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Pharmacology Exam #3 > Pain and Inflammation > Flashcards

Pain and Inflammation Flashcards

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1
Q

What are NSAIDs?

A

Nonsteroidal Anti-inflammatory Drugs

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2
Q

What do first generation and second generation NSAIDs block?

A
  • First generation NSAIDS: Block COX-1 and COX-2
  • Second generation NSAIDs: Block only COX-2
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3
Q

aspirin (ASA): class

A

first generation NSAIDS cox-1 & cox-2 inhibitor

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4
Q

aspirin (ASA): Use

A

Relieves mild to moderate pain, fever, inflammation, dysmenorrhea and reduces the risk of TIAs, CVAs and MIs

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5
Q

aspirin (ASA): EPA

A
  • Inhibits the actions of COX-1 & COX-2
  • Analgesic-acts both centrally and peripherally to block pain impulses
  • Antipyretic-reduces fever by acting on the hypothalamus
  • Antiplatelet-suppress platelet aggregation, blocks the synthesis of thromboxane A2
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6
Q

aspirin (ASA): administration

A

baby dose - 81 mg
adult dose - 325 mg

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7
Q

aspirin (ASA): ADRs

A

Nausea, epigastric discomfort, heartburn, GI bleed and hemorrhage, petechiae and bruising, acute toxicity, salicylism

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8
Q

What is acute toxicity of Aspirin?

A

Metabolic acidosis, respiratory failure, renal failure and cardiac collapse.

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9
Q

What is salicylism?

A

toxicity due to chronic use of aspirin Characterized by dizziness, tinnitus and mental confusion

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10
Q

aspirin (ASA): contraindications

A

Known risk for bleeding
Pregnancy-teratogenic
Anyone 18 years of age or less should not take b/c of risk of Reye’s Syndrome
BLACK BOX WARNING

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11
Q

aspirin (ASA): BLACK BOX WARNING

A

Children or teenagers should not take b/c of risk of Reye’s Syndrome

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12
Q

aspirin (ASA): RN Interventions

A

Take with food or after meals
Watch for bleeding or hearing loss
Avoid alcohol
Avoid aspirin for approx. 1 weeks before or after major surgeries or dental procedures

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13
Q

ibuprofen (Advil & Motrin): class

A

first generation NSAIDS (cox 1 and cox 2 inhibitor

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14
Q

ibuprofen (Advil & Motrin): other medication

A

naproxen (Aleve) & ketorolac (Toradol)-given IV

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15
Q

ibuprofen (Advil & Motrin): Use

A

Relieves mild to moderate pain, fever, inflammation, dysmenorrhea.

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16
Q

ibuprofen (Advil & Motrin): EPA

A

Inhibits the actions of COX-1 & COX-2, but slightly more selective with COX-2.

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17
Q

ibuprofen (Advil & Motrin): ADR

A

GI effects-dry mouth, nausea, heartburn and GI ulceration with blood loss, nephrotoxic (Kidney)!!

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18
Q

ibuprofen (Advil & Motrin): Contraindications

A

Known risk for bleeding
Pregnancy-teratogenic
Renal disease
BLACK BOX WARNING

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19
Q

ibuprofen (Advil & Motrin): BLACK BOX WARNING

A

Should not be given to patients after coronary artery bypass surgery to treat pain

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20
Q

ibuprofen (Advil & Motrin): RN Interventions

A

Take with food
Drink 2 to 3 courts of fluid daily
Watch for bleeding
Avoid alcohol

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21
Q

celecoxib (celebrex): class

A

second generation NSAIDS cox-2 inhibitor

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22
Q

celecoxib (celebrex): Use

A

Given to treat swelling in joints caused by (RA and OA) by suppressing inflammation.

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23
Q

celecoxib (celebrex): EPA

A

Inhibits COX-2 enzyme to decrease inflammation, it does not affect the COX-1 enzyme, thus protecting the lining of the GI tract and not inhibiting clotting factors.

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24
Q

celecoxib (celebrex): ADR

A

Gastric upset, kidney dysfunction, cardiovascular & cerebrovascular events, BLACK BOX WARNING

