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Anti-Inflammatory > Anti-Inflammatory > Flashcards

Anti-Inflammatory Flashcards

1
Q

A network of tissues and organs that help get rid the body of toxins, waste, and other unwanted materials

A

Lymphatic System/Lymphoid System

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2
Q

Primary function is to transport lymph - a fluid containing infection fighting white blood cells, all throughout the body

A

Lymphatic System/Lymphoid System

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3
Q

It consists of lymphoid cells, tissues, and organs such as tonsils, spleen, thymus, and lymph nodes

A

Lymphatic System/Lymphoid System

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4
Q

It is the first line of protection/defense from pathogen

A

Nonspecific Defenses (First Line of Defense)

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5
Q

Serves as barriers to microbes or environmental hazards

A

Nonspecific Defenses (First Line of Defense)

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6
Q

Unable to distinguish one type of threat from another and the response or protection is the same regardless of the pathogen

A

Nonspecific Defenses (First Line of Defense)

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7
Q

Physical barriers
Phagocytes
Natural killer cells
Complement systems
Fever
Interferons
Inflammation

A

Nonspecific Defenses (First Line of Defense)

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8
Q

The most important nonspecific defenses

A

Inflammation

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9
Q

Like epithelial lining of the skin, respiratory and gastrointestinal mucous membranes that are potential entry points from pathogen

A

Physical barriers

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10
Q

Line of defense that is particular to a certain threat

A

Second Line of Defense (Specific Defense)

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11
Q

A specific defense may act against only a single species of bacteria and be ineffective against all others

A

Immune response

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12
Q

Foreign agents that elicit an immune response against all others

A

Antigen

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13
Q

What are the strongest antigens?

A
  1. Foreign proteins such as those present on the surface of pollen grains
  2. Bacteria
  3. Nonhuman cells
  4. Viruses
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14
Q

The primary cell of the immune response that interacts with an antigen

A

Lymphocytes

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15
Q

It is initiated when an antigen encounters a type of lymphocytes known as B cell

A

Humoral Immunity

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16
Q

Primary function is to secrete antibodies specific to the antigen that initiated the challenge

A

Plasma Cells

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17
Q

It is a condition of being able to resist a particular disease

A

Immunity

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18
Q

Antibodies that are circulating through the body

A

Immunoglobulins

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19
Q

Physically interacts with the antigen to neutralize it or mark the foreign agent for destruction by other cells of the immune response

A

Immunoglobulins

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20
Q

Biological agents used to stimulate the immune system

A

Vaccines

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21
Q

What is the goal of a vaccine administration?

A

To prevent serious infections by life threatening pathogens

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22
Q

Administer a modified, harmless microorganism or its toxoid to the client so that an immune response occurs in the following weeks or months

A

Vaccinations or Immunizations

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23
Q

Most required follow up vaccinations called _________ to provide sustained protection

A

Boosters

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24
Q

Measures the amount of antibody produced after the vaccines has been administered to know the effectiveness of most vaccines

A

Titer

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25
Q

Two types of Immunity

A

Active Immunity
Passive Immunity

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26
Q

Immunity achieved through the administration of vaccines

The clients immune system is stimulated to produce antibodies by exposure to the antigen or a vaccine

A

Active Immunity

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27
Q

Occurs when performed antibodies are transferred from one person to another

A

Passive Immunity

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28
Q

Maternal antibodies cross the placenta and provide protection for the fetus and newborn. What type of immunity is this?

A

Passive Immunity

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29
Q

Examples of Selected Vaccines

A

Bacillus Calmette Guerin (BCG)
Hepatitis B Vaccine
Tetanus Toxoid
Measles Vaccine

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30
Q

Vaccines that provide Passive Immunity

A

Hepatitis B Immunoglobulin (IM)
Rabies Immunoglobulin (IM)
Tetanus Immune Globulin (IM)

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31
Q

Administered months or years after the initial vaccine

A

Booster vaccine

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32
Q

Stimulate the immune system to maintain enough memory cells to mount a rapid response to an antigen

A

Booster vaccine

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33
Q

Common Side Effects of Vaccines

A

Redness and discomfort on the site of injection
Fever
Anaphylaxis

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34
Q

A type of reaction where it is uncommon but has a severe effect and considered as a common side effect of vaccines

