Lecture 3: Headache, Fever and Pain I

Question 1

Acetaminophen Brand Names

Answer 1

FeverAll, Tylenol

Question 2

AC- Mechanism of Action

Answer 2

Inhibition of Prostaglandin synthesis

Question 3

AC- Pharmacokinetics

Answer 3

Onset- 30 mins

Duration- 4 hours ( 6-8 hrs if its ER)

Question 4

AC- Boxed Warnings

Precautions

Answer 4

Hepatotoxicity potential (liver damage)
Bc of this risks, you shouldn't take if patient has hepatic dysfunction or alcohol use

Question 5

AC- Contraindications

Answer 5

Active severe hepatic disease, hypersensitivity

Question 6

AC- Adverse Effects

Answer 6

Rashes

Question 7

AC- Drug interactions

Answer 7

Alcohol, other acetaminophen containing products and warfarin ( blood thinners)

Question 8

AC- Dosing

Answer 8

Pediatrics: Tablets ( 80mg or 160mg), Suspension (160mg/ 5mL)

• 10-15mg/ kg by mouth every 4-6 hours
• MDD- 480 per dose up to 5 doses. No more than 2400 total

Adults: Regular Strength: 325mg Extra strength: 500mg

• 325-1000mg by mouth every 4-6 hrs (6-8hrs for ER)
• MDD: 4000mg

Question 9

AC- Special Populations

Answer 9

Safe for pregnancy and breast feeding

Question 10

NSAIDS

Answer 10

Non-steroidal anti-inflammatory drugs

Question 11

NSAIDS: Brand Name for
Ibuprofen
Naproxen

Answer 11

• Advil, Motrin

- Aleve

Question 12

NSAIDS- Mechanism of Action

Answer 12

Central and peripheral inhibition of COX -> inhibition of prostaglandin synthesis

Question 13

NSAIDS- Pharmacokinetics

Answer 13

Onset- 30 mins

Duration- 6-8 hrs for Ibuprofen. 12 hrs for Naproxen

Question 14

NSAIDS- Boxed Warnings

Answer 14

Gastrointestinal bleeding, Blood clots, Heart attack

Question 15

NSAIDS- Contraindications

Answer 15

Allergic- type reaction after NSAID use, hypersensitivity,

Question 16

NSAIDS- Precautions

Answer 16

Known or risk factor for cardiovascular disease, gastrointestinal complications or renal dysfunction

Question 17

NSAIDS- Adverse Effects

Answer 17

Anorexia, dyspepsia, epigastric pain, heartburn, nausea

Question 18

NSAIDS- Drug Interactions

Answer 18

Anticoagulants, antihypertensives, aspirin, nephrotoxic agent

Question 19

Ibuprofen Dosing

Answer 19

Pediatrics: Chewable Tablets (100 mg), Concentrated Drops (50 mg/1.25 mL), Suspension (100 mg/5 mL)

• 5-10 mg/kg by mouth every 6-8 hours
• MDD: 300 mg per dose up to 4 doses or 1200 mg total

Adults : Regular Strength (200 mg)

• 200-400 mg by mouth every 4-6 hours as needed
• MDD: 1200 mg

Question 20

Ibuprofen Special Populations

Answer 20

• Avoided in Pregnancy, contradicted in third trimester

- Compatible with breastfeeding

Question 21

Naproxen Dosing

Answer 21

Pediatrics: Not recommended

Adults: Regular Strength (220 mg)

• 220 mg by mouth every 8-12 hours as needed
• MDD: 660 mg

For >65 yrs old, take 220mg every 12 hrs,
-MDD 440mg

Question 22

Naproxen Special Populations

Answer 22

• Avoided in pregnancy, contradicted in third trimester

- Not compatible with breastfeeding

Question 23

Aspirin Brand Names

Answer 23

Bayer, Ecotrin, St. Joseph, etc.

