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NR-NUR124 | Pharmacology > [5] MIDTERM | ANALGESICS & ANTI-INFLAMMATORY AGENTS > Flashcards

[5] MIDTERM | ANALGESICS & ANTI-INFLAMMATORY AGENTS Flashcards

1
Q

Are a class of medications designed specifically to relive pain

A

Analgesics

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2
Q

ANALGESICS

This includes ____ analgesics or by prescription when combined with another drug, and ____, which are only available by prescription

A

This includes over the counter (OTC) analgesics or by prescription when combined with another drug, and opiods (narcotics), which are only available by prescription

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3
Q

1-3 Mild Pain: ____
4-7 Moderate Pain: ____
8-10: ____

A

1-3 Mild Pain: Acetaminophen or Paracetamol
4-7 Moderate Pain: NSAIDs
8-10: Morphine or Tramadol

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4
Q

NSAIDS
N - ____ (for bones; arthritis)
S - ____ (e.g. Aspirin)
A - ____ (e.g. Paracetamol)
I - ____ (e.g. Alaxan FR) / ____ (for PDA)
D - ____ (e.g. Mefenamic Acid)

A

NSAIDS
N - Naproxen Sodium (for bones; arthritis)
S - Salicylates (e.g. Aspirin)
A - Acetaminophen (e.g. Paracetamol)
I - Ibuprofen (e.g. Alaxan FR) / Indomethacin (for PDA)
D - Diclofenac (e.g. Mefenamic Acid)

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5
Q

OPIODS, MORPHINE SOLUTION, TRAMADOL: WOF ____ AND ____

A

OPIODS, MORPHINE SOLUTION, TRAMADOL: WOF CNS AND RESPIRATORY DEPRESSION

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6
Q
  • Response to tissue injury and infection
  • Protective mechanism
  • Other causes: trauma, surgical
  • interventions, extreme hot and cold, and caustic chemical agents.
A

Inflammation

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7
Q

INFLAMMATION

TISSUE INJURY -> ____ & ____

A

TISSUE INJURY -> VASOCONSTRICTION & RELEASE OF CHEMICAL MEDIATORS

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8
Q

INFLAMMATION

EXAMPLES OF CHEMICAL MEDIATORS

A

HISTAMINE, KININS, PROSTAGLANDIN

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9
Q

INFLAMMATION

RELEASE OF CHEMICAL MEDIATORS
1. ____ -> Redness, Erythema
2. ____ -> Swelling Edema
3. ____ - Pain
4. ____ - Heat

A

RELEASE OF CHEMICAL MEDIATORS
1. VASODILATION -> Redness, Erythema
2. INC. CAPILLARY PERMEABILITY -> Swelling Edema
3. PAIN - Pain
4. FEVER - Heat

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10
Q

INFLAMMATION

ERYTHEMA, SWELLING EDEMA, PAIN, AND HEAT -> ____

A

ERYTHEMA, SWELLING EDEMA, PAIN, AND HEAT -> LOSS OF FUNCTION

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11
Q

Enzyme responsible for
conversion of arachidonic acid
into prostaglandins

A

CYCLOOXYGENASE (COX)

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12
Q
  • Protects stomach lining
  • Regulates blood platelets
A

COX-1

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13
Q
  • Triggers inflammation and pain
A

COX-2

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14
Q
  • Relieve pain (analgesic)
  • Reduce elevated body temperature (antipyretic)
  • Inhibit platelet aggregation (anticoagulant)
  • Prostaglandin Inhibitors
  • NSAIDs
A

ANTIINFLAMMATORY AGENTS

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15
Q

SEVEN GROUPS OF NSAIDs

A
  1. Salicylates
  2. Para-Chlorobenzoic Acid derivatives or indoles
  3. Phenylacetic Acids
  4. Propionic Acid derivatives
  5. Fenamates
  6. Oxicams
  7. Selective Cox-2 inhibitors
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16
Q

Aspirin, also known as acetylsalicylic acid (ASA)

A

SALICYLATES

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17
Q

SALICYLATES

Functions:
* A____
* A____
* A____

Therapeutic serum salicylate level: ____ mg/dl
Toxic serum salicylate level: ____ mg/dl

A

Functions:
* Anti-inflammatory
* Antiplatelet
* Antipyretic effects

Therapeutic serum salicylate leve0: 10–30 mg/dl
Toxic serum salicylate level: >40–50 mg/dl