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25
celecoxib (celebrex): BLACK BOX WARNING
increased risk for MI and CVA
26
celecoxib (celebrex): contraindications
Kidney disease Anyone with known bleeding disorder Allergy to sulfa or sulfonamides Hx of CVA or MI - Recent CABG surgery
27
celecoxib (celebrex): RN Interventions
- Give with food - Give 2 hr before or after magnesium-or aluminum-based antacids - Report chest pain or symptoms of a CVA.
28
acetaminophen (Tylenol): class
Nonopioid Analgesics
29
acetaminophen (Tylenol): EPA
To reduce fever, acts directly on hypothalamus to increase vasodilation and sweating. Inhibits COX to decrease pain but has no anti-inflammatory or anticoagulant effects.
30
acetaminophen (Tylenol): Use
reduce fever and decrease minor pain
31
acetaminophen (Tylenol): administration
DO NOT exceed 4000mg in 24 hours 325 mg tablets - Adult dose: 325-650 mg 500 mg tablets (extra strength)
32
acetaminophen (Tylenol): ADR
hepatotoxicity and HTN
33
acetaminophen (Tylenol): contraindications
alcohol use disorder, liver and kidney disease
34
acetaminophen (Tylenol): RN Intervention
do not exceed recommended dose, have BP checked regularly
35
tramadol (Ultram): class
centrally acting nonopioid
36
tramadol (Ultram): Use
treat moderate to moderately severe pain
37
tramadol (Ultram): EPA
Binds to select opioid receptors and blocks reuptake of norepinephrine and serotonin in the CNS
38
tramadol (Ultram): ADR
sedation, dizziness, and resp. depression is rare
39
tramadol (Ultram): contraindication
seizure disorder, respiratory depression
40
tramadol (Ultram): RN Intervention
Take with food Take med only when needed and for short-term Do not take prior to driving or activities that require mental awareness
41
What are the different opioid receptors in the body?
- Mu receptor: feelings of euphoria, respiratory depression, dependence, & sedation - Kappa receptor: pupil constriction, total sedation, dysphoria - Delta receptor: enables body to feel pain relief
42
morphine: class
opioid agonists
43
morphine: other medications
fentanyl, codeine, oxycodone, & methadone
44
Methadone EPA and Use
Methadone-chemically like morphine but blocks the euphoric effects of opioids and reduces cravings. Used to treat Opioid Use Disorder (OUD).
45
morphine: use
treat moderate to severe pain
46
morphine: EPA
Mimics the action of naturally occurring opioids, endorphins, and enkephalins. Does this by binding with the mu receptors at the opioid receptor sites. Stimulation of these receptors causes analgesia, sedation, euphoria, and respiratory depression.
47
morphine: ADR
lightheadedness, dizziness, constipation, and potential for abuse along with tolerance. M: miosis O: out of it R: respiratory depression P: pneumonia (aspiration/ cough suppression) H: hypotension I: Infrequent stools N: Nausea E: euphoria
48
morphine: contraindications
Resp. depression Pregnancy Older adults, infants Hepatic or kidney disease
49
morphine: RN Interventions
- Antidote: naloxone (Narcan) - Monitor respiratory status - Schedule II controlled substance - Take med only when needed and for short-term - Do not take prior to driving or activities that require mental awareness - Change positions gradually - Encourage bowel meds
50
buprenorphine (Buprenex): class
opioid agonist- antagonist
51
buprenorphine (Buprenex): Use
Analgesia for moderate to severe pain. Anesthesia adjunct. Also used to treat Opioid Use Disorder (OUD)
52
buprenorphine (Buprenex): EPA
Mu receptor antagonists and kappa receptor agonists. Fewer mu-related adverse effects, such as resp. depression, euphoria, and dependence. Produces milder analgesic effects.
53
buprenorphine (Buprenex): ADR
Respiratory depression (limited), nausea, constipation, increased cardiac workload.
54
buprenorphine (Buprenex): contraindications
Resp. depression Acute MI Hepatic or kidney disease
55
buprenorphine (Buprenex): RN Interventions
- Antidote: naloxone (Narcan)*May need repeated doses - Monitor respiratory status - Schedule IV controlled substance - Take med only when needed and for short-term - Do not take prior to driving or activities that require mental awareness - Change positions gradually
56
naloxone (Narcan): class
opioid antagonists
57
naloxone (Narcan): Use
Reversal of opioid effects, overdose
58
naloxone (Narcan): EPA
Block opioid receptors, effectively reversing or antagonizing the effects of opioids.
59
naloxone (Narcan): ADR
Ventricular arrythmias, increase in HR and RR, can cause withdrawal symptoms (HTN, vomiting, & tremors)
60
naloxone (Narcan): Contraindications
Opioid dependence Cardiac irritability
61
naloxone (Narcan): RN Interventions
Monitor vital signs Be aware-drug can increase pain because it is reversing the opioid effects Prepare to administer every 2 to 3 minutes until reversal of undesirable effects. Observe for nausea, vomiting, tachycardia, and diaphoresis (indications of opioid reversal)
62
allopurinol (zyloprim): class
antigout/antihyperuricemic
63
allopurinol (zyloprim): other medication
colchicine
64
allopurinol (zyloprim): use
Management of the signs and symptoms of gout to reduce uric acid concentrations
65
allopurinol (zyloprim): EPA
Inhibits the enzyme that is responsible for the conversion of purines to uric acid, therefore reducing uric acid production.
66
allopurinol (zyloprim): ADR
GI disturbances (N/V/D), bone marrow depression, and agranulocytosis.
67
allopurinol (zyloprim): Contraindications
Interferes with warfarin (Coumadin) Bone marrow depression Liver or kidney dysfunction
68
allopurinol (zyloprim): RN Intervention
- Take after meals to ensure absorption - Ingest at least 3L/day of fluid - Report decreased urine output or cloudy urine, which could be signs of a uric acid stone formation - Low purine diet, avoid: beer, alcohol, meat, sardines, anchovies, scallops, asparagus, spinach, peas

Pharmacology Exam #3 (10 decks)

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