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Pharm Exam 1 > Anti-Inflammatory Drug > Flashcards

Anti-Inflammatory Drug Flashcards

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1
Q

What are three of the five main categories for anti-inflammatory drugs

A

Corticosteroids, nonsteroidal and antihistamine

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2
Q

What is the purpose of Corticosteroids/Glucocorticoid

A

To prevent or limit inflammation by stopping all pathways of the inflammatory mediators production

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3
Q

What are the drug forms and routes for Corticosteroids

A

Oral: Prednisone
Parenteral: Dexamethasone
Inhalation; asthma
Topical: skin problem
Injected into joints
Rectal: Hemorrhoids
Drops ( eye problems)

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4
Q

What is the oral drug for corticosteroid

A

Prednisone

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5
Q

What is the parental drug for corticosteroid

A

Dexamethasone 

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6
Q

What is the action for Glucocorticoids

A

It initiates many complex reaction responsible for anti-inflammatory and immune suppressant effect
Increase glucose level

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7
Q

What are the 3 indication for glucocorticoids

A

It is a short term treatment for many inflammatory disorders such as respiratory inflammation and joint pain
It relieves discomfort
I guess the body a chance to heal from effect of inflammation

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8
Q

What are some respiratory inflammation

A

Pneumonia, Asthma, COPD

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9
Q

What is the intended responses for glucocorticoids

A

To reduce redness, pain, swollen at the site of information and increase function of affected area 

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10
Q

What are some short-term side effects of glucocorticoids

A

 hypertension, acne, insomnia, and nervousness

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11
Q

What are some long term therapy effect on glucocorticoid

A

Adrenal glands suppression, reduced immune function, delayed one healing, and the cushingoid appearance

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12
Q

What is the “Cushingoid” appearance

A

Think of the lady in the picture that you saw on the slide

Buffalo hump at your back, acne, Weight gain, stretch marks(striae), increase body and facial hair,  Truncal obesity (fat back), Extremity muscle wasting and weakness

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13
Q

What are some adverse effect of glucocorticoid

A

 they can max out infectin, And adrenal gland atrophy (lack of adrenal cortex support)

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14
Q

Can I patient just stop taking glucocorticoids drugs

A

No they will need to taper the drug meaning that they need to stop taking it very slowly. They can’t just stop taking it at once

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15
Q

As said nurse what should  You’ll be caution for( Glucocorticoids)

A

Diabetes because of hyperglycemia since the drug is known to suppress carbs and protein metabolism

Acute peptic Ulcer: I saw in the lining of your stomach (the small intestines)


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16
Q

Adults taking glucocorticoids should be reminded of the importance of taking the drugs During what time of the day

A

In the morning to approximate diurnal rhythm

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17
Q

Can glucocorticoid be applied on open lesions excoriated areas?

A

No it should be avoided

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18
Q

Can glucocorticoids be used during pregnancy? 

A

No because they can cross the placenta and could cause adverse effect on the fetus

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19
Q

What are some nursing implications for glucocorticoid

A

Assisted patient for symptoms of infection, assess the patient baseline weight and height, assess the patient intake and output status, assess the patient hydration and the nutritional status, says the patient vital signs especially for blood pressure the patient immune status, says the patient for edema and electrolyte imbalance since the patient for skin condition

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20
Q

What do you want to assist the patient for before given a glucocorticoids medication

A

 RN needs to assess the patient for drug allergies and potential drug interactions (prescription and over-the-counter drugs).
patient’s glucose level and be aware that this drug may alter serum glucose an electrolyte levels

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21
Q

 should you prepare Steroid medication at the same time every day especially in the morning? And can it be taken with food or meals?

A

Steroid medication can be prepared at the same time every day usually in the morning with meals or food

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22
Q

What is the oral form of corticosteroid durg and should be given with food

A

Prednisone
 Prednisone should be given with food or milk to minimize G.I. upset

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23
Q

What are Non-sterile anti-inflammatory drugs
(NSAID’s) specifically used for?

A

Pain

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24
Q

How does NSAID differ for corticosteroids?

