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N341A Pharmacology > Anti-inflammatories > Flashcards

Anti-inflammatories Flashcards

1
Q

What are the 5 cardinal signs of Inflammation?

A

Redness (erythema), swelling (edema), heat, pain, Loss of function.

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2
Q

What prototype drugs are listed as NSAIDs?

A

Salicylates (Aspirin)

Propionic acid Derivatives (ibuprofen)

Selective COX-2 Inhibitors (Celecoxib)

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3
Q

What prototype drugs are listed as Immune Modulators?

A

Infliximab

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4
Q

What prototype drugs are listed as Uric Acid Biosynthesis Inhibitors?

A

Allopurinol

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5
Q

What is the role of Cyclooxygenase (COX)?

A

Enzyme responsible for converting arachidonic acid into prostaglandins.

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6
Q

What are prostaglandins?

A

Causes inflammation and pain at the site of injury.

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7
Q

What are the two types of COX enzymes?

A

Cox-1

Cox-2

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8
Q

What are the functions of COX-1?

A

1) Protects stomach lining
2) Decreases fever
3) Promotes platelet aggregation.

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9
Q

What are the functions of Cox-2?

A

1) Triggers pain and inflammation

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10
Q

What happens if we inhibited COX-1 enzyme?

A

1) Loss of stomach lining protection= ulcer

2) Prevents blood clotting.

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11
Q

What happens if we inhibited COX-2 enzyme?

A

1) Reduces Pain

2) Suppresses inflammation

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12
Q

Which COX enzymes do aspirin and ibuprofen inhibit?

A

both COX-1 and Cox-2

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13
Q

Which COX enzyme does celecoxib block?

A

Only COX-2 enzyme.

It is classified as a COX-2 inhibitor.

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14
Q

What is the abbreviation of Salicylates?

A

ASA

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15
Q

What do anti-inflammatory agents do?

A

1) Relieves pain
2) Reduce fever
3) Anticoagulant
4) Reduces inflammation

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16
Q

Should we take ASA with any other NSAIDs?

A

No! Taking both would decrease blood levels and effectiveness of NSAIDs.

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17
Q

What is another name for Salicylates and ASA?

A

Aspirin.

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18
Q

What is the function of Aspirin?

A

It is a prostaglandin inhibitor that decreases inflammatory process.

It is also an anti-platelet aggregation drug. It decreases blood clotting.

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19
Q

Can ASA be given to cardiac/CVA patients?

A

Yes.

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20
Q

What is the MOA of Aspirin?

A

Inhibits prostaglandin synthesis and inhibits hypothalamic heat regulator.

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21
Q

What are the uses for Aspirin?

A

1) Reduce pain, inflammation and fever.
2) Inhibits platelet aggregation
3) Can be used for Osteoarthritis and rheumatoid arthritis

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22
Q

What are the adverse effects of Aspirin?

A

1) Tinnitus
2) GI bleed
3) Agranulocytosis (Severe and dangerous low levels of leukocytes)
4) Hemolytic anemia
5) Thrombocytopenia (low platelet count)
6) Hepatotoxicity

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23
Q

What is Reye’s Syndrome?

A

A rare but serious condition which causes swelling in the brain and liver in children and teenagers.

24
Q

What can cause Reye’s syndrome?

A

Administering ASA to children who have flu like symptoms

25
Q

What are the symptoms of Reye’s Syndrome?

A

Vomiting, Lethargy, delirium, and coma.

26
Q

Are ibuprofen and naproxen are highly protein bound?

A

Yes.

27
Q

What is the MOA of Ibuprofen?

A

Inhibition of prostaglandin synthesis. This causes relief pain and inflammation

28
Q

What are the adverse effects of Ibuprofen?

A

Hearing loss, tinnitus.

29
Q

What are the life threatening adverse effects of ibuprofen?

A

Anemia, neutropenia, thrombocytopenia, nephrotoxicity, anaphylaxis

30
Q

What is the contraindication for Ibuprofen?