Question 24

Aspirin Mechanism of Action

Answer 24

Irreversible inhibition of Cox-> inhibition of prostaglandins

Question 25

Aspirin Pharmacokinetics

Answer 25

Onset: 1-2 hours Durations: 4-6 hrs

Question 26

Aspirin Contraindications

Answer 26

Hypersensitivity

Question 27

Aspirin Precautions

Answer 27

Bleeding disorders, history of gout,

Question 28

Aspirin Adverse Effects

Answer 28

Abdominal Pain, dyspepsia, heartburn, nausea, vomiting

Question 29

Aspirin Drug Interactions

Answer 29

Alcohol, antihypertensives, NSAIDS, nephrotoxic agents, warfarin

Question 30

Aspirin Dosing

Answer 30

Pediatrics : Avoid in children and teenagers: Risk of Reye's syndrome Adults: Low Dose (81mg), Regular Strength (325mg), Extra Strength (500mg) - 325-1000mg by mouth every 4-6 hours - MDD: 4000 mg

Question 31

Aspirin Special Populations

Answer 31

Not recommended in pregnancy and breastfeeding

Question 32

Topical Products

Answer 32

Indicated for treatment of minor-moderate joint/ muscle aches and pains - Recommended as adjunct therapy

Question 33

Anesthetics (Lidocaine)

Answer 33

- Inhibits conduction of nerve impulses - Apply topically to affected area every 6-8 hours as needed for up to 7 days - Maximum of 3 applications in 24 hours

Question 34

Counterirritants

Answer 34

Produce mild, local inflammatory reaction - Less severe pain to counter a more intense one - Apply topically to affected area no more than 3-4 times a day up to 7 days

Question 35

NSAIDS-Topical product

Answer 35

- Inhibit prostaglandins to reduce pain and inflammation. - Apply topically to affected area 4 times daily - Adverse effects: Mild skin irritation

Question 36

Aspirin- Patient Education

Answer 36

- May be taken with food to minimize dyspepsia - Discontinue 48 hours prior to surgery - Stop 3 days before fecal blood test bc taking this drug may produce positive results

Question 37

NSAIDS- Patient Education

Answer 37

- May be taken with food, milk, or antacids if upset stomach occurs

Question 38

Counterirritants: Agents may include

Answer 38

- histamine dihydrochloride - capsaicin - methyl salicylate - camphor, menthol

Question 39

Histamine dihydrochloride

Answer 39

Cause vasodilation

Question 40

Capsaicin

Answer 40

Incite irritation

Question 41

Methyl salicylate

Answer 41

Increase blood flow

Question 42

Camphor, menthol)

Answer 42

Produce cooling sensation

Question 43

Counterirritants Directions

Answer 43

- Apply topically to affected area no more than 3-4 times a day up to 7 days

Question 44

Counterirritants: Adverse Effects

Answer 44

- All: Skin irritation/rash | - Capsaicin: cough, runny nose, sneezing

Question 45

NSAIDs ((Voltaren Gel® - diclofenac)

Answer 45

- Apply topically to affected area 4 times daily | - Use dosing care to measure dose

Question 46

NSAIDs ((Voltaren Gel® - diclofenac) Adverse Effects

Answer 46

§ Mild skin irritation

Question 47

Other factors associated with NSAIDs possible, although less likely

Answer 47

§ Adverse effects § Contraindications § Drug interactions § Precautions

Question 48

Topical Products-Patient Education

Answer 48

Do not bandage area/apply heat where product applied - Do not apply to wounded, damaged, broken, or irritated skin - Wash hands after application

Question 49

Aspirin for Heart Health?

Answer 49

- In the past, many used low-dose aspirin daily to prevent and treat cardiovascular disease (CVD) - New evidence shows marginal benefits for primary prevention of CVD - Risks of bleeding are high

Question 50

Many analgesics are combined with…

Answer 50

``` § Antihistamines § Caffeine § Decongestants § Other analgesics § Prescription medications ```