A

NSAID’s provide anti inflammatory and analgesic(pain) effect without the adverse effects associated with corticosteroids

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25
What are the three main purposes of NSAID’s?
Provide A strong anti-inflammatory response, analgesic (pain) and antipyretic (drugs used to prevent or reduce fever)
26
Drugs used to prevent fevers are classified as?
Antipyretic
27
Drugs used to prevent pain are classified as?
Analgesic
28
What kind of anti inflammatory drugs are sold OTC?
NSAIDs
29
In NSAIDs, what drugs are consider COX 1 inhibitors?
Ibuprofen and Acetylsalicylic Acid (focus more on for this class) Ketorolac and Naproxen
30
What are the routes for Ibuprofen?
Oral or IV
31
What are the routes for Ketorolac?
Oral, IV, IM, intranasal
32
What are the routes for Acetylsalicylic Acid?
Oral and R/S(respiratory therapy?)
33
What is the route for Naproxen?
Oral
34
What are the Cox 2 inhibitors? And what are their route
Celcoxib and Meloxicam They are both oral
35
What anti inflammatory drug classification is used in treatment of MI and other thromboembolic disorders?
NSAIDs
36
Inhibits synthesis of prostaglandin, used to treat mild to moderate pain and fever
NSAIDs
37
Where are NSAIDs drugs absorbed from?
Absorbed from the stomach
38
What is the peak time for NSAIDs drugs? In other words, when should the drug start working once someone takes it?
5-30 mins
39
NSAIDs are metabolized in the ——- and excreted in the ———
Liver and excreted in the Urine
40
What are the contraindications for NSAIDs
Presence of other NSAIDs Known allergy, bleeding abnormalities and impaired renal function
41
what is the purpose of NSAIDs
Suppress inflammation, Treat mild to moderate pain, reduce fever, and relieve dysmenorrhea which is painful for menses
42
What nonopioid analgesics is used to treat mild to moderate pain reduce fever and relieve this dysmenorrhea which is meant painful menses
NSAIDs
43
What is COX-1 inhibitors
Cox-1 is mainly present in tissue and involves tissue homeostasis,  what is a key production for prostaglandins Which offer is the protection of the gastric mucosa which intern prevent the formation of ulcers Regulation of renal blood flow, and childbirth 
44
What is Cox 2 inhibitors
Not normally present in tissues except for the kidney Cox 2 produce prostaglandins, pain, redness etc 
45
Effects of NSAIDs is believed to come from? COX ?
Cox 2
46
Adverse effect of NSAIDS such as gastrointestinal bleeding comes from?
COX 2
47
Side effect of celcoxib cox 2 inhibitors
Ulcers, bleeding or holes in the stomach
48
Where are NSAIDs absorbed and when do they reach their peak levels?
GI tract and reach their peak levels in 1 -3 hours
49
Contraindications for NSAIDS
Allergy to any NSAIDs or Salicylates and celecoxib someone with CV dysfunction or hypertension, peptic ulcer or known GI bleeding and pregnancy
50
Cautions for NSAIDS
Caution should be used for renal or hepatic dysfunction (liver disease) and any other known allergies
51
What are the adverse effects of NSAIDs
Nausea, dyspepsia, GI pain, Constipation, diarrhea, flatulence
52
While nausea is an adverse effect of taking NSAIDs, are vomiting usually seen?
No
53
What is this a contradiction of? Known allergy, bleeding abnormalities, impaired renal function
NSAIDs
54
What are the 2 actions/indicators for NSAIDs
Inhibits synthesis of prostagladin (lipids at site of injury that control inflammation, blood flow, blood clot) used to treat pain and fever Anti thrombotic effect: Used in the treatment of heart attack and other thromembolic disorders
55
What is an adverse effect that comes with Celcoxib
Allergy to sulfa drugs
56
Celecoxib is used to relieve pain, tenderness, swelling and stiffness caused by osteoarthritis (arthritis caused by a breakdown of the lining of the joints), rheumatoid arthritis (arthritis caused by swelling of the lining of the joints), and ankylosing spondylitis (arthritis that mainly affects the spine)
True
57
Salicylate toxicity is an adverse effect or?
NSADIs
58
What are salicylate drugs
Salicylates are a type of drug found in many over-the-counter and prescription medicines. Aspirin is the most common type of salicylate.
59
Drug and drug interactions What happens when you take NSAIDs drugs with other drugs and loop diuretics
When taking with other drugs, it interferes with the absorption There is a decrease diuretic effects with loop diuretics
60
Should you take NSADs drug with other loop diuretics?