A

Anaphylaxis

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35
Q
  1. Prior to administration, assess for
    any risk based precautions such as
    pregnancy, diabetes, heart disease,
    renal failure and various other
    serious and debilitating conditions
    and provide education on the
    importance of receiving
    vaccinations.
  2. Assess recent laboratory blood tests
    because vaccines are
    contraindicated to
    immunosuppressed clients.
  3. Answer all the questions and concerns of clients and family members regarding the benefits and risk of vaccines
A

Nursing Considerations for Vaccines

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36
Q
  1. Practice reliable contraception for 3
    months after administration of
    vaccines.
  2. Maintain immunization records and
    bring to health care appointments
    during visits for immunizations
  3. Keep all scheduled appointments
    for additional vaccinations
  4. Advise the client or care provider of
    the side effects may include pain at
    injection site, fever and soreness
  5. Immediately report shortness of
    breaths and allergic reaction.
A

Client Health Teaching: Vaccines

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37
Q

The 2nd branch of immune response that involves lymphocytes

A

T Cells

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38
Q

Give the 2 major types of T Cells

A

Helper T Cells
Cytotoxic T Cells

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39
Q

Has a CD4 receptor

Particularly important because they are responsible for activating most other immune cells, including B cells

A

Helper T Cells

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40
Q

A glycoprotein found on the surface of immune cells such as T helper cells, monocytes, macrophages, and dendritic cells

A

CD4

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41
Q

Has a CD8 receptor

Travels throughout the body, directly killing certain bacteria, parasites, virus infected cells, and cancer cells

A

Cytotoxic T Cells

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42
Q

It is a transmembrane glycoprotein that serves as a co-receptor for the T cell receptor (TCR)

A

CD8 (Cluster of Differentiation 8)

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43
Q

Hormone like proteins that regulate the intensity and duration of the immune response and mediate cell to cell communication

A

Cytokines

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44
Q

Enumerate the specific cytokines being released when activated by T Cells

A

Interleukins
Gamma interferon
Perforin

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45
Q

Cytokines secreted by leukocytes and macrophages that have been infected by a virus

A

Interferons (IFNs)

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46
Q

Slow spread of viral infection and enhance the activity of existing leukocytes

It also has an antiviral, anti-cancer, and anti-inflammatory properties

A

Interferons (IFNs)

47
Q

Its action includes modulation of immune functions such as increasing phagocytosis, and enhance cytotoxic activity of T cells

A

Interferons (IFNs)

48
Q

It consists of two different formulations: Beta 1a and Beta 1b

Primarily reserved for the treatment of severe multiple sclerosis

A

Interferon Beta

49
Q

Another class of cytokines - it synthesizes primarily by lymphocytes, monocytes, and macrophages that enhance the capabilities of the immune system

A

Interleukins

50
Q

It stimulates cytotoxic T cells activity against tumor cells, increased B cells, and plasma cell production and promotion of inflammation

A

Interleukins

51
Q

Derived from T helper lymphocytes - promotes the proliferation of both T lymphocytes and activated B lymphocytes

A

Interleukin 2

52
Q

Approved for the treatment of metastatic renal carcinoma

A

Aldesleukin

53
Q

Derived from the bone marrow cells

A

Interleukin 11

54
Q

A growth factor with multiple hematopoietic effects

A

Interleukin 11

55
Q

It has the ability to stimulate to platelet production in immunosuppressed clients

A

Oprelvekin (Neumega)

56
Q

Used to stimulate the production of B cells, T cells, and macrophages in clients with colon cancer

A

Levamisole (Ergamisol)

57
Q
  1. Prior to starting a client on these
    drugs, conduct a thorough
    assessment including a complete
    health history, present signs and
    symptoms, allergy and medical
    health history.
  2. Assess for the presence and or
    history of the following diseases or
    disorders; chronic hepatitis, AIDS
    related Kaposi’s sarcoma etc.
  3. Assessment of infections and cancer
    verifies the needs for this drugs.
  4. Immunostimulants are
    contraindicated for clients with renal
    or liver disease and pregnancy
  5. Before starting the therapy, obtain
    the results of lab test including a
    complete CBC, electrolytes, renal
    function and liver enzyme to provide
    baseline data
  6. Measure vital signs and body weight in the initial assessment and throughout the treatment regimen to monitor progress
A

