Anti-inflammatory, Anti-arthritis and Related Agents Flashcards
What is an Inflammatory response?
The inflammatory response protects the body from injury and pathogens by using chemical mediators to produce a reaction that destroy pathogens and promotes healing.
What is Analgesic?
A pain reliever
What are anti-Inflammatory agents?
Agents that block decrease the chemical reaction involved in inflammation.
What are Antipyretic?
Fever reducing medication
What is Chrysotherapy?
Inflammation treatment using gold salts.
What are disease- modifying antirheumatic drugs (DMARDs)?
Drugs used in the treatment of arthritis.
What is Gout?
Gout is a disease caused when there is a high amount of uric acid in the body and deposits of uric crystals form in the kidneys or joints.
What is Inflammatory bowel disease?
Chronic inflammation of the GI tract.
What is an inflammatory response?
The body responding to a perceived harmful stimuli such as bacteria, trauma or toxins.
What are NSAIDs?
Non-steroidal Anti Inflammatory drugs. Drugs that have anti-inflammatory, analgesic or antipyretic effects.
What are Salicylates?
Agents that have antipyretic and analgesic properties.
What is Salicysism ?
When a patient have had too much of Salicylate drugs and experience dizziness, nausea, vomiting, ear ringing,, mental confusion and diarrhea.
Why does the body swell locally during an inflammatory response?
Due to the chemical reaction of the immune system activating.
Why is there a loss of function to the inflamed area when the inflammatory response is activated?
The prevent movement that would make the injury worse.
What are some Anti-inflammatory, Anti-arthritis,
and Related Agents?
Corticosteroids
Antihistamines
Immune-modulating agents
OTC anti-inflammatory
How does corticosteroids work here?
They block or alter the chemical reactions that are associated with the inflammatory response
How does antihistamines work?
They block the release of histamines in the initiation of the inflammatory response.
What lifespan considerations should we take when giving any of these agents to children?
Children are more suseptible to GI and CNS effects.
Parents need to check OTC ingredients.
Salicylates should not be used for fever/viral infection due to risk of Reye Syndrome.
Acetaminophen is most commonly used.
What is Reye Syndrome?
If a child takes Salicylates for a fever/viral infection it may cause Reye Syndrome which may lead to liver failure. This is why children should not be taking Aspirin.
What lifespan considerations should we take when giving any of these agents to adults?
Adults should be cautious when using OTC products.
Show caution in pregnancy and lactation.
There may be severe ADE on neonate and mother with salicylates, NSAIDS and gold products.
What lifespan considerations should we take when giving any of these agents to older adults?
Older adults are more susceptible to ADE.
Dose should be adjusted as needed.
Gold salts are toxic for older adults.
When used, the dose must be lowered and the patient must be monitored closely for toxicity.
What part of inflammation does Salicylates affect?
Fever and inflammation.
What are the drug classes that we must know for Salicylates?
Aspirin and Mesalamine
What can Salicylates be used for?
Used to block the inflammatory response.
The can reduce fever due to having antipyretic properties.
Can be used as pain medication due to having analgesic properties.
How does Salicylates work on the body?
They inhibit synthesis of prostaglandin.
Which patients should we not give Salicylates to?
Patients with known allergies, bleeding abnormalities, impaired renal function, chickenpox/flu in children, surgery within a week. pregnancy/lactation.
What are some adverse effects of Salicylates?
Effects on stomach and clotting systems.
Are there any drug-drug interactions to Salicylates and if so what are they?
They might interact with other drugs by interfering with the other drugs absorption.
What nursing assessments should we do prior to giving a patient Salicylates?
Assess for contraindications and cautions.
Perform physical assessment.
Assess for the presence of any skin lesions because Salicylates may increase the risk of skin reactions and rashes.
Monitor temperature (toxicity)
Evaluate CNS status—orientation, reflexes, eighth cranial nerve function, and affect (to see if patient is close to reaching toxic levels)
Monitor pulse, blood pressure, and perfusion.
Evaluate respirations and adventitious sounds (toxicity)
Perform a liver evaluation and monitor bowel sounds.
Monitor CBC, liver and renal function tests, urinalysis, stool guaiac (to check for blood which may happen with too much) and clotting times.
What nursing diagnosis can be made prior to administering salicylates?
Impaired comfort related to CNS and GI effects.
Altered breathing pattern risk, if there is toxicity.
Altered sensory perception (auditory, kinesthetic) risk, if there is toxicity.
Knowledge deficit risk regarding drug therapy.
What implementations can we expect to possibly make when we are giving patients Salicylates?
Administer with food if GI upset is severe; provide small, frequent meals
Administer drug as indicated; check all drugs being taken for possible salicylate ingredients to avoid OD.
Monitor for severe reactions such as excessive bleeding or signs for salicylism, Reyes Syndrome (children) or toxicity.
Arrange for supportive care and comfort measures (rest, environmental control)
Ensure that the patient is well hydrated during therapy
Provide thorough patient teaching
Which NSAID’s do we need to know?
Propionic Acids - Ibuprofen and Naproxen.
Acetic Agents - Indomethacin and Ketorolac
Oxicam derivatives - Meloxicam
Cyclooxygenase-2 Inhibitors - Celecoxib
What effect does NSAID’s provide?
Strong anti-inflammatory, antipyretic and analgesic effect.
Most NSAID’s are sold OTC.
TRUE/FALSE
TRUE.
This is makes it at a risk for abuse which may result in GI bleeds.
What enzymes does NSAID’s block?
COX-1 & 2
What is COX 1?
Exist in tissues throughout the body and is involved in clotting, sodium and water balance in the kidney and protecting the stomach. Which explains why blocking COX 1 may result in stomach upset, kidney issues and increased bleeding.
What is COX 2?
Strictly involved in the inflammatory reaction.