No
61
What is meant by diuretic effect
Diuretics, sometimes called water pills, help rid your body of salt (sodium) and water. Most of these medicines help your kidneys release more sodium into your urine. The sodium helps remove water from your blood, decreasing the amount of fluid flowing through your veins and arteries. This reduces blood pressure.
62
What is the relationship between NSAIDs and Renal function?
Renal fictions depends partially on prostaglandins. When that is disrupted by NSAIDs drugs it can lead to acute or chronic renal failure
63
T/F Use of NSAIDs cannot comprise existing renal functions
False it can
64
When can renal toxicity occur?
Pt with dehydration, heart failure, liver dysfunction, use diuretics or ACE inhibitors
65
Salicylates (ASA) ( e,g like Aspirin). What is the daily tablets
Daily tablets low does is 81 mg and 325 for high dose
66
What is Salicylate (ASA) used for
Intended for adults who have strong risk factors of developing coronary artery disease or cardiovascular accident
67
When is Salicylate (ASA) effective
It is effective after MI( after the person has already had the heart attack
68
Antihistamines What is the first-generation?
Diphenhydramine (which is a medication that relieves the symptoms of allergies, treat pain and itching caused by insects bite)
69
S/S of first generation diphenhydramine
Sedating(drowsy) and makes you feel sleepy
70
What drug in the antihistamine category is used to treat pain and itching caused by insect bites, poison ivy, hay fever allegory and cold symptoms and insomnia
Diphenhydramine
71
What is the second generation of Antihistamine
Cetirizine
72
What is Cetirizine (second generation of antihistamine) used for
Red, itchy eye, hay fever, watery eyes, sneezing , allergy symptoms
73
What are some side effects of Antihistamine
Blurred vision, tachycardia, dry mouth, urinary retention
74
What are some adverse effect of Antihistamine?
Seizures and increased intraocular pressure
75
What are the three categories of drugs that support the treatment of pain
Nonopioid analgesics, opioid analgesics and looks antagonist 
76
What are narcotic agonist?
These are drugs that react with opiate receptors, causes analgesia (inability to feel pain), sedation(sleep, calm) or euphoria (happiness) Potential for physical dependence Controlled substances Rising problem of addiction 
77
What are mild agonists drugs?
Codeine and hydrocodone
78
What are are strong agonist drugs?
Morphine, hydromorphone, oxycodone, meperidine, fentanyl’ and methadone
79
What are the actions of narcotic agonist
Acts at specific opioid receptors sites in the CNS They produce analgesia, sedation and a sense of well-being
80
What are indications of narcotic agents
Relief severe acute or chronic pain Analgesia during anesthesia
81
What drug classification is an indication for analgesia during anesthesia
Narcotic agents
82
What are the Pharmacokinetics of Narcotic agonist
IV is the most reliable way to achieve therapeutic response IM and sub w rates of absorption varies between sexes Hepatic metabolism and generally excreted in the urine and bile
83
What are contraindications for Narcotic agonist
Known allergy, diarrhea caused by poisons and pregnancy, labor and lacation
84
Orthostatic hypotension is an adverse effect for what drug classification
Narcotic agonists
85
What are some cautions for narcotic agonist
Respiratory dysfunction, GI and GU Surgery, acute abdomen or ulcerative colitis
86
What are some adverse effects
Respiratory depression with apnea, Cardiac arrest, shock, orthostatic hypotension, nausea, vomiting, constipation, biliary spasm, psychoses, hallucinations 
87
What adverse effect is this a sign of? Drug classification Hallucination, respiratory depression with apnea, cardiac arrest, biliary spasm and psychoses 
Narcotic agonist
88
What are the drug to drug interactions with narcotic agonist
Barbiturate general anesthetic a, phenothiazine and MAOI
89
What is the first generation
Diphenhydramine: Benadryl for allergies
90
What is antihistamine
Antihistamines are drugs which treat allergic rhinitis, common cold, influenza, and other allergies.
91
Is antihistamine used for sessional allergy?
Yes
92
Second generation of antihistamine
Cetirizine and less sleepiness
93
Antipruritics effects
Topical antipruritics are a class of medications used to treat itchy skin in adults with eczema or other skin conditions that can lead to repeated scratching and thickened skin.
