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Pharmacology Exam 2 > Anti-inflammatory, Anti-arthritis and Related Agents > Flashcards

Anti-inflammatory, Anti-arthritis and Related Agents Flashcards

1
Q

What is an Inflammatory response?

A

The inflammatory response protects the body from injury and pathogens by using chemical mediators to produce a reaction that destroy pathogens and promotes healing.

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2
Q

What are some Anti-inflammatory, Anti-arthritis,
and Related Agents?

A

Corticosteroids
Antihistamines
Immune-modulating agents
OTC anti-inflammatory

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3
Q

How does corticosteroids work here?

A

They block or alter the chemical reactions that are associated with the inflammatory response

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4
Q

How does antihistamines work?

A

They block the release of histamines in the initiation of the inflammatory response.

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5
Q

What lifespan considerations should we take when giving any of these agents to children?

A

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.

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6
Q

What lifespan considerations should we take when giving any of these agents to adults?

A

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.

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7
Q

What lifespan considerations should we take when giving any of these agents to older adults?

A

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.

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8
Q

What are the drug classes that we must know for Salicylates?

A

Aspirin and Msalamine

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9
Q

What can Salicylates be used for?

A

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.

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10
Q

How does Salicylates work on the body?

A

They inhibit synthesis of prostaglandin.

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11
Q

Which patients should we not give Salicylates to?

A

Patients with known allergies, bleeding abnormalities, impaired renal function, chickenpox/flu in children, surgery within a week. pregnancy/lactation.

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12
Q

What are some adverse effects of Salicylates?

A

Effects on stomach and clotting systems.

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13
Q

Are there any drug-drug interactions to Salicylates and if so what are they?

A

They might interact with other drugs by interfering with the other drugs absorption.

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14
Q

What nursing assessments should we do prior to giving a patient Salicylates?

A

Assess for contraindications and cautions.
Perform physical assessment.
Assess for the presence of any skin lesions.
Monitor temperature.
Evaluate CNS status—orientation, reflexes, eighth cranial nerve function, and affect.
Monitor pulse, blood pressure, and perfusion.
Evaluate respirations and adventitious sounds.
Perform a liver evaluation and monitor bowel sounds.
Monitor CBC, liver and renal function tests, urinalysis, stool guaiac, and clotting times.

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15
Q

What nursing diagnosis can be made prior to administering salicylates?

A

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.

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16
Q

What implementations can we expect to possibly make when we are giving patients Salicylates?

A

Monitor patient response to the drug.
Evaluate the effectiveness of the teaching plan.
Monitor the effectiveness of comfort measures.

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17
Q

Which NSAID’s do we need to know?

A

Propionic Acids - Ibuprofen and Naproxen.
Acetic Agents - Indomethacin and Ketorolac
Oxicam derivatives - Meloxicam
Cyclooxygenase-2 Inhibitors - Celecoxib

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18
Q

What effect does NSAID’s provide?

A

Strong anti-inflammatory, antipyretic and analgesic effect.

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19
Q

Most NSAID’s are sold OTC.

TRUE/FALSE

A

TRUE.

This is makes it at a risk for abuse.

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20
Q

What enzymes does NSAID’s block?

A

COX-1 & 2

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21
Q

Why would you give a patient NSAID’s?

A

To treat inflammation, pain and fever.

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22
Q

Which patients should you not give NSAID’s to?

A

Patients with a know allergy to NSAID’s & Salicylate. If there is a known allergy to sulfonamides then Celecoxib should be avoided as well.

Patient with CV dysfunction or HTN, peptic ulcer, GI bleeding, pregnancy and lactation.

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23
Q

What are some known adverse effects to NSAID’s?

A

GI effects
CNS effects
CV effects
Bone marrow depression.

24
Q

What patients should we be cautious with administering NSAID’s to?

A

Patients with renal and hepatic dysfunction

25
Q

Are there any drug-drug interactions with NSAID’s and if so what are they?

A

Loop Diuretics
Beta-blockers
Lithium

26
Q

What do we give Acetaminophen to patients for?

A

To treat fever and pain.
To treat prophylaxis of children receiving diphtheria-pertussis-tetanus (DPT) immunizations.
Relief of musculoskeletal pain associated with arthritis.

27
Q

Which patients should we not give Acetaminophen to?

A

Patients with a known allergy to Acetaminophen.

28
Q

What patients/conditions should we be cautious of when giving Acetaminophen to a patient?

A

Patients that are pregnant or breastfeeding.
Patient that have hepatic dysfunction or chronic alcoholism

29
Q

What are some known adverse effects of Acetaminophen?

A

Headache, Hemolytic anemia, renal dysfunction, skin rash and fever.
Hepatotoxicity with barbiturates, carbamazepine, hydantoins or rifampin.

30
Q

What is the antidote for acetaminophen overdose?

A

Acetylcysteine

31
Q

What nursing assessments should we be doing prior to giving NSAID’s and Acetaminophen?