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18
Q

ANTICOAGULANTS SHOULD NOT BE GIVEN DURING ____

A

ANTICOAGULANTS SHOULD NOT BE GIVEN DURING BLEEDING

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19
Q

SALICYLATES

Drug Interactions:
* A____
* G____
* O_____

Hypersensitivity to salicylate products: ____, vertigo, _____

A

Drug Interactions:
* anticoagulants
* glucocorticoids
* oral hypoglycemic

Hypersensitivity to salicylate products: tinnitus, vertigo, bronchospasm

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20
Q

SALICYLATES

GI UPSET
* Should be taken with ____, WATER OR FOOD

REYE SYNDROME
* Not be taken by children with ____ symptoms

C/I: ____

A

GI UPSET
* Should be taken with MILK, WATER OR FOOD

REYE SYNDROME
* Not be taken by children with flu symptoms

C/I: PREGNANCY

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21
Q

It is an extremely serious pathological condition associated with swelling of liver and brain

A

REYE SYNDROME

22
Q

REYE SYNDROME

  • ____ - lethargy, confusion, seizures, coma
  • ____ - Tiredness, Nausea, Elevated AST, Elevated ALT
A
  • Encephalopathy - lethargy, confusion, seizures, coma
  • Liver Damage - Tiredness, Nausea, Elevated AST, Elevated ALT
23
Q

PARA-CHLOROBENZOIC ACID

  • ____
  • ____

Indications:
* R____
* G____
* O____

May cause Increased BP and sodium & water retention

A
  • **Indomethacin (Indocin)
  • Sulindac (Clinoril)**

Indications:
* Rheumatoid arthritis
* Gouty arthritis
* Osteoarthritis

May cause Increased BP and sodium & water retentio

24
Q

PHENYLACETIC ACID DERIVATIVES

  • ____

Indications:
* R____
* O____
* A____

A
  • Diclofenac Na (Voltaren)

Indications:
* Rheumatoid Arthritis
* Osteoarthritis
* Ankylosing spondylitis

25
Q

PHENYLACETIC ACID DERIVATIVES

  • short term management of pain
  • 1st injectable NSAIDs
  • Greater analgesic effect
  • ANST
A

KETOROLAC

26
Q

PROPIONIC ACID DERIVATIES

  • ____
  • Drug interactions: increase effects of ____, sulfonamides, certain cephalosporin, ____, insulin, ____
  • Side effects: gastric upset (to be
    taken with food)
A
  • Ibuprofens (Alaxan, Advil and Medicol)
  • Drug interactions: increase effects of warfarin, sulfonamides, certain cephalosporin, phenytoin, insulin, oral hypoglycemic
  • Side effects: gastric upset (to be
    taken with food)
27
Q

FENAMATES

  • ____
  • ____

Indications:
* Acute & chronic ____ conditions

SE: Gastric irritation

Contraindication:
* patient with ____

A
  • Mefenamic Acid (Ponstel) (Ponstan)
  • Meclofenamate Na Monohydrate (Meclomen)

Indications:
* Acute & chronic arthritic conditions

SE: Gastric irritation

Contraindication:
* patient with peptic ulcer

28
Q

PAIN MEDICATION ADMINISTRATION: WOF ____ AND ____ FUNCTION

A

PAIN MEDICATION ADMINISTRATION: WOF LIVER AND KIDNEY FUNCTION

29
Q

OXICAMS

  • ____
  • ____

Indication:
* ____ arthritic conditions

  • S/E: lower incidence of gastric problems; ____; ____ distress
  • Should NOT BE taken with ____; other NSAIDs
A
  • Piroxicam (Feldene Flash),
  • Meloxicam

Indication:
* Long term arthritic conditions

  • S/E: lower incidence of gastric problems; ulceration; epigastric distress
  • Should NOT BE taken with aspirin; other NSAIDs
30
Q

COX-2 INHIBITORS

Drug agents
* C____
* R____
* N____

A

Drug agents
* Celecoxib (Celebrex)
* Rofecoxib (Vioxx)
* Nabumetone (Relafen)

31
Q

COX-2 INHIBITORS

Caution: not to be taken during
____ trimester of pregnancy
* NSAIDs in the ____
* Assessment of ____ function
* Prescribed NSAID dose may need to be decreased

A

Caution: not to be taken during third
trimester of pregnancy
* NSAIDs in the elderly
* Assessment of renal function
* Prescribed NSAID dose may need to be decreased

