Anti-inflammation Drugs Flashcards
What are the classic signs of inflammation?
Redness Pain Warmth Swelling Loss of Function
What are COX-1 and COX-2? What happens when either are inhibited?
COX-1 = Protects lining of stomach and regulates platelets
- WHEN INHIBITED: Causes GI upset, gastric ulcers, and increased bleeding time
COX-2 = Triggers PROSTAGLANDINS to increase inflammation and pain response
- WHEN INHIBITED: Inhibits prostaglandin release, decreasing inflammation and pain
What are some important points with Aspirin (ASA)?
Is a salicylates
Inhibits BOTH COX 1/2
Causes increased bleeding time (so can also be used as an antiplatelet)
DO NOT USE IF: Pregnant, have liver/renal Dx, Hx of alcohol abuse (increases risk of gastric ulcers)
Discontinue before surgery (only 4 brain and spinal surgery)
SALICYLATE SYNDROME (Reye’s Syndrome): Occurs when a toxic amount of a salicylate is in the body
- N/V/HA
- Tinnitus
- Flushing
- Dizziness
What are some important points with Ibuprofen (Advil/Motrin)?
Is and NSAID
Cannot be used in THIRD Trimester of pregnancy (should be used w/ caution in 1st and 2nd trimester)
No more than 3200 mg/day OTC
Increases bleeding time
Can EASILY go into RENAL FAILURE
Cross toxicity w/ aspirin (so if pt allergic to Aspirin, DON’T use an NSAID)
Increases RISK of heart disease/stroke 4 pts w/ a Hx of heart disease/stroke
What are some important points with Celebrex?
Is a COX-2 Inhibitor (ONLY inhibits COX-2, so preferable to other NSAIDs/aspirin)
DO NOT USE W/: ACE Inhibitors, Warfarin (so don’t adjust INR too much), and if have liver/renal Hx (can cause toxicity)
What are some important points with Indomethacin (Indocin)? (not a very important NSAID)
Is a Para-Chlorobenzoic Acid
HIGHLY PB
Used 2 treat arthritis
What are some important points with Diclofenac Sodium (Voltaren)
Is a Phenylacetic Acid Derivative
Treats arthritis
DON’T TAKE IF: Have Hx of HF and stroke
ADDICTIVE (Similar to opioids)
What are some important points with Piroxicam (Feldene)?
Is an oxicam
Treats chronic pain (such as arthritis)
Usually used concurrently w/ corticosteroids
What are some important points with Infliximab (Remicade)?
Is a Tumor Necrosis Factor Blocker (Immunomodulator)
Used to treat pain associated with autoimmune disorders and other chronic disorders (like arthritis and Crohn’s Disease)
DECREASES IMMUNITY (bc suppresses immune system)
- Must get approval b4 given vaccines
What is gout? (What is it caused by? Where does it usually occur? What are foods high in purine?)
GOUT: An inflammatory condition that attacks tendons, joints, and other tissues
- Occurs when someone eats foods rich in fats (triglycerides and other bad fats)
CAUESD BY: Increase in uric acid due to a defect in purine metabolism (increased uric acid production)
OCCURS: Usually in the big toe
FOODS HIGH IN PURINE: Alcohol, organ meats (ex: liver), sardines, salmon, and gravy
GOUTY ARTHRITIS: A chronic arthritic condition that can occur due to long-term gout inflammation
What are some important points with Allopurinol (Zyloprom)?
Is an antigout medication
Must INCREASE FLUID INTAKE (To ~2L)
DIRECTLY AFFECTS uric acid levels (decreases)
Can cause CATARACTS
Decreases the acidity of the stomach (so antacids shouldn’t be used at the same time)
MONITOR: Cr and LFT’s while on
DO NOT USE WITH: Thiazide diuretics (can increase toxicity) -MUST KNOW
What are some important points with Colchicine?
Is an antigout medication
Causes GI irritation (so can take w/ food)
DOES NOT DIRECTLY AFFECT URIC ACID, instead it decreases WBC migration, decreasing inflammation at site
Also used post-OPEN HEART SURGERY to decrease inflammation of the heart
Monitor LFT’s and Cr while on
