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Pharm Exam 1 > Anti-Inflammatory Drug > Flashcards

Anti-Inflammatory Drug Flashcards

1
Q

What are three of the five main categories for anti-inflammatory drugs

A

Corticosteroids, nonsteroidal and antihistamine

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2
Q

What is the purpose of Corticosteroids/Glucocorticoid

A

To prevent or limit inflammation by stopping all pathways of the inflammatory mediators production

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3
Q

What are the drug forms and routes for Corticosteroids

A

Oral: Prednisone
Parenteral: Dexamethasone
Inhalation; asthma
Topical: skin problem
Injected into joints
Rectal: Hemorrhoids
Drops ( eye problems)

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4
Q

What is the oral drug for corticosteroid

A

Prednisone

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5
Q

What is the parental drug for corticosteroid

A

Dexamethasone 

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6
Q

What is the action for Glucocorticoids

A

It initiates many complex reaction responsible for anti-inflammatory and immune suppressant effect
Increase glucose level

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7
Q

What are the 3 indication for glucocorticoids

A

It is a short term treatment for many inflammatory disorders such as respiratory inflammation and joint pain
It relieves discomfort
I guess the body a chance to heal from effect of inflammation

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8
Q

What are some respiratory inflammation

A

Pneumonia, Asthma, COPD

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9
Q

What is the intended responses for glucocorticoids

A

To reduce redness, pain, swollen at the site of information and increase function of affected area 

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10
Q

What are some short-term side effects of glucocorticoids

A

 hypertension, acne, insomnia, and nervousness

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11
Q

What are some long term therapy effect on glucocorticoid

A

Adrenal glands suppression, reduced immune function, delayed one healing, and the cushingoid appearance

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12
Q

What is the “Cushingoid” appearance

A

Think of the lady in the picture that you saw on the slide

Buffalo hump at your back, acne, Weight gain, stretch marks(striae), increase body and facial hair,  Truncal obesity (fat back), Extremity muscle wasting and weakness

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13
Q

What are some adverse effect of glucocorticoid

A

 they can max out infectin, And adrenal gland atrophy (lack of adrenal cortex support)

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14
Q

Can I patient just stop taking glucocorticoids drugs

A

No they will need to taper the drug meaning that they need to stop taking it very slowly. They can’t just stop taking it at once

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15
Q

As said nurse what should  You’ll be caution for( Glucocorticoids)

A

Diabetes because of hyperglycemia since the drug is known to suppress carbs and protein metabolism

Acute peptic Ulcer: I saw in the lining of your stomach (the small intestines)


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16
Q

Adults taking glucocorticoids should be reminded of the importance of taking the drugs During what time of the day

A

In the morning to approximate diurnal rhythm

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17
Q

Can glucocorticoid be applied on open lesions excoriated areas?

A

No it should be avoided

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18
Q

Can glucocorticoids be used during pregnancy? 

A

No because they can cross the placenta and could cause adverse effect on the fetus

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19
Q

What are some nursing implications for glucocorticoid

A

Assisted patient for symptoms of infection, assess the patient baseline weight and height, assess the patient intake and output status, assess the patient hydration and the nutritional status, says the patient vital signs especially for blood pressure the patient immune status, says the patient for edema and electrolyte imbalance since the patient for skin condition

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20
Q

What do you want to assist the patient for before given a glucocorticoids medication

A

 RN needs to assess the patient for drug allergies and potential drug interactions (prescription and over-the-counter drugs).
patient’s glucose level and be aware that this drug may alter serum glucose an electrolyte levels

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21
Q

 should you prepare Steroid medication at the same time every day especially in the morning? And can it be taken with food or meals?

A

Steroid medication can be prepared at the same time every day usually in the morning with meals or food

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22
Q

What is the oral form of corticosteroid durg and should be given with food

A

Prednisone
 Prednisone should be given with food or milk to minimize G.I. upset

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23
Q

What are Non-sterile anti-inflammatory drugs
(NSAID’s) specifically used for?

A

Pain

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24
Q

How does NSAID differ for corticosteroids?

A

NSAID’s provide anti inflammatory and analgesic(pain) effect without the adverse effects associated with corticosteroids

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25
Q

What are the three main purposes of NSAID’s?

A

Provide A strong anti-inflammatory response, analgesic (pain) and antipyretic (drugs used to prevent or reduce fever)

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26
Q

Drugs used to prevent fevers are classified as?

A

Antipyretic

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27
Q

Drugs used to prevent pain are classified as?

A

Analgesic

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28
Q

What kind of anti inflammatory drugs are sold OTC?

