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nurs 252 > Anti-gout and anti inflammatory > Flashcards

Anti-gout and anti inflammatory Flashcards

1
Q

Inflammation

A

Protective response stimulated by injury to tissues

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2
Q

NSAID properties

A

Analgesic
Anti-inflammatory
Antipyretic
Aspirin caused platelet inhibition (only in aspirin

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3
Q

Uses of NSAIDs

A

Relief of mild to moderate headaches
Relief of myalgia
Relief of neuralgia
Relief of arthralgia
Relief of postoperative pain
Relief of pain associated with arthritic disorders such as rheumatoid arthritis, juvenile arthritis, ankylosing spondylitis, and osteoarthritis
Treatment of gout and hyperuricemia

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4
Q

Salicylates

A

Aspirin

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5
Q

Acetic acid derivatives

A
  • Diclofenac Sodium
  • Indomethacin sulindac
  • Ketorolac
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6
Q

Cyclo-oxygenase (COX-2) inhibitors

A

Celecoxib

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7
Q

Propionic acid dereviatives

A

Ibuprofen and naproxen

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8
Q

Types of NSAIDs

A

Salicylates
Acetic acid derivatives
Cyclo-oxygenase (COX)-2 inhibitors
Enolic acid derivatives
Propionic acid derivatives

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9
Q

What is aspirin used for (heart)

A

Reduce cardiac death after MI, given at the first sign of an MI

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10
Q

NSAID MOA

A

Stops the leukotriene pathway, prostaglandin pathway or both. Blocking the chemical activity of the COX enzyme

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11
Q

What does COX-1 enzyme

A

Maintains the GI mucosa

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12
Q

What does COX2 do

A

Promotes synthesis of prostaglandins involved in the inflammatory process

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13
Q

MOA of aspirin

A

Irreversible inhibitor of COX-1 receptors in the platelets causing antiplatelet activates.

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14
Q

Which NSAID has antiplatelet activities

A

Aspirin is the only one

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15
Q

Contraindications of NSAIDS

A

Drug allergies and conditions that place the patient at risk for bleeding (rhinitis, vit k deficiency, peptic ulcer disease)

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16
Q

NSAID adverse effects

A

Heartburn to severe GI bleeding
Acute kidney injury
Noncardiogenic pulmonary edema
Altered hemostasis
Hepatotoxicity
Skin eruption, sensitivity reaction
Tinnitus, hearing loss

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17
Q

What is misoprostol

A

helps reduce adverse effects of NSAIDs (inactivation of prostaglandins).
- Helps prevent GI bleeds
- Inhibits gastric acid secretion and has a cytoprotective component
-CI in pregnancy

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18
Q

How does NSAID affect kidney function

A
  • Through the disruption of prostaglandins causing kidney injury/failure
  • Kidney toxicity can occur with patients with dehydration, heart failure, or liver dysfunction, or with the use of diuretics or angiotensin-converting enzyme inhibitors
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19
Q

Salicylates forms

A
  • acetylsalicylic acid (aspirin) the most common
  • Oral (tablets, capsules), topical cream (Aspercreme®), oral liquids, rectal suppositories
  • aspirin–antacid combinations (Alka-Seltzer®)
  • Enteric-coated aspirin (Praxis ASA EC®)
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20
Q

What can aspirin cause

A

Reye’s syndrome

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21
Q

Dosage of aspirin

A

81-325 mg and both effectively prevent thrombotic events

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22
Q

What is aspirin used for (not heart)

A

Headache, neuralgia, myalgia, and arthralgia
Pain syndromes resulting from inflammation: arthritis, pleurisy, and pericarditis
Systemic lupus erythematosus: antirheumatic effects
Antipyretic action

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23
Q

Why does aspirin help systemic lupus erythematosus

A

Because of its antirheumatic effects

24
Q

How does reye’s syndrome occur

A

Triggered by viral illnesses and when one takes salicylate with the presences of a viral illness

25
Q

What is reye’s syndrome

A

Progressive neurological deficits that can lead to coma and may involve live damage. May cause permanent neurological damage

