Analgesics

Question 1

First -Generation NSAIDs (COX-1 and COX-2 inhibitors include which medications SELECT All THAT APPLY
1. Aspirin
2. Ibuprofen
3. Naproxen
4. Indomethacin
5. Diclofenac
6. Ketorolac
7. Meloxicam

Answer 1

All are First Generation

Question 2

True or False -Cyclooxygenase (COX) inhibitors includes Acetaminophen (APAP)?

Answer 2

True

Question 3

What are the three main therapeutic effects of this class of medications?

Answer 3

Suppress inflammation
Relieve pain
Reduce fever

Question 4

What drug is given first in an acute MI and a stroke?

Answer 4

Aspirin

Question 5

Think about the function of COX-1 & COX-2, Is COX found in all tissues?

Answer 5

Yes

Question 6

Which COX functions for platelets: platelet aggregation?

Answer 6

COX-1

Question 7

Which COX can protect against colorectal cancer?

Answer 7

COX-2

Question 8

There is only one (1) second-generation NSAID also known as selective COX-2 inhibitor, can you name it?

Answer 8

Celecoxib

Question 9

Does Acetaminophen have anti-inflammatory properties, Yes or No?

Answer 9

No

Question 10

NSAID-induced ulcers responsible for ~100,000 hospitalizations
Why?

Answer 10

COX-1 can cause gastric ulceration

Question 11

What is given for Aspirin toxicity overdose?

Answer 11

Activated charcoal & in some cases hemodialysis

Question 12

What is the chemical name for aspirin?

Answer 12

Chemical name acetylsalicylic acid (ASA)

Question 13

What are drug or medications interactions with ASA?

Answer 13

1) Heparin & Warfarin (increase the risk of bleeding 2) ETOH (increase the risk of bleeding 3) Ibuprofen DECREASES the antiplatelet effects of low-dose ASA used to prevent an MI) 4) Glucocorticoids increase the risk of gastric bleeding. *Angiotensin converting enzyme inhibitors
Angiotensin II receptor blockers

Question 14

What are the routes of administration for aspirin?

Answer 14

Oral & suppository

Question 15

What is the Lethal dose in adults of aspirin (ASA)

Answer 15

20-25 grams

Question 16

What is the Lethal dose in children?

Answer 16

4 grams

Question 17

Select all that apply What are the signs & symptoms of ASA toxicity?
1. Non-specific at first
2. Respiratory alkalosis (hyperventilation)
3. Hyperthermia, sweating
4. Electrolyte imbalances
5. Coma
6. Fever
7. Nausea & vomiting

Answer 17

1-5= 5& 6 are s& s of Acetaminophen OD

Question 18

What is the treatment for ASA overdose?

Answer 18

Treatment:
Supportive care
External cooling
Sodium bicarbonate infusion

Question 19

What are Fenoprofen
Ibuprofen
Ketoprofen
Naproxen
Diclofenac
Etodolac
Ketorolac
Meloxicam
Piroxicam
classified as ?

Answer 19

Non-Aspirin First Generation NSAIDs

Question 20

Non-Aspiring First Generations NSAIDs should be ordered and taken for chronic use? True or False, Why?

Answer 20

Use at lowest dose for shortest period of time

Question 21

Which First-Generation NSAIDs can be administered IV?

Answer 21

Indomethacin & Ketorolac

Question 22

Ketorolac has a Maximum day dose-how many days?

Answer 22

5 days

Question 23

What are the contraindications for First-Generation NSAIDs ?

Answer 23

PUD
Bleeding disorders
Hypersensitivity
CAUTION: pregnancy

Question 24

What are the adverse effects of the one lonely Second-generation NSAIDs, Celecoxib?

Answer 24

Gastric ulcers
CV events
Renal impairment

Question 25

Acetaminophen actions are to slow the production of prostaglandin ( COX enzymes in the CNS? True or False

Answer 25

True

Question 26

Acetaminophen are given for two reasons, what are they?

Answer 26

Pain relief Reduce fever

Question 27

What are the adverse effects?

Answer 27

Anaphylaxis (very rare) Steven’s Johnson Syndrome (very rare)

Question 28

What are the routes of administration?

Answer 28

Oral Rectal IV

Question 29

What are signs & symptoms of bleeding?

Answer 29

Bruising, petechiae, hematuria

Question 30

What is the treatment for acetaminophen overdose?

Answer 30

N-acetylcysteine IV or PO

Question 31

True or False GI bleeding can occur because NSAIDs affect platelet function?

Answer 31

True

Question 32

Important nursing interventions to assess select all that apply 1. Assess the patient for previous allergy to NSAIDs 2. Assess the GI system, and ask about any history of GI bleed, or PUD 3. Advise the patient to take the medication with food or milk to prevent GI distress 4. Advise to take on an empty stomach 5. Advise the patient to tell the provider about any of the OTC medication or vitamins before taking an NSAID

Answer 32

1,2,3, & 5 (4 is not correct taking an NSAID can cause an ulceration