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Pharm 1, Exam 2 > Pain > Flashcards

Pain Flashcards

1
Q

What type of NSAID is ASPIRIN

A

prototype

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2
Q

Aspirin belongs to what chemical family

A

Salicylates

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3
Q

Which NSAID inhibits clotting of blood for a prolonged period of time

A

Aspirin

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4
Q

Aspirin

Pharmacologic Actions and Therapeutic Use

A
  1. Analgesic- the ability to relieve mild to moderate Pain
  2. Anti-inflammatory- the ability to decrease mild to moderate inflammation
  3. Antipyretic- the ability to lower body temperature
  4. Suppression of platelet aggregation- the ability to prevent and/or treat cardiovascular conditions such as acute myocardial infarction (MI) and stroke`
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5
Q

ASPIRIN

Mechanism of Action

A

blocks the synthesis of prostaglandins by inhibiting the enzyme cyclooxygenase

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6
Q

ASPIRIN

Phatmacokinetics

A
  1. Route- PO, rectal
  2. Absorption- rapid and completely absorbed; enteric aspirin absurd at a different time
  3. Distribution- widely distributed in all tissues and fluids, does include CNS, crosses the placenta, also in breast milk, and fetal tissues
  4. Metabolism- metabolized rapidly in liver
  5. Elimination/Excretion- half life about 6 hrs, renal elimination(by urination)
  6. On set of action- PO: 5-30 minutes; rectal: 1- 2hours
  7. Duration of action- PO: 1-4hr; rectal 7hr
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7
Q

ASPIRIN

Potential Adverse Effects

A 
Dyspepsia (upsets stomach, nausea, vomiting)
Heartburn
Urticaria
Tachycardia
Tachypnea
Diaphoresis
TInnitus
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8
Q

ASPIRIN

Tolerance and physical dependence

A

NO & NO

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9
Q

ASPIRIN

Abuse liability

A

NO

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10
Q

ASPIRIN

Precautions

A

anybody with recent history of stomach or intestinal bleeding; people with ulcers or hemophilia(bleeding disorder where blood does not clot normally);
anyone with a history of allergic reactions, asthma, liver and kidney disease;
Anyone with HTN, gout, or heart failure;
If taking aspirin prophylatically then do not take Ibuprofen

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11
Q

ASPIRIN

Category for pregnancy

A

Category D at 3rd Trimester

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12
Q

ASPIRIN

Drug interactions

A

be careful taking with

  1. Chronic use of antacids may decrease the serum salicylate concentration
  2. SSRI’s- Selective Serotonin Reuptake inhibitors–> can potentiate the risk of bleeding
  3. Platelet inhibitors
  4. Hypoglymeic effect of insulin may be potentiated when taken with aspirin
  5. Can attenuate (taper/block gradually) the effects of anti-hypertensive drugs
  6. Caffeine may increase the concentration of salicylates–>could be good
  7. Alcohol(ETOH)- not a good idea because it can cause stomach bleeding and when we take an NSAID with it we can potentiate the bleeding
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13
Q

ASPIRIN

Toxicity

A

Can OD will have a dining in the ears

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14
Q

IBUPROFEN

prototype for

A

advil and motrin

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15
Q

IBUPROFEN

pharmacologic Actions and Therapeutic Use

A

Analgesic, anti-inflammatory, antipyrectic(when it impacts the hypothalamus it will increase the peripheral blood flow, causing vasodilation therefor heat will dissapate

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16
Q

IBUPROFEN

Mechanism of action

A

NON-selective inhibit of cyclooygenase so it inhibits COX1 and COX2

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17
Q

IBUPROFEN

Pharmacokinetics

A
  1. Route- PO
  2. Absorption: 80% is absorbed from the GI tract, peak plasma levels about an hour, half life is 2-4 hrs
  3. Distribution: highly protein bound, crosses the placenta; not known if secreted in breast milk
  4. Metabolism: hepatic (extensively metabolized via the liver) rapidly and then we get it out by urination; a little bit ends up in stool
  5. Excretion: Renal; small amount biliary
  6. Onset of action: 1hr
  7. Duration of action: 6-8 hrs
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18
Q

IBUPROFEN

Potential Adverse Effects

A

Peripheral Edema (unusual)
Fluid Retention
Dyspepsia
Flatulence
CNS affects: dizziness(unusual), nervousness(unusual), lightheadedness, headaches
Photosynthesizing agent–> easy to sunburn while taking
REGULAR USE WILL SOMETIMES EXACERBATE ASTHMA, SOMETIMES FATALLY
Lower dose/usual doses of Ibuprofen seems to have the lowest incident of digestive ADRS(Adverse Drug Reactions) of all nonselective NSAIDS;

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19
Q

IBUPROFEN

OD symptoms

A

lethargy, vertigo, tinnitus, CNS depression, convulsion/seizures. Treatment is activated charcoal and a laxative

20
Q

IBUPROFEN

Tolerance and physical dependence

A

NONE & NONE

21
Q

IBUPROFEN

Abuse liability

A

NONE

22
Q

IBUPROFEN

Precautions

A

those with known allergies to aspirin or other NSAIDS
Patients with liver problems(taking Ibuprofen as you should can elevate liver function test by 10-15%, and can cause liver failure)
Sever uncontrolled hypertension
Congestive heart failure CHF, can bring on anemia
Bleeding adnormalities
history of GI Bleeding
impaired renal or hepatic function

