Anti-inflammatory and Antigout (Flashcards)

Question 1

What happens in inflammation?

Answer 1

Localized protective response stimulated by injury to tissues, which serves to destroy, dilute, or wall off (sequester) both the injurious agent and the injured tissue
Pain, fever, loss of function, redness, and swelling
Endogenous compounds, including proteins of the complement system, histamine, serotonin, bradykinin, leukotrienes, and prostaglandins

Question 2

what does NSAIDs stand for?

Answer 2

Nonsteroidal Anti-inflammatory Drugs (NSAIDs)

Question 3

What type of activities does NSAID want to achieve?

Answer 3

A large and chemically diverse group of drugs that have:
Analgesic activities
Anti-inflammatory activities
Antipyretic activities
aspirin-platelet inhibition

Question 4

What are the uses of NSAIDs

Answer 4

Relief of mild to moderate headaches
Relief of myalgia
Relief of neuralgia
Relief of arthralgia
Relief of postoperative pain
Relief of pain associated with arthritic disorders such as rheumatoid arthritis, juvenile arthritis, ankylosing spondylitis, and osteoarthritis
Treatment of gout and hyperuricemia

Question 5

What are the NSAID drugs? (There’s 7)

Answer 5

• aspirin
• diclofenac
• indomethacin
• ketorolac
• celecoxib
• ibuprofen
• naproxen

Question 6

Aspirin what is it used for?

Answer 6

Use: Antiplatelet effects to prevent blood clots, pain relief, and to reduce inflammation.
Special Considerations: Do not use in children/teens with viral infections due to Reye’s syndrome risk.

Question 7

NSAIDs adverse effects?

Answer 7

Heartburn to severe GI bleeding
Acute kidney injury
Noncardiogenic pulmonary edema
Altered hemostasis
Hepatotoxicity
Skin eruption, sensitivity reaction
Tinnitus, hearing loss

Question 8

NSAIDs contraindications?

Answer 8

Conditions that place the patient at risk for bleeding
Rhinitis
Vitamin K deficiency
Peptic ulcer disease

Question 9

Misoprostol what does it do?

Answer 9

Many of the adverse effects of NSAIDs are secondary to their inactivation of protective prostaglandins that help maintain the normal integrity of the stomach lining.
Prevents GI bleed

Question 10

What drug is salicylate and what forms does it come in?

Answer 10

• acetylsalicylic acid (aspirin) the most common
• Oral (tablets, capsules), topical cream (Aspercreme®), oral liquids, rectal suppositories
• aspirin–antacid combinations (Alka-Seltzer®)
• Enteric-coated aspirin (Praxis ASA EC®)

Question 11

Aspirin, how should the med be taken?

Answer 11

Daily tablet (81 mg or 325 mg): prophylactic therapy for adults who have strong risk factors for developing coronary artery disease or cardiovascular accident
Effective after MI
The 81- and 325-mg strengths appear to be equally beneficial for the prevention of thrombotic events.

Question 12

What happens in salicylate intoxication?

Answer 12

Salicylate intoxication (when chronic, known as salicylism)
Increased heart rate
Tinnitus, hearing loss, dimness of vision, headache, dizziness, mental confusion, drowsiness
Nausea, vomiting, diarrhea
Sweating, thirst, hyperventilation, hypoglycemia or hyperglycemia

Question 13

indomethacin is used for what?

Answer 13

Uses: therapy for rheumatoid arthritis (RA), osteoarthritis (OA), acute bursitis or tendonitis, ankylosing spondylitis, acute gouty arthritis. Has both Oral and rectal routes.

Question 14

ketorolac tromethamine is used for what?

Answer 14

Used primarily for its powerful analgesic effects, which are comparable to those of narcotic drugs such as morphine sulphate
Indication: short-term use (up to 5 to 7 days) to manage moderate to severe acute pain

Question 15

Adverse effects of ketorolac?

Answer 15

kidney impairment, edema, GI pain, dyspepsia, and nausea

Question 16

ibuprofen (Motrin, Advil) uses?

Answer 16

Most commonly used NSAID
Uses: analgesic effects in the management of RA, OA, primary dysmenorrhea, dental pain, musculoskeletal disorders; antipyretic actions

Question 17

naproxen, uses?

Answer 17

Second most commonly used NSAID
Somewhat better adverse effect profile than ibuprofen
Fewer drug interactions with angiotensin-converting enzyme inhibitors given for hypertension. (i guess used because hads better adverse effects than ibuprofen).

Question 18

celecoxib (Celebrex®)

Answer 18

First and only remaining COX-2 inhibitor
Indicated for OA, RA, acute pain symptoms, ankylosing spondylitis, and primary dysmenorrhea
Adverse effects include headache, sinus irritation, diarrhea, fatigue, dizziness, lower-extremity edema, and hypertension
Little effect on platelet function
Not to be used in patients with known sulpha allergy

Question 19

NSAID adverse effects? (what drug can be used to help alleviate the adverse effects?)

Answer 19

GI
Dyspepsia, heartburn, epigastric distress, nausea, vomiting, anorexia, abdominal pain
GI bleeding*
Mucosal lesions* (erosions or ulcerations).
Renal
Reductions in creatinine clearance
Acute tubular necrosis with acute kidney injury
Cardiovascular
Noncardiogenic pulmonary edema
**Misoprostol can be used to reduce these dangerous effects.

Question 20

Serious NSAID interactions can occur when the drugs are given with?

Answer 20

Serious interactions can occur when given with:
Alcohol
Anticoagulants
acetylsalicylic acid (ASA)
Biphosphonates
Corticosteroids and other ulcerogenic medications
Protein-bound drugs
Diuretics and angiotensin-converting enzyme inhibitors
Other drugs

Question 21

What is gout?

Answer 21

A condition that results from inappropriate uric acid metabolism
Underexcretion of uric acid
Overproduction of uric acid
Uric acid crystals are deposited in tissues and joints, resulting in pain
Hyperuricemia

Question 22

WHat are the three antigout medications?

Answer 22

• allopurinol
• colchicine
• probenicid

Question 23

What is alluprinol used for and what side effects does it have?

Answer 23

Used to prevent uric acid production and to prevent acute tumour lysis syndrome
Side effects: exfoliative dermatitis, Stevens-Johnson syndrome, and toxic epidermal necrolysis
probenecid (Benuryl)

Question 24

whats probenecid used for?

Answer 24

Inhibits the reabsorption of uric acid in the kidneys and thus increases the excretion of uric acid

Question 25

colchicine what is it used for?

Answer 25

Treats acute gout attacks and prevents them when used regularly. Prophylaxis of acute attacks in dosages of 0.6 mg once or twice a day

Question 26

What are the two herbal products and what are they used for?

Answer 26

Glucosamine, Chondroitin. Used to treat the pain of OA.

Question 27

What food should these medications be taken with?

Answer 27

Because these medications generally cause GI distress, they are often better tolerated if taken with food, milk, or an antacid to avoid irritation.

Question 27

How long does it take for therapeutic effects to be seen?

Answer 27

Explain to patients that therapeutic effects may not be seen for 1 week or more.

Question 28

What should patients watch out for?

Answer 28

Educate patients about the various adverse effects of NSAIDs, and instruct them to notify their prescribers if these effects become severe or if bleeding or GI pain occurs.
Instruct patients to watch closely for the occurrence of any unusual bleeding, such as in the stool.