effects

25

Buffered ASA

Alka-Seltzer

  • No REAL evidence that they are better or faster
  • May DECREASE GI UPSET and local Gastric damage
    • pH may be INCREASED by antacids
    • increase dissolution + absorption
  • Only rec if patient can NOT swallow tablets
    • avoid in patients w/ High BP & CHF
    • Sodium restricted = HIGH SODIUM LOAD

26

​Temporal Fever Temperature

>4 y/o

>100.1

27

Glass Thermometers

  • Mercury w/ scale
    • AVOID GLASS, can break in rectum
  • Oral = 4 min
  • Rectal = 3 minutes
    • negative is HOW LONG it takes to get reading

28

Ibuprofen Infant Dose

for 6 mo-23mo

2x more concentrated than Childrens

50mg/1.25ml vs 100mg/5ml

29

How long can Children use APAP?

<5 Days for pain

 

<3 days for FEVER w/o MD advice

30

Tympanic Fever Temperature

>100