32
Q
  • Suppressing and preventing many of the components of the inflammatory process at the injured site.
  • Dexamethasone
  • Prednisone
  • Prednisolone
A

CORTICOSTEROIDS

33
Q

EXAMPLES OF CORTICOSTEROIDS

A
  • Dexamethasone
  • Prednisone
  • Prednisolone
34
Q

COMMON SIDE EFFECTS OF STEROIDS: INCREASED ____

STEROIDS CAN ALSO BE USED FOR ____ DISORDERS

PROLONG USED OF STEROID RESULT IN DECREASED ____

A

COMMON SIDE EFFECTS OF STEROIDS: INCREASED APPETITE

STEROIDS CAN ALSO BE USED FOR AUTO-IMMUNE DISORDERS

PROLONG USED OF STEROID RESULT IN DECREASED IMMUNITY

35
Q
  • Inflammation of the joints
  • Uric Acid
A

ANTIGOUT DRUGS

36
Q

ANTIGOUT DRUGS

  • For Acute Gout Attack
  • ____ - inhibit leukocytes on the inflamed site
  • Gastric irritation
  • ____
  • Diarrhea
  • ____ pain
A
  • For Acute Gout Attack
  • Colchicine - inhibit leukocytes on the inflamed site
  • Gastric irritation
  • NV
  • Diarrhea
  • Abdominal pain
37
Q

ANTIGOUT DRUGS - URIC ACID INHIBITOR

____:

  • Inhibit final steps of uric acid synthesis
  • No caffeine and alcohol
  • Indicated gout patients with renal impairment

____:

  • Increase level of uric acid
A

Allopurinol:

  • Inhibit final steps of uric acid synthesis
  • No caffeine and alcohol
  • Indicated gout patients with renal impairment

Thiazide diuretics (e.g. Hydrochlorothiazide):

  • Increase level of uric acid
38
Q

ANTIGOUT DRUGS - URIC ACID INHIBITOR

____:
* Alleviating chronic gout

____:
* Increase rate of uric acid excretions in the kidneys.
* SE: Sore gums, headache, flushed skin

A

Uricosurics:
* Alleviating chronic gout

Probenecid:
* Increase rate of uric acid excretions in the kidneys.
* SE: Sore gums, headache, flushed skin

39
Q

ANALGESICS

  • ____ – acts on PNS
  • ____ – acts on CNS
A
  • NONOPIOID – acts on PNS
  • OPIOID – acts on CNS
40
Q

Unpleasant sensory and emotional experience related to tissue injury

A

PAIN

41
Q

Relief of Pain

A

ANALGESIC

42
Q

NONOPIOD ANALGESICS - NSAIDs

____:
* Safe, effective analgesic and antipyretic drug used for muscular aches, pains and fever caused by viral infections

  • ____; little to no GI distress
  • Therapeutic serum range: ____ mcg/ml
  • ANTIDOTE: ____
A

ACETAMINOPHEN:
* Safe, effective analgesic and antipyretic drug used for muscular aches, pains and fever caused by viral infections

  • Hepatotoxic; little to no GI distress
  • Therapeutic serum range: 5- 20 mcg/ml
  • ANTIDOTE: ACETYLCYSTEINE
    (MUCOMYST)
43
Q

OPIOD ANALGESICS
* Opioid ____

  • Can cause addiction
  • Analgesia, ____, euphoria, and ____
  • ____ suppression
  • ____ effect
  • S/E: nausea, vomiting, constipation, decrease in ____, urinary retention, ____ effects
A

OPIOD ANALGESICS
* Opioid agonists

  • Can cause addiction
  • Analgesia, respiratory depression, euphoria, and sedation
  • Cough suppression
  • Antidiarrheal effect
  • S/E: nausea, vomiting, constipation, decrease in BP, urinary retention, antitussive effects
44
Q

OPIOD ANALGESICS

____:
* Pain medicine similar to an opioid. It acts in the ____ to relieve pain.

  • ____ have been reported in patients taking tramadol. The risk is higher if you are taking higher doses than recommended.
  • Maximum dose: ____ mg per day.
  • Tramadol ( TDL HCL) ____ mg/cap
  • Tramadol HCL ____ mg, Paracetamol 325 mg ( ____ )
A

TRAMADOL:
* Pain medicine similar to an opioid. It acts in the central nervous system (CNS) to relieve pain.

