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pharm 140 > ch 16 anti-inflammatory drugs > Flashcards

ch 16 anti-inflammatory drugs Flashcards

(58 cards)

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1
Q

salicylates

A

used in managing conditions from headache to MI

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2
Q

NSAIDs

A

used primarily as anti-inflammatory drugs but are also used as analgesic

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3
Q

acetylsalicylic acid (aspirin) indications

A

mild to moderate pain
fever
prevents platelet aggregation

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4
Q

acetylsalicylic acid (aspirin) pharmacokinetics

A

absorbed in stomach/small intestine

highly protein bound

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5
Q

acetylsalicylic acid (aspirin) pharmacodynamics

A

fever: inhibits PGE2 synthesis in hypothalamus
inflammation: peripheral inhibition of prostaglandin
antiplatelet: irreversible inhibition of thromboxane A2

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6
Q

acetylsalicylic acid (aspirin) contraindications

A 
hypersensitivity
peptic ulcer disease
bleeding disorders
"children with illness"
last trimester of pregnancy
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7
Q

acetylsalicylic acid (aspirin) adverse effects

A 
renal failure
abnormal bleeding
GI upset
drowsiness
confusion
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8
Q

acetylsalicylic acid (aspirin) interactions

A

coumadin/heparin (may icnrease r/o bleeding)
beta blockers (may decrease antihypertensive effect)
anti-diabetic drugs (may increase hypoglycemic effect)
corticosteroids (may decrease aspirin effects)
other drugs that are highly protein bound

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9
Q

acetylsalicylic acid (aspirin) nursing dx

A

acute or chronic pain r/t ineffectiveness of aspirin

risk for injury (GI bleed, hepatic/renal toxicity) r/t drug therapy

disturbed sensory perception r/t blurred vision or tinnitus

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10
Q

acetylsalicylic acid (aspirin) interventions

A

max therapeutic effects: give with milk/food to avoid GI upset, use uncoated aspirin for cardiac, use coated aspirin in stomach ulcer pts

min adverse effects: stop drug 5-7 days before elective surgery to allow time for production and release of new platelets

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11
Q

acetylsalicylic acid (aspirin) assessments

A

during prolonged therapy: assess hematocrit, Hb level, PT, INR, renal function

monitor for tinnitus

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12
Q

acetylsalicylic acid (aspirin) pt education

A

do not crush enteric coated tabs
discard if strong vinegar odor
ibuprofen may decrease low dose aspirin therapy effects

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13
Q

aspirin is contraindicated in

A

children with varicella

can cause Reye syndrome (rapid worsening brain disease with flu-like symptoms, vomiting, seizures)

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14
Q

NSAIDs

A

inhibit COX and prostaglandin synthesis

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15
Q

NSAID black box warning

A

may increase risk of MI or stroke
may cause GI bleed
may cause aseptic meningitis

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16
Q

ibuprofen indications

A 
arthritis
mild to moderate pain
dysmenorrhea
migraine
fever
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17
Q

ibuprofen pharmacokinetics

A

absorbed from GI
peak 1-2 hrs
highly protein bound

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18
Q

ibuprofen pharmacodynamics

A

inhibited synthesis or release of prostaglandins

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19
Q

ibuprofen contraindications

A

GI disease

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20
Q

ibuprofen adverse effects

A 
GI upset/bleeding
hepatotoxicity, acute renal failure
increased risk of CVA/MI
fluid/electrolyte imbalances
skin rash
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21
Q

ibuprofen interactions

A

digoxin (increase risk of dig toxicity)
blood thinners (increased risk for bleeding)
cyclosporine (nephrotoxicity)

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22
Q

ibuprofen nursing dx

A

acute/chronic pain r/t ineffectiveness of ibuprofen therapy

increased risk for injury r/t incorrect self admin OR drug induced GI bleeding OR hepatic/renal toxicity

ineffective protection r/t blood dyscrasias

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23
Q

ibuprofen interventions

A

max therapeutic effect: give with food or milk to decrease GI distress

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24
Q

ibuprofen pt education

Study These Flashcards
A

medication has CV risk
monitor BP; drug can cause HTN
avoid alcohol use
avoid excessive exposure to sunlight and wear sunscreen