A

NSAIDs

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29
Q

In NSAIDs, what drugs are consider COX 1 inhibitors?

A

Ibuprofen and Acetylsalicylic Acid (focus more on for this class)

Ketorolac and Naproxen

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30
Q

What are the routes for Ibuprofen?

A

Oral or IV

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31
Q

What are the routes for Ketorolac?

A

Oral, IV, IM, intranasal

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32
Q

What are the routes for Acetylsalicylic Acid?

A

Oral and R/S(respiratory therapy?)

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33
Q

What is the route for Naproxen?

A

Oral

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34
Q

What are the Cox 2 inhibitors? And what are their route

A

Celcoxib and Meloxicam
They are both oral

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35
Q

What anti inflammatory drug classification is used in treatment of MI and other thromboembolic disorders?

A

NSAIDs

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36
Q

Inhibits synthesis of prostaglandin, used to treat mild to moderate pain and fever

A

NSAIDs

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37
Q

Where are NSAIDs drugs absorbed from?

A

Absorbed from the stomach

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38
Q

What is the peak time for NSAIDs drugs? In other words, when should the drug start working once someone takes it?

A

5-30 mins

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39
Q

NSAIDs are metabolized in the ——- and excreted in the ———

A

Liver and excreted in the Urine

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40
Q

What are the contraindications for NSAIDs

A

Presence of other NSAIDs
Known allergy, bleeding abnormalities and impaired renal function

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41
Q

what is the purpose of NSAIDs

A

Suppress inflammation, Treat mild to moderate pain, reduce fever, and relieve dysmenorrhea which is painful for menses

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42
Q

What nonopioid analgesics is used to treat mild to moderate pain reduce fever and relieve this
dysmenorrhea which is meant painful menses

A

NSAIDs

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43
Q

What is COX-1 inhibitors

A

Cox-1 is mainly present in tissue and involves tissue homeostasis,
 what is a key production for prostaglandins Which offer is the protection of the gastric mucosa which intern prevent the formation of ulcers

Regulation of renal blood flow, and childbirth 

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44
Q

What is Cox 2 inhibitors

A

Not normally present in tissues except for the kidney
Cox 2 produce prostaglandins, pain, redness etc 

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45
Q

Effects of NSAIDs is believed to come from? COX ?

A

Cox 2

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46
Q

Adverse effect of NSAIDS such as gastrointestinal bleeding comes from?

A

COX 2

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47
Q

Side effect of celcoxib cox 2 inhibitors

A

Ulcers, bleeding or holes in the stomach

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48
Q

Where are NSAIDs absorbed and when do they reach their peak levels?

A

GI tract and reach their peak levels in 1 -3 hours

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49
Q

Contraindications for NSAIDS

A

Allergy to any NSAIDs or Salicylates and celecoxib
someone with CV dysfunction or hypertension, peptic ulcer or known GI bleeding and pregnancy

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50
Q

Cautions for NSAIDS

A

Caution should be used for renal or hepatic dysfunction (liver disease) and any other known allergies

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51
Q

What are the adverse effects of NSAIDs

A

Nausea, dyspepsia, GI pain, Constipation, diarrhea, flatulence

52
Q

While nausea is an adverse effect of taking NSAIDs, are vomiting usually seen?

A

No

53
Q

What is this a contradiction of?

Known allergy, bleeding abnormalities, impaired renal function

A

NSAIDs

54
Q

What are the 2
actions/indicators for NSAIDs

A

Inhibits synthesis of prostagladin (lipids at site of injury that control inflammation, blood flow, blood clot) used to treat pain and fever

Anti thrombotic effect: Used in the treatment of heart attack and other thromembolic disorders

55
Q

What is an adverse effect that comes with Celcoxib

A

Allergy to sulfa drugs

56
Q

Celecoxib is used to relieve pain, tenderness, swelling and stiffness caused by osteoarthritis (arthritis caused by a breakdown of the lining of the joints), rheumatoid arthritis (arthritis caused by swelling of the lining of the joints), and ankylosing spondylitis (arthritis that mainly affects the spine)

A

True

57
Q

Salicylate toxicity is an adverse effect or?

A

NSADIs

58
Q

What are salicylate drugs

A

Salicylates are a type of drug found in many over-the-counter and prescription medicines. Aspirin is the most common type of salicylate.

59
Q

Drug and drug interactions
What happens when you take NSAIDs drugs with other drugs and loop diuretics

A

When taking with other drugs, it interferes with the absorption

There is a decrease diuretic effects with loop diuretics

60
Q

Should you take NSADs drug with other loop diuretics?

