Anti-inflammatory and Antigout Drugs Flashcards
What are common signs of Inflammation?
Pain, fever, loss of function, redness, and swelling
What is the goal of Inflammation?
to destroy, dilute, or wall off (sequester) both the injurious agent and the injured tissue
What Activities do NSAIDS preform?
Analgesic activities
Anti-inflammatory activities
Antipyretic activities
only aspirin preforms platelet inhibition
What properties do all NSAIDS share?
Antipyretic properties
Analgesic properties
Anti-inflammatory properties
What are NSAIDS are Salicylates?
aspirin
What NSAIDS are Acetic acid derivatives?
diclofenac sodium (Voltaren®)
indomethacin sulindac
ketorolac (Toradol®)
What NSAIDS are Cyclo-oxygenase (COX)-2 inhibitors
celecoxib (Celebrex®)
What NSAIDS are Propionic acid deravities?
ibuprofen
naproxen
Aspirin is shown to reduce the risk of what if taken at the first signs?
MI
When are NSAIDS contraindicated?
allergy
risk for bleeding
rhinitis
vit k deficiency
peptic ulcer disease
What are the AEs of NSAIDs
Heartburn to severe GI bleeding
Acute kidney injury
Noncardiogenic pulmonary edema
Altered hemostasis
Hepatotoxicity
Skin eruption, sensitivity reaction
Tinnitus, hearing loss
What causes many of the AEs of NSAIDs?
due to the inhibition of prostaglandins which help maintain the stomach lining
What drug has a cytoprotective component and inhibits gastric acid secretion?
Misoprostol
How do NSAIDS influence the Kidneys?
disrupt prostaglandins which may cause acute or chronic kidney failure
When may kidney toxicity occur if pt takes an NSAID?
dehydration, heart failure, or liver dysfunction, or with the use of diuretics or angiotensin-converting enzyme inhibitors.
A patient is at increased risk for MI, CVA, and GI AEs if taking what type of drug?
NSAID
What is the most common Salicylate?
Aspirin
What route can Salicylate be given?
PO, Topical, rectal,
Salicylates may cause what syndrome?
Reye’s syndrome
What are the common dosages of Aspirin
81 mg or 325 mg
What is Reye’s syndrome triggered by?
viral illnesses (influenza) use of salicylates and viral illness combo
What dose Reye’s syndrome result in?
Permanent neurological damage
What are the signs of a Salicylate intoxication (Salicylism)?
Increased heart rate
Tinnitus, hearing loss, dimness of vision, headache, dizziness, mental confusion, drowsiness
Nausea, vomiting, diarrhea
Sweating, thirst, hyperventilation, hypoglycemia or hyperglycemia
What is Indomethacin used for?
rheumatoid arthritis (RA), osteoarthritis (OA), acute bursitis or tendonitis, ankylosing spondylitis, acute gouty arthritis
This drug has analgesic effects comparable to morphine
Toradol
How long is Ketorolac indicated for?
5-7 days
What are some AEs for Ketorolac
kidney impairment, edema, GI pain, dyspepsia, and nausea
What is the most common NSAID
Ibuprofen
What is Ibuprofen used for?
analgesic effects in the management of RA, OA, primary dysmenorrhea, dental pain, musculoskeletal disorders; antipyretic actions
This drug a somewhat better AE profile compared to Ibuprofen?
Naproxen
What are some AEs of COX-2 inhibitors?
headache, sinus irritation, diarrhea, fatigue, dizziness, lower-extremity edema, and hypertension
What is Misoprostol used for
To reduce the AEs associated with NSAIDs
What are the AEs of NSAIDS?
Dyspepsia, heartburn, epigastric distress, nausea, vomiting, anorexia, abdominal pain
GI bleeding*
Mucosal lesions* (erosions or ulcerations)
decreased creatinine clearance
AKI
pulmonary edema
What is Gout?
A condition caused by inappropriate uric acid metabolism resulting in pain
What are the Antigout drugs you need to know for the exam?
Allopurinol
colchicine
probenecid
What dose Allopurinol do?
prevents uric acid production and prevents acute tumor lysis syndrome
What are the side effects of Allopurinol?
exfoliative dermatitis, Stevens-Johnson syndrome, and toxic epidermal necrolysis
What dose probenecid do?
Inhibits the reabsorption of uric acid in the kidneys and thus increases the excretion of uric acid
What dose Colchicine do?
Reduces the inflammatory response to the deposits of urate crystals in joint tissue
What is the dosage of colchicine for acute gout attacks?
0.6 mg OD or BID
What herbal products are used for gout?
Glucosamine and Chondroitin
What dose the nurse need to look out for when patients is taking NSAIDS
GI lesions, peptic ulcer disease, bleeding disorders
Who should never receive salicylates? Why?
Children or teens due to Reye’s syndrome
What should NSAIDS be given with?
food, milk, or antacid to avoid irritation
How long can it take for NSAIDs to show a therapeutic effect?
1 week