23
Q

IBUPROFEN

Pregnancy Category

A 
Category B (first and second trimesters)
Category D (third trimester)
24
Q

IBUPROFEN

Drug interactions

A

can make some antihypertensive actions less effective;
Use with other NSAIDS, alcohol, or corticosteriods may cause serious adverse GI events;
1. patients taking diuretics have shown a decrease in the effectiveness of said diuretics–> reduce desired effect & not peeing out fluid
2. Lithium can increase plasma levels of lithium causing toxicity;
WARFARIN w/NSAIDS will increase GI bleeding, antacids are ok

25
Q

IBUPROFEN

toxicity

A

one overdose can destroy your liver(renal failure), apnea, cyanosis, drowsiness, GI bleeding, nausea, vomiting, and sweating;
Can be life threatening complications

26
Q

What has long term use of NSAIDS and ibuprofen been linked to?

A

1.4 times likely to have erectile dysfunction

27
Q

IBUPROFEN

Food precautions

A

take under fasting conditions; without food

28
Q

CELECOXIB has what type of warning

A

BLACK BOX warning–> may cause higher risk of heart attack or stroke; New onset or worsening HTN; it could kill you; used mostly for RA

29
Q

CELECOXIB

Pharmacologic Actions and Therapeutic Use

A

Anti-inflammatory,

Approved to treat mild to moderate pain and inflammation associated with RA, osteoarthritis, dysmenorrhea

30
Q

CELECOXIB

Mechanism of action

A

inhabitation of prostaglandins COX2, NSAID

31
Q

CELEXOCIB

Pharmacokinetics

A

Route- PO; 3hrs to reach desired plasma levels;3-5 days to get steady level

Absorption- well absorbed

Distribution- widely distributed;is likely secreted in breast milk, 97%(HIGHLY PROTEIN BOUND) stays a long time

Metabolism- CP450

Excretion- via liver primarily feces, with some in urine

32
Q

CELEXOCIB

Potential Adverse Effects

A 
Dyspepsia 
diarrhea
flatulence
peripheral edema (UNUSUAL(
URI(upper respiratory infection) -UNUSUAL ex. sinusitis, pharyngitis, rhinitis
33
Q

CELEXOCIB

Tolerance and Physical Dependence

A

NONE & NONE

34
Q

CELEXOCIB

abuse liability

A

NONE

35
Q

CELEXOCIB

Precautions

A

people that are allergic, people with history of asthma, be careful using it preoperatively with patient having coronary artery bypass graft (CARB); patients with known cardiovascular disease or risk factors may be at increased risk for death; people with elevated liver enzymes. GI issues can be potentially fatal, PUD(peptic ulcer disease),

Celebrex- CAN CREATE NEW ONSET OR WORSENING OF HYPERTENSION; BP SHOULS BE MONITORED FREQUENTLY WITH CELEBREZ, CAUTIOUS WITH ELDERLY, RISK FOR SJS(STEVEN JOHNSON SYNDROME)

36
Q

CELEXOCIB

pregnancy category

A

category c

and later D in third trimester

37
Q

CELEXOCIB

Drug interactions

A

don’t take with antihypertensive because it may make them not work as good;

Warfarin is fine

might increase lithium levels

Don’t take with aspirin because increase GI bleeding

Don’t use with alcohol, corticosterioids, or other NSAIDS may cause serious adverse GI events.

Decreases lasix effects

38
Q

CELEXOCIB

Toxicity

A

overdose may cause acute renal failure, apnea, cyanosis, drowsiness, GI bleeding, and nausea, vomiting and sweating.

OD is treated with administration of activated charcoal and nasogastric suction

39
Q

ACETAMINOPHEN
(Tylenol)

Pharmacologic Actions and Therapeutic Use

A

Synthetic non-opiod centrally acting analgesic, antipyretic works differently

40
Q

Tylenol

Mechanism of Analgesic Action

A

Reduces fever

acts centrally in the CNS by inhibiting COX; no effect on COX in peripheral tissues; May also inhibit the chemical mediators of pain, but its mechanism is unclear

41
Q

Tylenol

Pharmacokinetics

A
  1. Route: PO; rapidly and almost completely absorbed via the gut; elate bioavailability ranges between 85%-95; there is an injectable form also
  2. Absorption: rapid and complete. BIOAVAILABILITY 85-98%
  3. Distribution: widely distributed throughout most body fluids EXCEPT ADIPOSE TISSUE, crosses the placenta, has a hard time getting into fat, secreted into breast milk; 25% protein bound
  4. Metabolism: primarily liver (hepatic), half-life 2-3 HOURS
  5. Excretion: Renal; half life of 2-3 hours
  6. On set duration: 30-60 minutes
  7. Duration of ACtion: 3-8 hours
42
Q

Tylenol

Potential Adverse Effects

A

serious adverse effects are rare; excessive use in the US in then number one cause of acute hepatic failure; first suicide attempt/OD can kill your liver

43
Q

Tylenol

Precautions

A

use caution when giving to patients with RA, can worsen patient with renal impairment

44
Q

Tylenol

Pregnancy Category

A

Category B

45
Q

Tylenol

Drug Interactions

A

patients with known allergy; No alcohol

46
Q

Tylenol

Toxicity

A

Can OD, one over does your dead; administer acetylcystine(Mucomyst) as antidote

Pharm 1, Exam 2 (1 decks)

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