A

No

61
Q

What is meant by diuretic effect

A

Diuretics, sometimes called water pills, help rid your body of salt (sodium) and water. Most of these medicines help your kidneys release more sodium into your urine. The sodium helps remove water from your blood, decreasing the amount of fluid flowing through your veins and arteries. This reduces blood pressure.

62
Q

What is the relationship between NSAIDs and Renal function?

A

Renal fictions depends partially on prostaglandins. When that is disrupted by NSAIDs drugs it can lead to acute or chronic renal failure

63
Q

T/F Use of NSAIDs cannot comprise existing renal functions

A

False it can

64
Q

When can renal toxicity occur?

A

Pt with dehydration, heart failure, liver dysfunction, use diuretics or ACE inhibitors

65
Q

Salicylates (ASA) ( e,g like Aspirin). What is the daily tablets

A

Daily tablets low does is 81 mg and 325 for high dose

66
Q

What is Salicylate (ASA) used for

A

Intended for adults who have strong risk factors of developing coronary artery disease or cardiovascular accident

67
Q

When is Salicylate (ASA) effective

A

It is effective after MI( after the person has already had the heart attack

68
Q

Antihistamines
What is the first-generation?

A

Diphenhydramine (which is a medication that relieves the symptoms of allergies, treat pain and itching caused by insects bite)

69
Q

S/S of first generation diphenhydramine

A

Sedating(drowsy) and makes you feel sleepy

70
Q

What drug in the antihistamine category is used to treat pain and itching caused by insect bites, poison ivy, hay fever allegory and cold symptoms and insomnia

A

Diphenhydramine

71
Q

What is the second generation of Antihistamine

A

Cetirizine

72
Q

What is Cetirizine (second generation of antihistamine) used for

A

Red, itchy eye, hay fever, watery eyes, sneezing , allergy symptoms

73
Q

What are some side effects of Antihistamine

A

Blurred vision, tachycardia, dry mouth, urinary retention

74
Q

What are some adverse effect of Antihistamine?

A

Seizures and increased intraocular pressure

75
Q

What are the three categories of drugs that support the treatment of pain

A

Nonopioid analgesics, opioid analgesics and looks antagonist 

76
Q

What are narcotic agonist?

A

These are drugs that react with opiate receptors, causes analgesia (inability to feel pain), sedation(sleep, calm) or euphoria (happiness)
Potential for physical dependence
Controlled substances
Rising problem of addiction 

77
Q

What are mild agonists drugs?

A

Codeine and hydrocodone

78
Q

What are are strong agonist drugs?

A

Morphine, hydromorphone, oxycodone, meperidine, fentanyl’ and methadone

79
Q

What are the actions of narcotic agonist

A

Acts at specific opioid receptors sites in the CNS
They produce analgesia, sedation and a sense of well-being

80
Q

What are indications of narcotic agents

A

Relief severe acute or chronic pain
Analgesia during anesthesia

81
Q

What drug classification is an indication for analgesia during anesthesia

A

Narcotic agents

82
Q

What are the Pharmacokinetics of Narcotic agonist

A

IV is the most reliable way to achieve therapeutic response
IM and sub w rates of absorption varies between sexes
Hepatic metabolism and generally excreted in the urine and bile

83
Q

What are contraindications for Narcotic agonist

A

Known allergy, diarrhea caused by poisons and pregnancy, labor and lacation

84
Q

Orthostatic hypotension is an adverse effect for what drug classification

A

Narcotic agonists

85
Q

What are some cautions for narcotic agonist

A

Respiratory dysfunction, GI and GU Surgery, acute abdomen or ulcerative colitis

86
Q

What are some adverse effects

A

Respiratory depression with apnea, Cardiac arrest, shock, orthostatic hypotension, nausea, vomiting, constipation, biliary spasm, psychoses, hallucinations 

87
Q

What adverse effect is this a sign of?
Drug classification
Hallucination, respiratory depression with apnea, cardiac arrest, biliary spasm and psychoses 

A

Narcotic agonist

88
Q

What are the drug to drug interactions with narcotic agonist

A

Barbiturate general anesthetic a, phenothiazine and MAOI

89
Q

What is the first generation

A

Diphenhydramine: Benadryl for allergies

90
Q

What is antihistamine

A

Antihistamines are drugs which treat allergic rhinitis, common cold, influenza, and other allergies.

91
Q

Is antihistamine used for sessional allergy?

A

Yes

92
Q

Second generation of antihistamine

A

Cetirizine and less sleepiness

93
Q

Antipruritics effects

A

Topical antipruritics are a class of medications used to treat itchy skin in adults with eczema or other skin conditions that can lead to repeated scratching and thickened skin.

94
Q

What is the main mediator of inflammation?

