Anti-Infammatory Drugs

Question 1

Oral Corticosteroids

Answer 1

dexamethasone - Decadron

prednisone

Question 2

Parenteral Corticosteroids

Answer 2

cortisone acetate - Cortone

Question 3

Topical Corticosteroids

Answer 3

hydrocortisone - Ala-Cort, Dermacort, Lanacort

Question 4

How do systemic corticosteroids work?

Answer 4

Decrease production of body chemicals (mediators) that trigger inflammation and slow production of WBC in bone marrow

Question 5

What are intended responses for corticosteroids?

Answer 5

Swelling at inflammation site reduced, redness and pain at site reduced, area affected by inflammation demonstrates increased function

Question 6

What are side effects of systemic corticosteroids?

Answer 6

Hypertension, acne, insomnia, nervousness, increase blood glucose level

Question 7

What are adverse effects of systemic corticosteroids?

Answer 7

Adrenal gland suppression, reduced immune function, delayed wound healing

Question 8

Before administering Corticosteroids

Answer 8

Check dose and drug name, check symptoms for infection, check patients BP and weight - corticosteroids cause sodium and water retention that leads to high BP

Question 9

After administering corticosteroids

Answer 9

Check vitals once per shift, minimize use of tape, weigh pt. for water retention

Question 10

Patient teaching for corticosteroids

Answer 10

Never stop taking suddenly, if pt is ill drug can be given parenterally, wear medical alert bracelet, take in morning - if dose is higher take 2/3 in morning and 1/3 at night, take with food

Question 11

What do topical corticosteroids do?

Answer 11

Relieve itching and skin rashes

Question 12

What do topical corticosteroids come in?

Answer 12

Creams, ointments, pastes, lotions, foams, and gels

Question 13

Patient teaching for topical corticosteroids

Answer 13

Apply thin layer just to area affected, they lower immunity in area applied, never apply to area that may be infected

Question 14

Side effects for topical corticosteroids

Answer 14

Acne, thinning of skin, changes in skin color

Question 15

NSAIDs

Answer 15

Taken for pain or inflammation - used for fever, arthritis, rheumatologic disorders, gout, systemic lupus, pain after surgery, menstural cramps, blood clots

Question 16

Common COX-1 inhibitors

Answer 16

Salicylic acid - aspirin
Propionic acid - ibuprofen, Motrin
Acetic acid - indomethacin, Indocid

Question 17

Common Cox-2 inhibitors

Answer 17

celecoxib - Celebrex

Question 18

How NSAIDs work

Answer 18

To inhibit action of COX enzyme

Question 19

COX-1

Answer 19

Enzyme found in normal cells - purpose is to help make different types of prostaglandins

Question 20

Prostaglandins

Answer 20

Chemicals made by body - some cause signs and symptoms of inflammation - help cells and tissues remain healthy and functional

Question 21

COX-2

Answer 21

Enzyme found in inflammatory cells - purpose is to help make mediators of inflammatory response

Question 22

Leukotriene

Answer 22

Chemical made by body that binds to its receptors and maintains inflammatory response

Question 23

Kinins

Answer 23

Chemical made by body that cause signs and symptoms of inflammation, especially pain - most common is bradykinin

Question 24

Intended responses for NSAIDs

Answer 24

Redness, pain, swelling, warmth, fever reduced, body function in affected area increased

Question 25

Side effects of NSAIDs

Answer 25

Bleeding problems, GI ulcers/pain, fluid retention, hypertension

Question 26

Adverse effects of NSAIDs

Answer 26

Induction of asthma, allergic reaction, kidney damage - avoided by patient with angina or high blood cholesterol levels

Question 27

Before administering NSAIDs

Answer 27

Before giving celecoxib, ask patient if allergic to sulfa antibiotics, ask if patient had problems with any other NSAID, give with full glass of water or milk, check patient BP (NSAIDs cause patient to retain sodium and water)

Question 28

After administering NSAIDs

Answer 28

Examine patients for increased bleeding, check BP, breathing pattern, O2

Question 29

Patient teaching for NSAIDs

Answer 29

Always take with food, do not chew, check BM for signs of bleeding, check for signs of bleeding, do not take aspirin, take celecoxib as prescribed

Question 30

Antihistamines

Answer 30

Reduce inflammation, end in -ine

Question 31

Common antihistamines

Answer 31

cetirizine - Zyrtec diphenhydramine - Benadryl loratadine - Claritin

Question 32

H1 receptors

Answer 32

Located in blood vessels and respiratory mucous membranes - most antihistamines are H1

Question 33

H2 receptors

Answer 33

Located in stomach lining

Question 34

How do antihistamines work?

Answer 34

Bond to H1 receptor sites in respiratory mucous membranes, blood vessels, heart muscle, and skin

Question 35

Intended responses of antihistamines

Answer 35

Blood vessels do not dilate, swelling reduced, mucous, nasal, eye, and respiratory secretions reduced, narrowed airways widen, hives decreased

Question 36

Side effects of antihistamines

Answer 36

Sleepiness, dry mouth, blurred vision, tachycardia, urinary retention

Question 37

Adverse effects of antihistamines

Answer 37

Seizures, intraocular pressure, allergic reactions

Question 38

Before administering antihistamines

Answer 38

Ask patient if being treated for glaucoma, high BP, or prostate enlargement (antihistamines can make these problems worse), check to see if taking opioids

Question 39

After administering antihistamines

Answer 39

Check BP, pulse, and respiratory rate at least q4hr,

Question 40

Patient teaching for antihistamines

Answer 40

No alcohol, avoid driving, remind them of dry mouth, do not take during acute asthma attacks

Question 41

How leukotriene inhibitors work

Answer 41

Montelukast - Singulair - block leukotriene receptors on cells

Question 42

Common Leukotriene inhibitors

Answer 42

montelukast sodium - Singulair

Question 43

Intended responses for leukotriene inhibitors

Answer 43

Swelling of oral, nasal, eye, and respiratory mucous membranes reduced, secretions reduced, narrowed airways opened

Question 44

Side effects of leukotriene inhibitors

Answer 44

Headache and abdominal pain

Question 45

Adverse effects of leukotriene inhibitors

Answer 45

Liver impairment and allergic reactions

Question 46

Before administering leukotriene inhibitors

Answer 46

Ask patient about liver problems, check baseline liver function tests

Question 47

After administering leukotriene inhibitors

Answer 47

Asses patient for signs and symptoms of decreased liver function (constant fatigue, itchy skin, yellowing of skin or sclera), asses patient taking montelukast (Singulair) for mood changes

Question 48

Patient teaching for leukotriene inhibitors

Answer 48

Report any skin yellowing, pain over liver area, or darkening of urine