Nursing Considerations: Immunostimulants

58
Q
  1. Used interferon alfa-2b (Intron A)
    with caution in clients with hepatitis,
    other than hepatitis C, leukopenia,
    and pulmonary disease, promotes
    development of leukemia because
    of bone marrow suppression.
  2. Interferon alfa-2a (Roferon-A) should
    be used with caution in clients with
    cardiac disease, herpes zoster, and
    recent exposure to chicken pox.
  3. Keep client well hydrated during
    pharmacotherapy
  4. Use of immunostimulant can lead to
    the development of
    encephalopathy; therefore assess for
    changes in mental status.
  5. Be specially vigilant for signs and
    symptoms of depression and
    suicidal ideation
A

Nursing Considerations: Immunostimulants

59
Q
  1. Practice reliable contraception and
    notify your health care provider if
    pregnancy is planned or suspected.
  2. Avoid the use of corticosteroids
    because this hormones reduce the
    drug’s antitumor effect
  3. Liver, endocrine or neurological
    adverse effects that occurs during
    therapy may be permanent
  4. Avoid alcohol use, because it may
    induce a disulfiram (Antabuse)
    reaction
A

Client Health Teaching: Immunostimulants

60
Q
  1. Keep all scheduled appointments
    and laboratory visits for testing
  2. Immediately report symptoms of
    nausea or stomatitis.
  3. Immediately report hematuria,
    petechiae, tarry stools, bruising,
    fever, sore throat, jaundice, dark colored urine, clay colored stool, feeling of sadness and nervousness
  4. Used non alcoholic mouthwashes to treat stomatitis
A

Client Health Teaching: Immunostimulants

61
Q

Drugs used to inhibit the immune response

A

Immunosuppressants

62
Q

Used for clients receiving transplanted tissues or organs

This agents may be prescribe for severe cases of rheumatoid arthritis or other autoimmune diseases

A

Immunosuppressants

63
Q

Examples of Immunosuppressants

A

Glucocorticoids
Antimetabolites
Antibodies
Calcineurin inhibitors

64
Q

Potent inhibitors of inflammation

Treatment of asthma and arthritis

A

Glucocorticoids

65
Q

Examples of Glucocorticoids

A

Prednisone
Betamethasone
Dexamethasone

66
Q

Inhibits aspects of lymphocyte replication

A

Antimetabolites

67
Q

Examples of Antimetabolites

A

Silorimus (Rapamune)
Azathiprine (Imuran)

68
Q

Binding to the intracellular messenger calcineurin

A

Cyclosporine (sandimmune , neoral)

69
Q

It simply disrupts the T cell function

A

Tacrolimus (prograft)

70
Q

Value in treating psoriasis, inflammatory disorder of the skin

A

Calcineurin inhibitors

71
Q
  1. When providing care for the clients
    taking immunosuppressants,
    complete a through health
    assessment, including, the presence
    of history of organ transplant or
    grafting and verify the need for the
    drugs.
  2. Immunosuppressants are
    contraindicated in clients with
    leukemia, metastatic cancer, active
    infection renal or liver disease or
    pregnancy.
  3. These drugs should be use with
    cautions in clients who have
    pancreatic or bowel dysfunction,
    hyperkalemia, hypertension and
    infection.
  4. Obtain vital signs and results of lab
    testing, including CBC, electrolytes
    and liver profile, to provide baseline
    data and reveal any abnormalities
A

Nursing Considerations: Immunosuppressants

72
Q
  1. Superinfection may occur, causing
    an increase in white blood cell count
    due to dampen effect of immune
    system.
  2. Monitor vital signs, especially
    temperatures, and blood testing for
    indications of infection
  3. Carefully monitor the degree of
    bone marrow suppression
    (thrombocytopenia and leukopenia)
    because the adverse effect can be
    life threatening
  4. Monitor patients who are taking in
    Azathioprine (imuran) for the development of secondary malignancies; also inform the client of this possible side effects
A

Nursing Considerations: Immunosuppressants

73
Q
  1. Take antibiotics as prescribed by
    your physician to prevent infection.
  2. Keep all scheduled laboratory visits
    for hematology studies.
  3. Avoid exposure to individuals with
    infection and other situations in
    which there is a high risk of
    infection.
  4. Immediately report alopecia,
    increased pigmentation, arthralgia
    respiratory distress, edema, nausea,
    vomiting, paresthesia, fever, blood
    in the urine, black stool, feeling of
    sadness
A

