Anti-inflammatory/Anti-gout drugs (week 3) Flashcards
What does NSAIDS stand for?
Non-sterodial anti-inflammatory drugs
What are NSAIDS?
They are a large and chemicals diverse group of drugs known to have the following affects:
- analgesic
- anti-inflammatory
- antipyretic
- platelet inhibition (ASA)
What is the action of NSAIDS?
- inhibition of the leukotriene pathway, the prostaglandin pathway, or both
- block the activity of the COX enzymes
What is the role of the COX-1?
COX-1 has the role of the gastrointestinal mucosa, so if this enzyme is blocked it increases G.I. side effects
What is the role of COX -2?
COX-2 promotes synthesis of prostaglandins involved in the inflammatory response
Why were COX-2 inhibitors developed?
To help decrease the risk for G.I. adverse reaction’s
briefly describe the arachidonic pathway.
Arachidonic acid is released from Phospholipid’s in cell membranes in response to a triggering event. It is metabolized by either prostaglandin pathway for the Leukotriene pathway, both of which cause inflammation, headache, edema, and other pain associated with inflammatory response.
Describe what happens in the prostaglandin pathway.
- arachidonic acid is converted by the enzyme cyclooxyrgenase into prostacyclin and thromboxane.
- prostaglandins mediate and perpetuate inflammation by inducing vasodilation and enhancing vasopermeability
- potentiate the action of pro inflammatory substances such as histamine and bradykinin, in the production of edema and pain
Why does edema and pain occur during the inflammatory process of the prostaglandin pathway?
edema and pain is caused by PG-induced hyperalgesia which is excessive motor sensitivity
What happens when PGE-2 is synthesized in the pre-optic hypothalamic region of the hypothalamus?
a fever results.
Describe what happens in the leukotriene pathway.
- arachidonic acid is metabolized by lipoxygenase and converted into leukotriene pathways
- mediation of inflammation, vasoconstriction, bronchospasm and permeability occur.
This unsaturated fatty acid is oxygenated and further transformed into a variety of products which mediate or modulate inflammatory reactions
Arachidonic acid
What does prostacyclin do?
prostacyclin inhibits platelet activation and is also an effective vasodilator
What does thromboxane do?
thromboxane induces platelet aggregation and arterial constriction
what is another term for aspirin?
acetylsalicylic acid (ASA)
What does aspirin do in the body?
reverses the inhibitor of COX-1 receptors within the platelets themselves.
-Reduced formation of thromboxane A2,
What does thromboxane do in the body?
a substance that promotes platelet aggregation (also known as antiplatelet activity)
What are some conditions that place the patient at risk for bleeding when taking NSAIDS?
- rhinitis
- vitamin k deficiency
- peptic ulcer disease
what is rhinitis (think autumn has it)
is irritation and inflammation of the mucous membrane inside the nose
When NSAIDs are mixed with alcohol what can result?
GI bleeding
What results when aspirin interacts with other NSAIDS?
Increased G.I. toxicity with no therapeutic advantage
What would you monitor, as a nurse, in a patient who is taking NSAIDs?
decrease swelling, pain, stiffness, tenderness of a joint or muscle
list properties that all NSAIDS share.
antipyretic
analgesic
anti-inflammatory
What can NSAIDS treat?
gout and hyperuricemia
What is hyperuricemia?
the overproduction or under secretion of uric acid.
myalgia
muscle paoin
neuralgia
sever pain due to nerve damage
arthralgia
pain in a joint
What are conditions that place the patient at risk for bleeding
rhinitis
vitamin k deficiency
peptic ulcer disease
what are some adverse effects of NSAIDS?
dyspepsia heartburn GI bleeding musical lesions abdominal pain
What are some symptoms of salicylate intoxication?
increased heart rate
tinnitus
naseau, vomiting, diarrhea
sweating, thirst, hyperventilation
