Module 8 Flashcards

(45 cards)

1
Q

Nociceptors

A

Nerve endings that selectively respond to painful stimuli and send pain signals to the brain and spinal cord

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2
Q

Antiprostaglandin

A

Drug that inhibits the synthesis of prostaglandins

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3
Q

Antipyretic

A

Drug that has the ability to lower body temperature

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4
Q

Arachidonic acid

A

phospholipid released in the cell membrane in response to cellular injury

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5
Q

Cyclooxygenase

A

Enzyme that produces prostaglandins from arachidonic acids

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6
Q

Non-steroidal anti-inflammatory drug

A

medication that inhibits the synthesis of prostaglandins; used to prevent and treat mild to moderate pain and inflammation

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7
Q

Prostaglandin

A

Chemical mediator found in most body tissues; helps regulate many cell functions and participate in the inflammatory response as well as initiate uterine contractions in labor

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8
Q

pyrogens

A

Fever-producing agent

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9
Q

Reye’s syndrome

A

potentially fatal disease characterized by encephalopathy and fatty liver accumulations; associated with the use of aspirin and NSAIDS after viral infections such as chickenpox or influenza in children and adolescents

characteristics: encephalopathy, hepatic damage, other serious problems

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10
Q

Salicylism

A

toxic effects of a salicylate drug; may occur with an acute overdose or with chronic use of therapeutic doses, especially the higher doses taken for anti-inflammatory effects

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11
Q

Somatic pain

A

simulation of nociceptors in the skin, bone, muscle and soft tissue such as sprains (well localized)

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12
Q

somatic pain description

A

described as sharp, burning, gnawing, throbbing, or cramping

low moderate intensity may stimulate the sympathetic nervous system

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13
Q

Visceral pain

A

nociceptors stimulated in abdomen, thoracic organs and surrounding tissues such as pancreatitis, cholecystitis (diffused, not well localized)

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14
Q

Visceral pain described as

A

deep, dull, aching, or cramping
severe visceral pain stimulates the parasympathetic nervous system

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15
Q

Neuropathic pain

A

caused by lesions of physiologic changes that injure peripheral pain receptors, nerves, or CNS (common cause of chronic pain)

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16
Q

Neuropathic pain is described as

A

Usually described as severe, shooting, burning, or stabbing

usually with:
diabetes mellitus
herpes zoster infections
traumatic nerve injuries
some types of cancer or cancer treatments

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17
Q

Duration of pain

A

acute: results from injury, trauma, spasm, disease processes, diagnostic procedures, or surgeries that damage body tissues

chronic: last 3 months or longer, and related to chronic disease

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18
Q

Mechanical pain

A

occurs when stress is placed on a joint or soft tissue, such as when you bend your finger all the way back or stretch your calf

-when you have pain that comes and goes or changes with different movements and or positions it is mechanical

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19
Q

Chemical pain

A

caused by the body’s inflammatory response to injury. An example of chemical pain would be hitting your thumb with a hammer or a toothache

chemical pain is described as throbbing, constant and does not change with movement

20
Q

Prostaglandins effect in stomach

A

decrease gastric acid secretion, increase mucous secretion, and regulate blood circulation

21
Q

Prostaglandins effect in the kidneys

A

maintain adequate blood flow and function

22
Q

Prostaglandins effect in cardiovascular system

A

help regulate vascular tone and platelet function

23
Q

prostaglandins effect on bronchioles

A

dilates bronchioles

24
Q

Cox-1 enzyme

A

enzymes are continuously in all tissues, not just at the time of inflammation. They secrete a cytoprotective mucus