94
What is the main mediator of inflammation?
Histamine
95
What are the chemical mediators for inflammation
Histamine, prostaglandins, serotonin, leukotrienes, bradykinin
96
NSAIDS and nonopioid drugs both helps with?
Inhibiting prostaglandin to stop pain, fever and inflammation
97
What are the actions for Glucocorticoids?
Responsible for anti-inflammatory and immunosuppressive effects
98
What are the indications for glucocorticoids
Short-term treatment for many inflammatory disorders such as respiratory inflammation and joint pain Relieve discomfort Give the body a chance to heal from The effect of inflammation
99
What are the intended response Glucocorticoids?
Reduce redness, pain, swollen outside of inflammation, and increase function of the affected area
100
What are the short term effect of glucocorticoid
Hypertension, actually, insomnia, nervousness
101
What are the long term effect of glucocorticoids
Adrenal gland suppression, reduced immune function, delayed wound healing, and “cushingoid appearance “
102
What are the adverse effect of glucocorticoids
Adrenal gland atrophy, masking infection
103
What should you be caution with when it comes to glucocorticoids HO-DHL
Diabetics and peptic ulcers  patients with hypertension hypothyroidism osteoporosis or liver disease
104
What are NSAIDs medication importances 
Provide strong anti-inflammatory and analgesic, and antipyretic effects  and can blood inflammatory response
105
What are the cooks one inhibitors of NSAIDs  I-KAN
Ibuprofen (oral or IV) Ketorolac (oral, IM and intranasal) Acetylsalicylic Acid (oral, r//) Advil naproxen (oral ) 
106
What are cox 2 inhibitors of NSAIDs
Celcoxib -oral Meloxicam- oral
107
What are the action/indications of NSAIDs
Inhibits synthesis of Prostaglandin, used to treat to moderate pain and fever It also has a antithrombotic effects: Used to treat MI and other blood clots like ASA (aspirin) which is a blood thinner 
108
What is the pharmacokinetics of non-steroid cortisol drugs
Absorbed in the stomach usually takes 50 to 30 minutes(on slide) but 1-2 hours on Ppt. It is metabolized in the liver and excreted in urine 
109
What are the contraindications of NSAIDs
Presences of other NSAIDs Known allergy, bleeding abnormalities, and impaired renal function
110
What are adverse effects of NSAIDS
Effect on stomach and clotting systems Celcoxib: allergy to sulfa drugs Salicylate toxicity
111
What are the drug and drug interactions
Interact with other drugs by interfering with absorption Loop diuretics Beta blockers Possible lithium toxicity
112
Should people with renal function issues be administered and NSAIDs 
No. Part of the renal function depends on the prostaglandins. NSAIDs block those if it’s strong enough and can cause renal functions like blood in stool
113
What are the first generation for of Antihistamine
Diphenhydramine
114
What is the second generation of antihistamine
Cetirizine
115
Why are antihistamine important
Reduce inflammation by preventing inflammatory mediators (usually histamine or leukotriene)  from binding to its receptor Blocks effect of histamine at the histamine one receptor And decrease allergic response 
116
What drug classification decrease allergic response
Antihistamine
117
Histamines Explain the H1 receptors
H1 receptors and blood vessels, respiratory mucous membranes
118
Histamine Explains H2 receptors
H2 receptors in stomach lining
119
What is the main mediator of inflammation and capillary leak
Histamine
120
What is the intended respond of antihistamines
Blood vessels do not dilate, reduce swelling, mucus, other nasal eye and respiratory secretion are reduced, and narrow airway widening, decrease hives in size and itchiness
121
What are the side effects of antihistamines
Sleepiness, tachycardia , dry mouth, urinary retention , and blurred vision
122
What are the adverse effect of antihistamines
seizure(rare) increase intraocular pressure
123
What should you check before administering antihistamine drugs
Glucose, high blood pressure, and prostrate enlargement You should also check if other drugs are being taken That’s cause sedation
124
What should you check after administering antihistamine drugs,
Vital signs and assist the patient when you get an out of bed
125
What did you teach the patient about antihistamine drugs
Avoid alcohol and avoid driving or operating machinery within six hours of administration
126


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