25
ibuprofen nursing interventions
monitor renal/hepatic function (BUN, Cr, liver enzymes, Hg, Hct) monitor and report vision changes in pt
26
para-aminophenol derivatives
analgesic/antipyretic | prototype acetaminophen
27
acetaminophen indications
fever | mild pain
28
acetaminophen pharmacokinetics
given PO, absorbed GI peak 60 min half life 1-3.5 hrs
29
acetaminophen action
primarily centrally acting | inhibits prostaglandin synthesis in CNS
30
acetaminophen contraindications
hepatic disease viral hepatitis alcoholism warfarin/heparin
31
acetaminophen adverse effects
overdose can be fatal | hypoxia, dyspnea, atelectasis, pleural effusion, pulmonary edema, stridor
32
acetaminophen interactions
``` activated charcoal antacids ethanol (alcohol) (liver damage) hydantoins warfarin sulfinpyrazone (risk for liver damage) ```
33
acetaminophen pregnancy category
category B
34
acetaminophen nursing dx
acute/chronic pain r/t ineffectiveness of acetaminophen risk for injury r/t drug induced hepatic and renal toxicity ineffective protection r/t potential blood dyscrasias
35
acetaminophen interventions
max therapeutic effect: given without regard to meals min adverse effect: periodic CBC, platelet count, liver and renal function tests for pts on long term therapy, monitor IV infusions closely
36
acetaminophen pt education
pay attention to dose limit | seek medical attention if rash or other reactions occur
37
acetaminophen in children
use with children under 2 should be checked with provider first appears in breastmilk in low levels
38
tylenol is contraindicated in
pt with hepatitis
39
serotonin-selective drugs
used to relieve pain and inflammation r/t migraine headaches not useful for other headaches or other pain/inflammation -triptans
40
sumatriptan (Imitrex) indications
migraine headache, cluster headache
41
sumatriptan (Imitrex) pharmacokinetics
given PO, intranasally, subQ | met in liver, excreted by kidneys
42
sumatriptan (Imitrex) action
selective for 5-HT1B/1D receptors located on cranial blood vessels and sensory nerves of trigeminovascular system stimulation of receptors results in vasoconstriction
43
sumatriptan (Imitrex) contraindications
CAD | ischemic cardiac diseases
44
sumatriptan (Imitrex) adverse effects
``` coronary artery vasospasm cardiac dysrhythmias angina myocardial ischemia dizziness ```
45
sumatriptan (Imitrex) interactions
SSRIs: risk for serotonin syndrome MAOIs: may reduce Imitrex clearance and use within 2 weeks of MAOI is contraindicated
46
sumatriptan (Imitrex) pregnancy category
category C
47
sumatriptan (Imitrex) nursing dx
risk for impaired tissue perfusion r/t cardiovascular or cerebrovascular events risk for injury r/t weakness, dizziness, lightheadedness
48
sumatriptan (Imitrex) interventions
max therapeutic effect: confirm diagnosis of migraine, administer as soon as headache begins min adverse effect: assess for CV history, monitor for s/s allergy or vasospasm monitor for seizures
49
sumatriptan (Imitrex) pt education
identify migraine triggers | drug will only treat migraines and will not prevent them
50
fever
temperature reg = hypothalamus pyrogens: substances that cause fever fever causes activation of monocytes/macrophages that secrete cytokines cytokines increase synthesis and secretion of prostaglandins in hypothalamus
51
inflammation
local: warmth. swelling, redness, pain, LOF | acute inflammation is divided into cellular and vascular responses
52
cellular inflammation response
1. margination of WBC to periphery of blood vessels 2. emigration of WBC to tissue spaces 3. chemotaxis; cellular debris becomes more "attractive" to WBC 4. phagocytosis; neutrophils and macrophages engulf cellular debris
53
prostaglandin
modulates some components of inflammation, body temp, pain transmission, platelet aggregation derived from arachidonic acid and covnerted by cyclooxygenase (COX)
54
COX-1
synthesizes prostaglandins that are involved in the regulation of normal cell activity
55
COX-2
appears to produce prostaglandins mainly at sites of inflammation
56
platelet aggregation
first temp in sequence of events that leads to a thrombus (clot) platelet aggregation is increased in smokers and hypercholesterolemia
57
migraine headache
2 types: migraine with aura: sensory disturbances like light flashes and blind spots migraine without aura
58
migraine pathology
it is postulated that migraine begins when intracranial blood vessels dilate this dilation stimulates the trigeminovascular system resulting in abnormally excitable neurons that send pain impulses to the brain's pain receptors

pharm 140 (18 decks)

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