25
Cox-2 enzyme
Normally present in several tissues (brain, bone, kidneys, GI, femal reproductive system). Is usually present in a small amount and usually inactive until simulated by pain and inflammation. Induced by interlukin-1 and TNF-alpha, H-pylori. Overall prostaglandins produced by COX-2 are associated w/ pain and other signs of inflammation
26
Fever
elevation in body temp which is controlled by the hypothalamus hypothalamus responds to pyrogens and resets the body temp to a higher set point this temp is regulated and mediated by prostaglandins mechanisms that cause the increased body temp include vasoconstriction that shunts blood to the core, and shivering
27
NSAID Examples
ibuprofen Aspirin (also a salicylate) Celebrex
28
NSAID indications
inflammatory disorders -degenerative joint disease, osteoarthritis, RA, bursitis To reduce fever -blocks prostaglandins -ASA not to be used in children due to risk of Reye's syndrome To relieve pain
29
MOA of Ibuprofen
Blocking of COX enzymes These drugs are classified into two types or generations. First generation NSAIDs block both COX-1 and COX-2 and second generation NSAIDS block only COX-2
30
Adverse effects of ibuprofen
Related to blocking of both enzymes and changes in the functions they influence nausea, dyspepsia, constipation, epigastric pain GI bleed with COX-1 HTN (caused by varying effects of prostaglandins) Nephrotoxicity increased BUN and creatinine, Edema respiratory- dyspnea, bronchospasm, pharyngitis
31
Drug on Drug interactions with ibuprofen
Anticoagulants- increase the risk of bleeding Codeine, Oxycodone, and hydrocodone- have an additive analgesic effect Corticosteroids- have additive gastric irritant and possible ulcerogenic effects Glucocorticoids and alcohol increase the risk of GI bleed
32
Contraindications for ibuprofen
Increase risk of serious GI adverse events -bleeding -ulceration -perforation of stomach and intestines Contraindicated by the presence of -peptic ulcer disease -GI or other bleeding disorders -impaired renal function
33
General info of NSAIDS
advise client to stop aspirin 1 week prior to any elective surgery advise client to take NSAIDS with food or milk (reduce stomach discomfort) Concurrent use with opioids allows for lower dosage of opioids (minimize effects such as constipation, respiratory depression) Toradol is used for short-term treatment of moderate to sever pain associated with post op surgery - only given IV, IM (liquid ibuprofen)
34
Salicylates (Aspirin)
Aspirin is an NSAID has anti inflammatory properties antipyretic properties analgesia properties * Suppresses platelet aggregation (antiplatelet) *
35
Indication for Aspirin
-Reduces Fever -suppress platelet aggregation -effective in treating mild to moderate pain (HA, minor trauma, minor surgery)
36
Adverse effects of aspirin
GI- blood loss, petechia, and bruising reyes syndrome
37
Toxicity of Aspirin
salicylism -toxic effects of a salicylate drug -may occur with an acute overdose or with chronic use of therapeutic doses, especially the higher doses taken for anti-inflammatory effects -toxicity occurs at levels above 300 mcg/ml -effects include hyperventilation, confusion, seizures, and coma
38
Aspirin Contraindicated by
presence of peptic ulcers and bleeding disorders impaired renal function alcohol abuse, presence of viral infections avoid in pregnancy
39
Acetaminophen indications
-fever -pain- other used as a replacement for aspirin in pain treatment because it does not cause nausea, vomiting, or GI bleeding and it does not interfere with blood clotting. Lacks anti-inflammatory activity
40
MOA of acetaminophen
Fever: acts directly on the hypothalamus to increase vasodilation and sweating Pain: unknown mechanism of action
41
Pharmacokinetics of acetaminophen
metabolized in the liver; small amount remains in the body as toxic metabolite
42
adverse effects of acetaminophen
hepatotoxicity is the most common adverse effect of acetaminophen
43
Toxicity of acetaminophen
prevention: maximum daily dose is 4g from all sources overdose causes hepatotoxicity metabolism of acetaminophen produces a toxic metabolite that is normally inactivated by combining with glutathione. When glutathione is depleted, the metabolite can cause damage overdose may be accidental or intentional signs/symptoms are nonspecific 24-48 hours after overdose, liver function test begin to show increased levels later manifestations may include jaundice, vomiting, CNS stimulation with excitement, and delirium followed by coma and death
44
treatment for acetaminophen toxicity
Gastric lavage and activated charcoal -if overdose detected within 4 hours after ingestion antidote: acetylcysteine -oral or IV -most beneficial if given 8-10 hours after ingestion, may be helpful within 36 hours -does not reverse damage already sustained
45
contraindications of acetaminophen
know hypersensitivity caution with administration in impaired hepatic and renal function