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Pharma > Anti-inflammatory_arthritis_gout > Flashcards

Anti-inflammatory_arthritis_gout Flashcards

1
Q

Name two salicylates examples

A

Aspirin
81mg-baby asprin
325mg-fever reducer
-EC, PO, Chewable

Aspirin-acetaminophen-caffeine (Excedrin)-(migraine)

Bismuth subsalicylate (Pepto-Bismol)-upset stomach, diarrhea

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2
Q

What is chewable salicylate aspirin used for?

A

Chewable aspirin is given for MI, and has a faster effect than swallowing.

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3
Q

Salicylates MOA

A

inhibit synthesis of prostaglandin.

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4
Q

Salicylates indication is?

A

treat mild to moderate pain/ fever
MI’s and prevention by inhibition of platelet aggregation

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5
Q

What other reasons may salicylates be used for?

A

Salicylates can be given for MI prevention, stroke prevention

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6
Q

What are the side effects of salicylates

A

Nausea, dyspepsia (indegestion),
-clotting systems (prolonged bleeding time),
-Reye’s syndrome in children*

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7
Q

What are the adverse effects of aspirin due to asprin toxicity?

A

Salicylism- (dizziness, mental confusion, tinnitus*, sweating, hyperventilation/respiratory alkalosis.

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8
Q

What do salicylates interreact with?

A

NSAIDS
Blood thinners (Warfarin)

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9
Q

What can contraindicate salicylates?

A

bleeding abnormalities (ASA prolongs bleeding/interacts with blood thinners)
impaired renal function

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10
Q

What would you educate a patient about salicylates

A

·Patient ed:
· Stop one week before surgery
· Monitor for bruising, bleeding gums, coffee-ground emesis, Dark tarry stool
· -Do NOT give to children and teens with recent viral infection or fever- (Reyes syndrome)
· Can take with food, milk or antacid to avoid GI irritation.

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11
Q

NSAIDs examples

A
  • Ibuprofen
  • Naproxen
  • Diclofenac
  • Ketorolac
  • Indomethacin (PO, R, or IV)
  • nabumetone (Relafen)
  • meloxicam (Mobic)
  • Cyclooxygenase-2 Inhibitors (Celecoxib)
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12
Q

NSAIDs MOA

A

non-selective inhibition of cyclooxygenase
enzyme that controls pain, fever, inflammation
as well as thromboxane which stimulated the clotting of blood.

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13
Q

Ibuprofen indication

A

inflammation and pain, dysmenorrhea, musculoskeletal disorders

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14
Q

Naproxen indications

A

Joint and arthritis pain

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15
Q

Indomethacin indication

A
  • acute gout,
  • tendonitis, pericarditis
  • neonates to promote closure of the duct between the pulmonary artery and aorta
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16
Q

Ketorolac Indications

A

*short term use (5 days), mod-severe pain & inflammation-post-op

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17
Q

Nabumetone indication

A

(Relafen)- mild-mod OA, RA and gouty arthritis

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18
Q

*Celecoxib indication

A
  • Celecoxib- OA, RA, pain
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19
Q

NSAIDS side effects and adverse effects

A

Nausea & vomiting (most common),*
dyspepsia (mucosal lesion-ulcer),* burring!
GI bleed, (impacts GI a lot)* GI pain*
acute renal failure*
platelet inhibition, blood clotting issues*
-report allll the above

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20
Q

What should you be aware of for patients on NSAIDs about their condition?

A

Ask for any stomach or kidney disorders (cuz of peptic ulcer, GI pain/bleeding,
NSAIDS are hard on the stomach and kidneys (renal failure)

21
Q

NSAIDS interactions

A

Anticoagulants
Corticosteroids
diuretics,
decrease
the antihypertensive effect of beta-blockers
(Heart meds) (aspirin)

22
Q

NSAIDs contraindications

A

Peptic Uclers (indesgestion),*
GI bleeding*
Pregnancy D,*
bleeding disorders,*
Renal and hepatic dysfunction,*
Vit K deficiency,*
(Stomach or kidney problems)

23
Q

What are all the nursing implications for NSAIDS

A

· NSAIDs can compromise existing renal function
· Renal toxicity can occur in patients with dehydration, heart failure, liver dysfunction, or use of diuretics or ACE inhibitors.
· Assess: CBC (to monitor for blood loss/ blood clotting ability), liver and renal function, GI disorders - bleeding or peptic ulcer

24
Q

which drug decreases inflammation, fever, and pain but does not decrease platelet aggregation

A

COX-2

25
Q

what should a nurse monitor for patients on NSAIDs

A

Renal function
dehydration, heart failure
liver function,
diuretics or ace inhibitors
Assess CBC -monitor bleeding disorders
Assess GI issues like peptic ulcers

26
Q

Acetominophen MOA

A

Acts directly on the thermoregulatory cells of the hypothalamus

27
Q

Acetominophen indication

A

Used as analgesic & antipyretic, Relief of musculoskeletal pain associated with arthritis

28
Q

Acetominophen SE/AE

A

Acute toxicity- N/V, diarrhea, sweating, GI pain, to liver failure, coma & death
Hepatotoxicity usually associated with chronic use and overdose
hard on the liver

29
Q

acetominophen interactions

A

with Oral anticoagulants increase bleeding

30
Q

Acetaminophen contraindications

A

Hepatic/liver dysfunction or chronic alcoholism

31
Q

What is the antidote for acetaminophen?

A

Acetylcysteine

32
Q

Acetylcysteine AE

A
  • can cause allergic reaction (rash, itching, angioedema, bronchospasm, hypotension) most often in response to the first dose
33
Q

Nursing Implications of acetaminophen

A

metabolized in the liver, assess liver function test,
assess for renal disease
Max does 3,000
The absolute max is 4,000

34
Q

antigout examples

A

Colchicine
Allopurinol

35
Q

colchicine indication

A

acute gout attack 7-10

36
Q

acute gout attack.

A

chronic gout

37
Q

colchicine SE AE

A

diarrhea, sudden onset of muscle pain/tenderness, renal dysfunction

38
Q

what can colchicine interact with?

A

grapefruit/grapefruit juice

39
Q

Nursing Implications for monitoring evaluation of colchicine?
how do you know the drug is working?

A

Nursing Implications: Evaluation:
Improvement of pain
Decreased gout attacks
Decreased uric acid level*
Decreased swelling, pain, stiffness, and tenderness of a joint or muscle area

40
Q

allopurinol SE AE

A

Kidney injury, hepatitis

41
Q

what is a nursing implication to look out for when monitoring allopurinol pt.

A

Rhabdomyolysis
-dark urine color and muscle pain

42
Q

what labs would a nurse monitor for a patient on allopurinol?

A

Uric acid levels
CBC
LFT’s
Renal function

43
Q

What would you educate a pt using allopurinol on doing frequently?

A

Pt ed: drinking 2 L of water/day*
water decreases kidney injury and rhabdo
flush out uric acid

44
Q

give examples of herbal remedies

A

Glucosamine
Chondroitin

45
Q

what do these herbal remedies treat?

A

Treats pain of Osteoarthritis

46
Q

Herbal remedies SE AE

A

GI discomfort, headache

47
Q

Herbal remedies interactions

A

May increase insulin resistance (glucosamine),
Enhances effects of warfarin

48
Q

Herbal remedies nursing implications?

A

Nursing Implications: Those with A-fib or anyone on warfarin should not use.

Pharma (12 decks)

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