Injury Pharm

Question 1

NSAIDS

Answer 1

Non Steroidal Anti-Inflammatory Drugs

ex. Aspirin

Question 2

NSAIDS Mechanism of Action

Answer 2

• Indirect stimulation of nociceptors

- Targets COX 1 and COX 2

Question 3

What is COX 1

Answer 3

• Protective Prostaglandins: stomach mucosa and platelet stickiness
• Found in most tissues
• Responsible for synthesizing the prostaglandins that maintain gastric mucosa and renal function

Question 4

What is COX 2

Answer 4

• Inflammatory Prostaglandins: pain, fever, inflammation
• Normally not present in healthy cells
• Produced by presence of inflammation

Question 5

What is the classification of Aspirin (ASA)?

Answer 5

First generation NSAID

Question 6

What is the major use/labeled indication of Aspirin?

Answer 6

• Inflammation suppression
• Analgesia
• Antipyretic (not in peds)
• Prevention of platelet aggregation

Question 7

What is the primary mechanism of action of Aspirin?

Answer 7

• Nonselective, irreversible COX inhibition

Question 8

What are common and life-threatening adverse reactions and risks of Aspirin?

Answer 8

• Peds: Reye’s syndrome - encephalopathy and fatty liver, link between ASA use in peds and viral illness
• Adults: GI effects, bleeding, renal impairment, salicylate toxicity
• Drug interactions: other NSAIDS, glucocorticoids, anticoagulants

Question 9

Nursing Considerations with Aspirin

Answer 9

• Other drugs
• Know formulations
• May take with food

Question 10

What are the 3 opioid receptors?

Answer 10

• Mu: analgesia, respiratory depression, euphoria, sedation, decreased GI motility, physical dependence
• Kappa: analgesia, sedation, decreased GI motility
• Delta: learning more about this receptor - may be a novel target for pain and depression treatments

Question 11

Pure Opioid Agonists

Answer 11

• Agonist at Mu
• Agonist at Kappa
• Mimic endogenous opioids
• Ex. morphine, oxycodone, hydrocodone, fentanyl

Question 12

Agonist-Antagonist Opioids

Answer 12

• Antagonist at Mu

- Agonist at Kappa

Question 13

Pure Opioid Antagonists

Answer 13

• Antagonist at Mu
• Antagonist at Kappa
• Ex. Naloxone, naltrexone

Question 14

What is the classification of morphine (and oxycodone)?

Answer 14

Oral opioid analgesic (morphine may also be parenteral)

Question 15

What is the major use of morphine?

Answer 15

Pain relief

Question 16

What is the primary mechanism of action of morphine?

Answer 16

• Pure opioid agonist (at mu and kappa receptors)

- Mimics action of endogenous opioid peptides primarily at mu

Question 17

What are common and life-threatening adverse reactions and risks of morphine?

Answer 17

• Respiratory depression, constipation, orthostatic hypotension, urinary retention, cough suppression, biliary colic, emesis, sedation, euphoria
• Drug interactions: CNS depressants, anticholinergic drugs, hypotensive drugs

Question 18

What are nursing considerations for morphine?

Answer 18

• Tolerance vs. physical dependence/addiction
• Respiratory treatment
• Constipation: use bowel regimen

Question 19

Tolerance

Answer 19

• State in which a larger dose is required to produce same response as before on smaller dose
• Tolerance to respiratory depression and sedation develops but not constipation

Question 20

Physical Dependence

Answer 20

• State in which an abstinence syndrome will occur if drug use is abruptly stopped
• Physiologic

Question 21

Addiction

Answer 21

• Condition manifesting as uncontrollable cravings
• Inability to control drug use, compulsive drug use, and use despite doing harm to oneself or others
• Behavioral