Client Health Teaching: Immunosuppressants

74
Q

Give the 2 Classifications of Inflammation

A

Acute Inflammation
Chronic Inflammation

75
Q

Caused by minor physical injury

Has a short duration, ranging from few hours to few days

8-10 days are normally needed for the symptoms to resolve and for repair to begin

A

Acute Inflammation

76
Q

Signs of Acute Inflammation

A

Swelling
Pain
Warmth
Redness of the affected area
Loss of function

77
Q

Inflammation of prolonged duration, usually weeks to months and even years

A

Chronic Inflammation

78
Q

The response is characterized predominantly by lymphocytes and macrophages, tissue repair, such as healing, fibrosis and granular tissue formation, all of which may occur simultaneously

A

Chronic Inflammation

79
Q

Most anti-inflammatory drugs are: specific or non specific?

A

Most of it are non specific

80
Q

Allergic rhinitis, anaphylaxis, chron’s disease

Ankylosing spondylitis, contact dermatitis

Glomerulonephritis, hashimoto’s thyroiditis

Peptic ulcers, rheumatoid arthritis

Systemic lupus erythematosus (SLE)

Ulcerative colitis

A

Common disease that have an anti-inflammatory component that may benefit from anti-inflammatory pharmacotherapy

81
Q

Examples of Chemical mediators of inflammation

A

Histamine
Leukotrienes
Bradykinin
Complement
Prostaglandins

82
Q

What are the fundamental steps in acute inflammation?

A
  1. Vasodilation - redness and heat
  2. Vascular permeability - edema
  3. Cellular infiltration - pus
  4. Thrombosis - clots
  5. Stimulation of nerve ending - pain
83
Q

Key chemical mediator of inflammation

A

Histamine

84
Q

It is stored primarily within mast cells located in the tissue spaces under epithelial membranes such as the skin, bronchial tree, digestive tract, and along blood vessels

A

Histamine

85
Q

A life threatening allergic response that may result in shock and even death

A

Anaphylaxis

86
Q

Give the 2 Histamine Receptors

A

H1 Receptors
H2 Receptors

87
Q

Present in the smooth muscles of the vascular system, bronchial tree, and the digestive tract

A

H1 Receptors

88
Q

Stimulation of these receptors results in itching, pain, edema, vasodilation, bronchoconstriction, and the characteristic symptoms of inflammation and allergy

A

H1 Receptors

89
Q

Present primarily in the stomach and their stimulation results in the secretion of large amounts of hydrochloric acid

A

H2 Receptors

90
Q

Drug of choice for the treatment of mild to moderate inflammation

Available as OTC or over the counter drugs

A

NSAIDs

91
Q

Have analgesic, antipyretic, and anti-inflammatory properties such as aspirins and ibuprofen, the newer COX-2-inhibitors

A

NSAIDs

92
Q

Acts by inhibiting the synthesis of prostaglandin

Block inflammatory by inhibiting cyclooxygenase (COX)

A

NSAIDs

93
Q

It is the key enzyme in the biosynthesis of prostaglandins

A

Cyclooxygenase (COX)

94
Q

Are lipids found in all tissues that
have potent physiological effects, in
addition to promoting inflammation,
depending on the tissue to which
they are found.

A

Prostaglandinds

95
Q

2 Forms of COX

A

Cyclooxygenase - 1 (COX-1)
Cyclooxygenase - 2 (COX-2)

96
Q

Present in all tissues and serves as protective functions such as:
- reducing gastric acid secretion
- promoting renal blood flow
- regulating smooth muscle tone in blood vessels and in the bronchial tree

A

Cyclooxygenase - 1 (COX-1)

97
Q

It is present only after tissue injury and serves to promote inflammation

A

Cyclooxygenase - 2 (COX-2)

98
Q

These are the first generation NSAID drugs

A

Aspirin and Ibuprofen

99
Q

These drugs both block COX-1 and COX-2

A

Aspirin and Ibuprofen

100
Q

Their inhibition reduces inflammation, the inhibition of COX-1 results in undesirable effects such as bleeding, gastric upset, and reduced kidney function

A

Aspirin and Ibuprofen

101
Q

Binds to both COX-1 and COX-2 enzymes

Changing their structures and preventing them from forming inflammatory prostaglandins

A

Aspirin

102
Q

Often a drug of choice for treating mild inflammation

A

Aspirin

103
Q

It has also protective effects on the
cardiovascular system and is taken
daily in small doses by millions of
people to prevent abnormal clot
formation and strokes.