26
Q

Salicylate toxicity aka…

A
  • salicylism
    Increased heart rate
    Tinnitus, hearing loss, dimness of vision, headache, dizziness, mental confusion, drowsiness
    Nausea, vomiting, diarrhea
    Sweating, thirst, hyperventilation, hypoglycemia or hyperglycemia
27
Q

Indomethacin properties

A

Analgesic, anti inflammatory, antirheumatic and antipyretic properties that

28
Q

Uses of indomethacine

A

RA, osteoarthritis, acute bursitis or tendonitis

29
Q

Ketorolac tromethamine

A
  • Some anti-inflammatory properties
  • Mostly an analgesic
30
Q

Indication of Ketorolac tromethamine

A

Used for short term use (up to 5-7 days) to manage pain

31
Q

Adverse effects of ketorolac tromethamine

A

kidney impairment, edema, GI pain, dyspepsia, and nausea

32
Q

Propionic acid derivatives Ibuprofen uses

A

Uses: analgesic, management of RA, osteoarthritis, dysmenorrhea, dental pain, MSK disorder and antipyretic

33
Q

Propionic acid derivatives Naproxen uses

A
  • A little better than adverse effects of ibuprofen
  • Few drug interactions of ACE< and hypertension
34
Q

COX-2 inhibitor:Celecoxib

A
  • Only COX-1 inhibitor, used for osteoathritus, RA, acute pain sympotms, ankylosing spondylitis, and primary dysmenorrhea, little effect on platelet function
  • Not to be used in patient siwht a known sulpha allergy
35
Q

Nabumetone compared to other GI adverse events and some NSAID…

A

Nabumetone is better

36
Q

NSAID adverse effects GI

A

Dyspepsia, heartburn, epigastric distress, nausea, vomiting, anorexia, abdominal pain
GI bleeding*
Mucosal lesions* (erosions or ulcerations)

37
Q

Misoprostol on NSAID GI adverse effects

A

Misoprostol can be used to reduce adverse effects.

38
Q

Misoprostol on NSAID Renal adverse effects

A

Reduction in creatinine clearance, acute tubular necrosis with acute kidney injury

39
Q

Misoprostol on NSAID cardiovascular adverse effects

A

Noncardiogenic pulmonary edema

40
Q

NSAID interactions

A

Alcohol
Anticoagulants
acetylsalicylic acid (ASA)
Biphosphonates
Corticosteroids and other ulcerogenic medications
Protein-bound drugs
Diuretics and angiotensin-converting enzyme inhibitors
Other drugs

41
Q

What is Gout

A

Underexcretion or overexcretion(hyperuricemia) of uric acid causing uric acid to deposited in tissues, joints causing pain

42
Q

Antigout drugs

A

Allopurinol, colchicine, probenecid

43
Q

Indications of allpurinol

A

Prevent uric acid production and prevent acute tumour lysis syndrome

44
Q

Side effects of allopurinol

A

exfoliative dermatitis, Stevens-Johnson syndrome, and toxic epidermal necrolysis

45
Q

Indication ofProbenecid

A

Inhibits reabsorption of uric acid in the kidneys and thus getting rid of more uric acid

46
Q

Indications of Colchicine

A
  • Reduces inflammatory response to the deposits of urate crystals in joint tissue
  • Also may cause short term leukopenia as it can inhibit mitosis
47
Q

Dose of colchicine and why

A

Dose of 0.6mg once or twice a day for prophylaxis of acute attacks

48
Q

how do you take colchicine

A

on empty stomach

49
Q

Herbal products

A

Glucosamine and chondroitin

50
Q

Glucosamine and chondroitin use

A

Treat pain of osteoarthritis

51
Q

Glucosamine Adverse effects

A

Gi discomfort, drowsiness, headache, skin reactions

52
Q

Chondroitin adverse effect:

A

GI discomfort (normally well tolerated)

53
Q

Drug interactions of glucosamine and chondroitin

A
  • Enhances effects of warfarin
  • Glucosamine may increase insulin resistance
54
Q

Why shouldn’t one give salicylates to children and teenagers

A

May risk reye’s syndrome

55
Q

How long may till occur therapeutic effects

A

1 week or more

56
Q

What should patients watch for when on NSAIDs

A

nurs 252 (23 decks)

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