A

Coronary Artery Bypass Grating (CABG) due to increased heart attacks from ibuprofen.

31
Q

What do you take Ibuprofen for?

A

To reduce inflammatory process; relieve pain; reduce fever; for arthritic conditions

32
Q

A patient has severe arthritis and wants to relieved of their pain with medication. What NSAID would you give to the patient?

A

COX-2 inhibitor; celecoxib

33
Q

What is the MOA of celecoxib?

A

Inhibits COX-2, which normally promotes prostaglandin synthesis and inflammatory response but does not inhibit COX-1.

34
Q

What is celecoxib taken for?

A

Osteoarthritis, rheumatoid arthritis, moderate to severe pain, ankylosing spondylitis

35
Q

What are the adverse reactions to celecoxib?

A

Peripheral edema, bleeding, HTN (hypertension)

36
Q

What is the life threatening adverse reaction to celecoxib?

A

CVA

37
Q

If NSAIDs do not control immune mediated arthritic pain, what type of medication should we use?

A

DMARDS (disease modifying antirheumatic drugs)

38
Q

What drugs are classified as DMARDS?

A

Immunosuppressants, immunomodulators, and antimalarials

39
Q

What is the main function of DMARDS?

A

To alleviate symptoms of RA (psoriatic arthritis, Chrohn’s and ulcerative colitis)

40
Q

How do immunomodulators work?

A

They disrupt inflammatory process and delay disease progression in severe RA.

Neutralizes TNF that is a contributor to synovitis.

41
Q

What is the MOA of Infliximab?

A

Binds to TNF and prevents it from attaching to TNF receptors on synovial cell surfaces

Reduces infiltration of inflammatory cells and delays inflammatory process

42
Q

What uses does Infliximab have?

A

Works against RA, psoriatic arthritis, spondylitis, ulcerative colitis, Crohn disease, psoriasis

43
Q

What adverse effects can come from Infliximab?

A

Severe infections, blood pressure fluctuation, seizures, elevated liver enzymes, Steven-Johnson Syndrome, anemia

44
Q

What are the contraindications for Infliximab?

A

Heart Failure

45
Q

What is Gout?

A

Inflammatory condition that attacks joints, tendons and other tissues.

46
Q

How does Gout work?

A

Uric acid accumulation leads to developing uric acid crystals in joints.

47
Q

What should you do if the patient has an acute gout attack?

A

Increase fluid intake, avoid foods high in purines like organ meats, liver, gravy, and beer, and NSAIDs.

48
Q

What could you do to prevent infections for a patient taking Infliximab?

A

Making sure the patient is up to date on their vaccines.

49
Q

what is Steven-Johnson Syndrome?

A

A rare but serious disorder of the skin and m mucus membrane. It is a reaction to taking a medication while having flu-like symptoms. It starts out as a rash all over the skin.

Steven-Johnson Syndrome becomes Toxic Epidermal Necrolysis when the painful rash covers more than 30% of the total body surface area.

50
Q

What is the goal of a nurse who has a patient with Steven-Johnson Syndrome?

A

Pain management

Finding out which medication caused the syndrome

Wound Care.

This is a medical emergency.

51
Q

What is the MOA of Allopurinol?

A

Inhibits the final step of uric acid biosynthesis and lowers serum uric acid levels.

52
Q

What is Allopurinol used for?

A

Prophylactic (prevent from forming) for gout, chronic tophaceous gout.

53
Q

What are the adverse reactions for Allopurinol?

A

Hepatic impairment, angioedema, hyperglycemia, hyperlipidemia.

54
Q

Can you use Allopurinol in a patient with acute gout attack?

A

No. Before giving allopurinol, get the pain under control.

55
Q

What adverse effect are you most concerned about when the patient is taking ibuprofen?

A

Poor renal clearance

Nephrotoxicity

N341A Pharmacology (7 decks)

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