A

Aspirin

104
Q
  1. Large doses of aspirin that are
    needed to suppress severe
    inflammation may results in high
    incidence of adverse effects,
    especially on the digestive system
    which includes:
    - Increasing gastric acid
    secretion and irritating the
    stomach lining
    - Epigastric pain, heartburn
    - Bleeding due to ulceration
  2. Because of its anticoagulant effect,
    potential for bleeding must be
    monitored.
  3. High doses of aspirin may produce
    Salicyclism, a syndrome that
    includes symptoms such as tinnitus,
    dizziness, headache, and excessive
    sweating.
A

Adverse Effects of Aspirin

105
Q

Developed as alternatives to aspirin

Like aspirin, they exhibit their effects through inhibition of both COX-1 and COX-2 although the inhibition by these drugs is reversible

A

Ibuprofen (Motrin, Advil)

106
Q

This is given to clients with significant pre-existing renal impairment for pain or fever

A

Acetaminophen

107
Q

Treatment of choice for moderate to severe inflammation

A

Selective COX-2 Inhibitors

108
Q

Celecoxib (Celebrex)

A

Aside from its anti-inflammatory indications, this is also used to reduce the number of colorectal polyps in adults

109
Q
  1. NSAIDs may be used for their
    analgesic, antipyretic and anti
    inflammatory effects.
  2. NSAIDs are primarily metabolized by
    the liver, they should not be given to
    clients with liver dysfunction it could
    lead to hepatic failure
  3. Assess clients for bleeding
    disorders, peptic ulcer disease, CHF,
    fluid retention, hypertension, renal
    disease and use of use of diuretics,
    lithium, anticoagulants, herbal
    supplements, alcohol and cigarettes,
    NSAIDs may be contraindicated in
    these clients.
  4. Obtain baseline kidney and liver
    function test and CBC prior to
    initiation of NSAIDs therapy.
  5. Monitor bleeding time with long
    term administration
  6. Assess for changes in pain (intensity,
    frequency and type) and reduction
    in temperature and inflammation to
    determine effectiveness.
A

Nursing Considerations: NSAIDs

110
Q
  1. Assess for gastrointestinal bleeding,
    hepatitis, nephrotoxicity, hemolytic
    anemia and salicylate toxicity.
  2. Assess for the common side effects
    may include tinnitus, abdominal
    cramping and heartburn
  3. Use cautiously in elderly clients because of the potential for increase bleeding
  4. Use may be cautioned in pregnancy
    and lactation, depending on a
    specific drugs
  5. Use ibuprofen with caution in infants
    younger than 6 months, and
    naproxen with caution in children
    younger than 2 years old.
  6. Aspirin is contraindicated in
    pediatric clients younger than 18
    years old. This is especially critical if
    the child has varicella or influenza
    infections because of the possibility
    of developing
A

Nursing Considerations: NSAIDs

111
Q

A rare, though serious disorder characterized by an acute increase in intracranial pressure and massive accumulation of lipids in the liver

A

Reye’s Syndrome

112
Q

What are the intracranial pressure?

A

headache, blurred vision, feeling less alert than usual, vomiting, changes in behavior, weakness or problems with moving and talking and lack of energy or sleepiness

113
Q
  1. Take NSAIDs with food or milk to decrease
    GI upset.
  2. Read the labels OTC drugs, carefully,
    because may maintain aspirin or other
    salicylates (example: excedrin and
    pepto-bismol)
  3. Avoid alcohol use
  4. Report signs of bleeding such as prolonged
    bleeding from injury, gingivinal bleeding,
    dark stools or urine, and increase in severity
    or frequency of bruising.
A

Client Health Teaching: NSAIDs

114
Q
  1. Do not take aspirins and other NSAIDs
    together, because the NSAID effects may
    decreased.
  2. Optimal effects from the NSAID therapy
    may not be experienced for 1 to 3 weeks
  3. Aspirin - generally contraindicated to below
    18 years old - Reye’s syndrome
A

Client Health Teaching: NSAIDs

Anti-Inflammatory (2 decks)

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