A

Histamine

95
Q

What are the chemical mediators for inflammation

A

Histamine, prostaglandins, serotonin, leukotrienes, bradykinin

96
Q

NSAIDS and nonopioid drugs both helps with?

A

Inhibiting prostaglandin to stop pain, fever and inflammation

97
Q

What are the actions for Glucocorticoids?

A

Responsible for anti-inflammatory and immunosuppressive effects

98
Q

What are the indications for glucocorticoids

A

Short-term treatment for many inflammatory disorders such as respiratory inflammation and joint pain

Relieve discomfort

Give the body a chance to heal from
The effect of inflammation

99
Q

What are the intended response Glucocorticoids?

A

Reduce redness, pain, swollen outside of inflammation, and increase function of the affected area

100
Q

What are the short term effect of glucocorticoid

A

Hypertension, actually, insomnia, nervousness

101
Q

What are the long term effect of glucocorticoids

A

Adrenal gland suppression, reduced immune function, delayed wound healing, and “cushingoid appearance “

102
Q

What are the adverse effect of glucocorticoids

A

Adrenal gland atrophy, masking infection

103
Q

What should you be caution with when it comes to glucocorticoids
HO-DHL

A

Diabetics and peptic ulcers
 patients with hypertension hypothyroidism osteoporosis or liver disease

104
Q

What are NSAIDs medication importances


A

Provide strong anti-inflammatory and analgesic, and antipyretic effects
 and can blood inflammatory response

105
Q

What are the cooks one inhibitors of NSAIDs 
I-KAN

A

Ibuprofen (oral or IV)
Ketorolac (oral, IM and intranasal)
Acetylsalicylic Acid (oral, r//) Advil
naproxen (oral ) 

106
Q

What are cox 2 inhibitors of NSAIDs

A

Celcoxib -oral
Meloxicam- oral

107
Q

What are the action/indications of NSAIDs

A

Inhibits synthesis of Prostaglandin, used to treat to moderate pain and fever

It also has a antithrombotic effects: Used to treat MI and other blood clots like ASA (aspirin) which is a blood thinner 

108
Q

What is the pharmacokinetics of non-steroid cortisol drugs

A

Absorbed in the stomach usually takes 50 to 30 minutes(on slide) but 1-2 hours on Ppt.
It is metabolized in the liver and excreted in urine 

109
Q

What are the contraindications of NSAIDs

A

Presences of other NSAIDs
Known allergy, bleeding abnormalities, and impaired renal function

110
Q

What are adverse effects of NSAIDS

A

Effect on stomach and clotting systems
Celcoxib: allergy to sulfa drugs
Salicylate toxicity

111
Q

What are the drug and drug interactions

A

Interact with other drugs by interfering with absorption
Loop diuretics
Beta blockers
Possible lithium toxicity

112
Q

Should people with renal function issues be administered and NSAIDs 

A

No. Part of the renal function depends on the prostaglandins. NSAIDs block those if it’s strong enough and can cause renal functions like blood in stool

113
Q

What are the first generation for of Antihistamine

A

Diphenhydramine

114
Q

What is the second generation of antihistamine

A

Cetirizine

115
Q

Why are antihistamine important

A

Reduce inflammation by preventing inflammatory mediators (usually histamine or leukotriene)  from binding to its receptor
Blocks effect of histamine at the histamine one receptor
And decrease allergic response 

116
Q

What drug classification decrease allergic response

A

Antihistamine

117
Q

Histamines
Explain the H1 receptors

A

H1 receptors and blood vessels, respiratory mucous membranes

118
Q

Histamine
Explains H2 receptors

A

H2 receptors in stomach lining

119
Q

What is the main mediator of inflammation and capillary leak

A

Histamine

120
Q

What is the intended respond of antihistamines

A

Blood vessels do not dilate, reduce swelling, mucus, other nasal eye and respiratory secretion are reduced, and narrow airway widening, decrease hives in size and itchiness

121
Q

What are the side effects of antihistamines

A

Sleepiness, tachycardia , dry mouth, urinary retention , and blurred vision

122
Q

What are the adverse effect of antihistamines

A

seizure(rare) increase intraocular pressure

123
Q

What should you check before administering antihistamine drugs

A

Glucose, high blood pressure, and prostrate enlargement
You should also check if other drugs are being taken That’s cause sedation

124
Q

What should you check after administering antihistamine drugs,

A

Vital signs and assist the patient when you get an out of bed

125
Q

What did you teach the patient about antihistamine drugs

A

Avoid alcohol and avoid driving or operating machinery within six hours of administration

126
Q



A

Pharm Exam 1 (1 decks)

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