PAIN AND INFLAMMATORY AGENTS Flashcards by michaela gail

class of medications designed specifically to relieve pain

analgesics

How well did you know this?

Not at all

Perfectly

response to tissue injury and infection
protective mechanism

inflammation

How well did you know this?

Not at all

Perfectly

enzyme responsible for conversion of arachidonic acid intro prostaglandins

cyclooxygenase (COX)

How well did you know this?

Not at all

Perfectly

COX:

protects stomach lining
regulates blood platelets

COX-1

How well did you know this?

Not at all

Perfectly

COX:

triggers inflammation and pain

COX-2

How well did you know this?

Not at all

Perfectly

prostaglandin inhibitors
relieve pain
reduce elevated temperature
inhibits platelet aggregation
NSAIDs

anti-inflammatory agents

How well did you know this?

Not at all

Perfectly

seven groups of nsaids

salicylates
para-chlorobenzoic acid derivatives / indoles
phenylacetic acids
propionic acid derivatives
fenemates
oxicams
selective cox-2 inhibitors

How well did you know this?

Not at all

Perfectly

aspirin, also known as acetylsalicylic acid
anti-inflammatory
antiplatelet
antipyretic effects

salicylates

How well did you know this?

Not at all

Perfectly

therapeutic serum salicylate level

10-30 mg/dl

How well did you know this?

Not at all

Perfectly

toxic serum salicylate level

> 40-50 mg/dl

How well did you know this?

Not at all

Perfectly

salicylates + anticoagulants

affects blood clotting = risk for bleeding

How well did you know this?

Not at all

Perfectly

salicylates + glucocorticoids

risk for stomach ulcers / GI bleeding

How well did you know this?

Not at all

Perfectly

salicylates + oral hypoglycemic drugs

risk for low blood sugar / hypoglycemia

How well did you know this?

Not at all

Perfectly

salicylates should be taken with ___ to reduce GI upset

milk, water, or food

How well did you know this?

Not at all

Perfectly

why should salicylates not be taken by children with flu symptoms?

to avoid reye syndrome

How well did you know this?

Not at all

Perfectly

true or false: salicylates are contraindicated to pregnant women

true

How well did you know this?

Not at all

Perfectly

swelling of liver and brain

reye syndrome

How well did you know this?

Not at all

Perfectly

indomethacin / sulindac
may cause increased BP and sodium and water retention

para-chlorobenzoic acid

How well did you know this?

Not at all

Perfectly

indicated for:
- rheumatoid arthritis
- gouty arthritis
- osteoarthritis

para-chlorobenzoic acid

How well did you know this?

Not at all

Perfectly

diclofenac na
indicated for:
rheumatoid arthritis
osteoarthritis
ankylosing spondylitis

phenylacetic acid dervatives

How well did you know this?

Not at all

Perfectly

for short term management of pain
1st injectable NSAIDs
greater analgesic effect

ketorolac

How well did you know this?

Not at all

Perfectly

ibuprofens (alaxan, advil, medicol)
increase effects of warfarin, sulfonamides, cephalosporins, phenytoin, insulin, and oral hypoglycemics

propionic acid derviatives

How well did you know this?

Not at all

Perfectly

true or false: propionic acid derivates can be taken with an empty stomach because it is not irritating to the GI lining

false - it can cause gastric upset, always take with food

How well did you know this?

Not at all

Perfectly

for acute and chronic arthritic conditions
SE: gastric irritation

fenamates

How well did you know this?

Not at all

Perfectly

fenamates are contraindicated to patients with ___

peptic ulcer

- mefenamic acid (ponstel, ponstan) - meclofenamate sodium monohydrate (meclomen)

fenamates

- proxicam (feldene flash), meloxicam - for long term arthritic conditions

oxicams

SE: lower risk of GI problems, ulceration; epigastric distress should not be taken with aspirin / other NSAIDs

oxicams

drug agents: - celecoxib (celebrex) - rofecoxib (vioxx) - nabumetone (relafen)

cox-2 inhibitors

- not to be taken during 3rd trimester of pregnancy - NSAIDs in the elderly - assessment of renal function - prescribed NSAID dose may need to be decreased

cox-2 inhibitors

- suppressing and preventing many of the components of the inflammatory process at the injured site - dexamethasone, prednisone, prednisolone

corticosteroids

reduces inflammation of the joints due to increased uric acid

antigout drugs

- inhibit leukocytes on the inflamed site - SE: gastric irritation, NV, diarrhea, abd pain

colchicine

2 uric acid inhibitors

allopurinol thiazide diuretics

uric acid inhibitors - inhibits final steps of uric acid synthesis - no caffeine and alcohol - indicated gout patients with renal impairment

allopurinol

uric acid inhibitor - treats hypertension and prevent fluid retention - increase level of uric acid

thiazide diuretics

alleviates chronic gout

uricosurics

uricosurics: - increase rate of uric acid excretions in the kidneys - SE: sore gums, headache, flushed skin

probenecid

nonopioid analgesics act on ___, while opioid analgesics act on ___

PNS, CNS

unpleasant sensory and emotional experience related to tissue injury

pain

2 types of nonopioid analgesics

- NSAIDS - acetaminophen

- safe, effective analgesic and antipyretic drug used for muscular aches, pain and fever caused by viral infection - hepatotoxic - little to no GI distress

acetaminiphen

therapeutic serum range of acetaminophen

5-20 mcg/ml

antidote for acetaminophen

acetylcysteine (mucomyst)

- opioid agonists - can cause addiction - analgesia, respi depression, euphoria, and sedation

opioid analgesics

- cough suppression - antidiarrheal effect - SE: NV, constipation, decrease in BP, urinary retention, antitussive effects

opioid analgesics

- pain medicine similar to an opioid - act in the CNS to relieve pain

tramadol

___ have been reported in patients taking tramadol. risk of this is high if taking higher doses than recommended

seizures

maximum dose of tramadol

400 mg per day

tramadol usual dose TDL HCL

50 mg/cap

DOLCET components

tramadol HCL 37.5 mg paracetamol 325 mg

- AMI, CA, pulmonary edema - as pre-op medication - relieve anxiety - oral, iv, im, sq

morphine

antidote for morphine

naloxone (narcan)

nursing responsibilities for morphine

- monitor RR, BP, UO, BS - antidote at bedside - no alcohol / CNS depressants - safety

- shorter duration of action than morphine - oral, im, iv - no antitussive property

meperidine (demerol)

- less SE than morphine - neurotoxic - can decrease BP

meperidine (demerol)

- more potent than morphine - faster onset, shorter duration of action than morphine - oral, rectal, sq, im, iv

hydromorphone

what should be done to hydromorphone to reduce risk of withdrawal synrome?

SIVP - slow IV push

what are the symptoms associated with withdrawal syndrome?

irritability diaphoresis muscle twitching increased PR and BP

preventive treatment for headaches: migraine and cluster

- beta-adrenergic blockers - anticonvulsant - tricyclic antidepressants

treatment / cessation of attack for headaches: migraine and cluster

opioid analgesics ergot alkaloids selective serotonin

long acting opioid analgesics medications for round the clock for acute and chronic pain

oxycontin

immediate acting opioid analgesic medications for breakthrough pain

oxynorm

- oxycodone + naloxone - for the management of moderate too severe chronic pain unresponsive to non-narcotic analgesia - treatment / prophylaxis of opioid-induced constipation

targin

- powerful opioid used as a pain medication and together with other medications for anesthesia - 50-100 x more potent than morphine - available in transdermal patch and ampule

fentanyl

PAIN AND INFLAMMATORY AGENTS Flashcards

(65 cards)