A

Assess for contraindications or cautions.

Assess for presence of any skin lesions; temperature; orientation, reflexes, and
affect; pulse, blood pressure, and perfusion; respirations and adventitious sounds; liver evaluation; bowel sounds

Monitor CBC, liver and renal function tests, urinalysis, stool guaiac, and serum electrolytes.

32
Q

Why do we give patient’s Anti-arthritis agents?

A

To prevent and suppress arthritis in selected patients with rheumatoid arthritis.
They can potentially debilitate inflammatory processes.

33
Q

What is the drug we need to know for Gold Compounds?

A

Auranofin

34
Q

How does Auranofin work on the body?

A

It is absorbed bt macrophages, which results in inhibition of phagocytosis.
Tissue destruction is decreased.

35
Q

Which patients/diseases should we not give Auranofin to?

A

Allergy
Patients with diabetes, CHF, renal or hepatic impairment, blood dyscrasias, pregnancy and lactation.

36
Q

What are some known adverse reactions to Auranofin/Gold Compounds?

A

Stomatitis, Glossitis Gingivitis, bone marrow depression, dermatitis, interstitial pneumonitis and anaphylactic shock.

37
Q

Are there any known drug-drug interactions to Auranofin, and if so, what are they?

A

Yes, Penicillamine, Antimalarials, cytotoxic drugs and immunosuppressive agents.

38
Q

Why are Disease Modifying Antirheumatic Drugs (DMARD’s) used?

A

When treating arthritis that aggressively affect the process of inflammation.
Used in early diagnosis before joint damage has occurred.

39
Q

What are the drug names that we need to know for TNF blockers?

A

Adalimumab
Etanercept - receptor fusion protein
Infliximab

39
Q

DMARD’s side effects may be life threatening.

TRUE/FALSE

A

TRUE

40
Q

How does TNF blockers work?

A

They decrease the local effects of the TNF which is a locally released cytokine that causes the death of tumor cells and stimulate a wide range of proinflammatory activities.

41
Q

Why do we give TNF blockers?

A

We give it to treat Rheumatoid arthritis, polyarticular juvenile arthritis, psoriatic arthritis, plaque psoriasis and ankylosing spondylitis.

42
Q

which patients/conditions should we not give TNF blockers to?

A

Acute infections, cancer, sepsis, TB, Hepatitis, myelosuppression or demyelinating disorders.

43
Q

Which patients should we exhibit caution when administering TNF blockers to?

A

Pregnant and lactating patients and patients suffering from hepatic and renal disorders.

44
Q

What are some adverse effects of TNF blockers?

A

BB warning: serious to fatal infections and the developement of lymphomas and other cancers.
Injection site irritation

45
Q

Are there any drug-drug interactions to TNF blockers and if so, what are they?

A

Immune suppressant drugs and live vaccines.

46
Q

What should we be assessing before giving patients DMARD’s?

A

Assess for contraindications or cautions
Perform physical assessment
Assess lesions, temperature, any sign of infection
Evaluate CNS status—orientation, reflexes, eighth cranial nerve function, and affect
Arrange for required cancer screening
Monitor range of motion, movement, and pain levels
Evaluate respirations and adventitious sounds
Monitor CBC, liver and renal function tests, and TB test

47
Q

What nursing diagnosis can be made prior to giving patients DMARD’s?

A

Acute pain related to CNS, disease process.
Infection risk related to drug effects.
Fear/anxiety risk related to disease process and drug effects.
Knowledge deficit risk regarding drug therapy.

48
Q

What implementations should we be prepared to make when giving patients DMARD’s?

A

Teach patient proper preparation, administration of subcutaneous injections, and safe disposal of needles and syringes.
Monitor for immune suppression reactions.
Monitor for CNS toxicity.
Arrange for continuation of nondrug therapies.
Ensure that the patient has routine cancer screening and regular follow-up.
Provide thorough patient teaching.

49
Q

What is Gout and how is it characterized?

A

Gout is characterized by elevated uric acid and urate crystal deposits in kidneys and joints. It is very painful due to the local inflammation caused by the crystal deposits.

50
Q

What are the drug classes we need to know for Antigout agents?

A

Allopurinol & Colchicine

51
Q

How does Antigout agents work?

A

By decreasing inflammation by blocking the action of neutrophils (colchicine).

Inhibits xanthine oxidase, and enzyme needed to convert xanthine to uric acid (Allopurinol)

52
Q

What patients should we not give antigout agents to?

A

Allergy / hypersensitivity

53
Q

What patient should we be cautious with giving antigout agents to?

A

Patients with severe renal and hepatic diseases.

54
Q

What are some adverse effects of Antigout agents?

A

GI distress
Hepatic and renal dysfunction
Blood dyscrasias & Rhabdomyolysis

55
Q

There are numerous drug-drug interactions with antigout agents.

TRUE/FALSE

A

True

Pharmacology Exam 2 (10 decks)

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