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Undeleted > 1 Anti-inflammatory (non-opioid) > Flashcards

1 Anti-inflammatory (non-opioid) Flashcards

1
Q

pain threshold

A

level of stimulus needed to create painful sensation

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2
Q

pain tolerance

A

amount of pain a person can endure without having it interfere with normal functioning

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3
Q

analgesic

A

prescribed for the relief of pain

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4
Q

opioid aka

A

narcotic aka

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5
Q

acute pain

A

mild, moderate, severe

typically associated with specific tissue injury

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6
Q

chronic pain

A

vague origin, onset with prolonged duration

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7
Q

nociceptor pain

A

pain originating from tissue injury

somatic and visceral pain

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8
Q

somatic pain

A

bone & muscle

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9
Q

visceral pain

A

organ

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10
Q

neuropathic pain

A
  • unusual sensory disturbance often involving neural supersensitivity
  • due to injury or disease of the peripheral or central nervous system
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11
Q

antipyretic effect

A

lowers elevated body temperature

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12
Q

OTC NSAIDS (x3)

A

aspirin
ibuprofen
naproxen

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13
Q

aspirin contraindications

A
  • contraindicated for any elevated temperature, due to danger of Reye’s Syndrome
  • children under 2yo (or 12 yo according to book?!)
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14
Q

Reye’s Syndrome

A
  • childhood illness associated with ASA
  • neurologic problems (encephalopathy, liver degeneration) associated with viral infection treated with salicylates

DON’T GIVE ASPIRIN TO CHILDREN UN

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15
Q

Inhibition of COX-1

A

Decreases protection of stomach lining

Decrease platelet aggregation

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16
Q

Inhibition of COX-2

A

Decreases inflammation and pain

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17
Q

Cyclooxygenase

A

Converts arachadonic acid into prostaglandins and their products

  • promotes thromboxane synthesis
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18
Q

Prostaglandin effects

A
  • activation of inflammatory response
  • fever
  • vasodilation
  • relax smooth muscle
  • increased capillary permeability
  • sensitization of nerve cells to pain
  • proliferation of WBC to damaged tissues
  • induces labor, other reproductive processes
  • clotting and anti-coagulation
  • inhibit gastric acid synthesis, increase mucus secretion-
  • increase blood flow in kidneys
  • promote constriction of bronchi (asthma)
19
Q

Salicylic acid

A

Important active metabolite of aspirin (acetylsalicyclic acid -> prodrug to SA)

20
Q

Metabolite

A

Any substance produced during metabolism or may also refer to product remaining after drug is broken down

21
Q

7 groups of NSAIDs

A

FIRST GEN

  1. Salicylates
  2. Para-chlorobenzoic acid derivatives, or indoles
  3. Phenylacetic acids
  4. Propionic acid derivatives
  5. Fenamates
  6. Oxicams

SECOND GEN
7.Selective COX-2 inhibitors

22
Q

Aspirin aka

A

Acetylsalicylic acid, ASA

23
Q

Acetominophen aka x2

A

Paracetamol

APAP (N-acetyl-p-aminophenol)

24
Q

2nd generation NSAIDs

A

COX-2 inhibitors

25
Q

Good for fever

A

Aspirin, ibuprofen, acetominophen

26
Q

COX-1

A
  • protects stomach lining
  • promotes platelet aggregation
  • in all tissues
27
Q

COX-2

A

Triggers pain and inflammation

- at site of tissue injury

28
Q

5 cardinal signs of inflammation

A 
H eat
E dema
L oss of function
P ain
R edness
29
Q

NSAID effects

A
  • reversibly inhibit COX-1 and COX-2 enzymes
  • decrease formation of prostaglandin
  • inhibit chemotaxis (lymphocyte activity, neutrophil aggregation)
30
Q

NSAID indications

A
  • analgesic (CNS & peripheral effect)
  • antipyretic (CNS effect)
  • antiinflammatory (act locally)
  • antiplatelet (irreversible; CVA & MI prophylaxis - mostly COX-1 inhibitors)
31
Q

salycylism

A

aspirin toxicity

32
Q

salycylism S&S

A
  • headache
  • tinnitus
  • diaphoresis
  • disequilibrium
  • CNS alterations
  • hyperventilation s/t acid-base disturbances
  • nausea, vomiting
  • dehydration
  • cardiovascular collapse: coma, convulsions, death
33
Q

salycylism treatment

A
  • decrease absorption (charcoal, emetics, gastric lavage) ONLY EFFECTIVE IF RECENTLY INGESTED
  • supportive measures: F&E support, sodium bicarbonate
  • enhance excretion: alkalinize urine, force diuresis, hemodialysis
34
Q

ASA MOA

A

Protein bound in blood (harder to get rid of)

35
Q

Drugs to watch out for due to potential salicylism

A

Alkaseltzer
Lortab
Percodan

36
Q

Acetaminophen major metabolism pathway

A

Converts APAP to nontoxic form

37
Q

Acetaminophen minor metabolism pathway

A

CyP450 converts to toxic <— ETOH SLOWS DOWN

38
Q

APAP MOA

A

Inhibits prostaglandin in CNS

39
Q

APAP max dosage

A

10-15 mg/kg/dose

4g/day (2 if alcoholic)

40
Q

Celebrex

A

Celecoxib, COX-2 inhibitor (2nd gen NSAID)

41
Q

Celebrex indications

A

Osteoarthritis, rheumatoid arthritis

42
Q

Mucomyst

A

acetylcysteine
hepatoprotective, APAP antidote
restores glutathione

43
Q

Mucomyst indications

A
  • protect nephropathy during IV contrast procedure

- APAP overdose

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