  • Seizures have been reported in patients taking tramadol. The risk is higher if you are taking higher doses than recommended.
  • Maximum dose: 400 mg per day.
  • Tramadol ( TDL HCL) 50 mg/cap
  • Tramadol HCL 37.5 mg, Paracetamol 325 mg (DOLCET)
45
Q

OPIOD ANALGESICS

____:
* ____ (AMI), CA, ____ edema

  • As pre op medication - relieve ____
  • Oral; IV; IM; SUBQ
  • ANTIDOTE: ____

Nursing responsibilities:
* Monitor RR, BP, UO, BS

  • Antidote at bedside
  • No ____ / ____
  • Safety
A

MORPHINE SULFATE:
* Acute Myocardial Infarction (AMI), CA, pulmonary edema

  • As pre op medication - relieve anxiety
  • Oral; IV; IM; SUBQ
  • ANTIDOTE: NALOXONE (NARCAN)

Nursing responsibilities:
* Monitor RR, BP, UO, BS

  • Antidote at bedside
  • No alcohol / CNS depressants
  • Safety
46
Q

OPIOD ANALGESICS

____:
* Shorter duration of action than Morphine

  • Oral, IM, IV
  • No ____ property
  • Less S/E than morphine
  • ____
  • Can decrease ____
A

MEPERIDINE (DEMEROL):
* Shorter duration of action than Morphine

  • Oral, IM, IV
  • No antitussive property
  • Less S/E than morphine
  • Neurotoxic
  • Can decrease BP
47
Q

OPIOD ANALGESICS

____:
* More potent than morphine

  • ____ onset, ____ duration of action than Morphine
  • Oral, rectal, subcutaneous, IM, IV
  • ____ (SIVP)
  • ____ – irritability, diaphoresis, muscle twitching, increase in PR and BP
A

HYDROMORPHONE:
* More potent than morphine

  • Faster onset, shorter duration of action than Morphine
  • Oral, rectal, subcutaneous, IM, IV
  • Slow IV Push (SIVP)
  • Withdrawal syndrome – irritability, diaphoresis, muscle twitching, increase in PR and BP
48
Q

HEADACHES: MIGRAINE & CLUSTER
Preventive treatment:
* Beta-adrenergic blockers ( ____ & ____ )
* Anticonvulsant ( ____ & ____ )
* TCA ( ____ & ____ )

Treatment/ cessation of attack:
* Opioid analgesics
* ____
* Selective serotonin ( ____ )

A

HEADACHES: MIGRAINE & CLUSTER
Preventive treatment:
* Beta-adrenergic blockers (Propranolol & Atenolol)
* Anticonvulsant (Valproic Acid & Gabapentin)
* TCA (amitriptyline & imipramine)

Treatment/ cessation of attack:
* Opioid analgesics
* Ergot alkaloids
* Selective serotonin (Triptans)

49
Q

OPIOD ANALGESICS

____:
* Oxycontin- long acting opioid analgesic medications for round the clock for acute and chronic ____.

  • ____- immediate acting opioid analgesic medications for breakthrough pain.
  • Available in oral and IV
  • ____ – this is for the management of moderate to severe chronic pain unresponsive to non-narcotic analgesia. Treatment and /or Prophylaxis of OPIOID-Induced constipation.
A

OXYCODONE:
* Oxycontin- long acting opioid analgesic medications for round the clock for acute and chronic pain.

  • Oxynorm- immediate acting opioid analgesic medications for breakthrough pain.
  • Available in oral and IV
  • TARGIN - (Oxycodone + Naloxone) – this is for the management of moderate to severe chronic pain unresponsive to non-narcotic analgesia. Treatment and /or Prophylaxis of OPIOID-Induced constipation.
50
Q

OPIOD ANALGESICS

____:
* Powerful opioid used as a pain medication and together with other medications for anesthesia.

  • ____ to ____ times more potent than Morphine
  • Available in Transdermal patch and Ampule
  • For example of transdermal - ____
  • For example of ampule - ____
A

FENTANYL:
* Powerful opioid used as a pain medication and together with other medications for anesthesia.

  • 50 to 100 times more potent than Morphine
  • Available in Transdermal patch and Ampule
  • For example of transdermal - Durogesic D- Trans
  • For example of ampule - Hospira Fentanyl Citrate

NR-NUR124 | Pharmacology (10 decks)

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