Anti-inflammatory Drugs

Question 1

5 main chategories of Anti-inflammatory

Answer 1

i. Corticosteroids
ii. Nonsteroidal anti-inflammatory drugs (NSAIDs)
iii. Antihistamines
iv. Leukotriene inhibitors
v. Disease-modifying antirheumatic drugs (DMARDs)

Question 2

Prevent or limit inflammation by slowing or stopping all known pathways (Prostaglandins, Leukotrienes) of inflammatory mediator production

Answer 2

corticosteroids

Question 3

Parenteral corticosteriod

Answer 3

Methyprednisolone

Question 4

Intended response of corticosteroids

Answer 4

i. Reduced redness, pain, swelling at site of inflammation; increased function of affected area

Question 5

adrenal gland suppression, reduced immune function, delayed wound healing, “Cushingoid appearance”

Answer 5

Long term therapy for corticosteroids

Question 6

Short term corticosteriods

Answer 6

hypertension, acne, insomnia, nervousness

Question 7

(corticosteroids) Assess for contraindications to adrenal drugs

also what levels?

Answer 7

peptic ulcer disease

glucose levels-may alter serum glucose & electrolyte levels

Question 8

l. Sudden discontinuation of these drugs (glucocorticoid therapy) can precipitate

Answer 8

Adrenal crisis

Question 9

Caution pts (corticosteroids)

Answer 9

w hypertension, hypothyroidism, diabetes mellitus, osteoporosis or liver disease (cautiously)

Question 10

i. Fungal infection
ii. Seizure disorder
iii. Ulcerative colitis
iv. Coagulopathy

Answer 10

contraindications for corticosteroids

Question 11

Because of the risk for hypokalemia, there is an increased risk of dysrhythmias caused by

Answer 11

Digoxin

Question 12

NSAIDs used to relieve:

Answer 12

i. Mild to moderate headaches
ii. Myalgia (muscle pain)
iii. Neuralgia (nerve pain)
iv. Arthralgia (muscle pain)
v. Alleviation of postoperative pain

Question 13

MOA NSAIDS

Answer 13

i. Inhibition of the leukotriene pathway, the prostaglandin pathway, or both

Question 14

promote synthesis, keeping GI lining intact

Answer 14

prostaglandin pathway COX 1

Question 15

synthesis throughout the body

Answer 15

COX 2

Question 16

check after NSAID

Answer 16

i. Bleeding, even with one dose

ii. Sensitivity reaction

Question 17

Patient teaching NSAID

Answer 17

ii. Monitor for bleeding

iii. Do not take with warfarin (Coumadin)

Question 18

known aspirin allergy aka

Answer 18

can’t take NSAID

Question 19

Conditions that put pts at risk for bleeding:

Answer 19

i. Vitamin K deficiency

ii. Peptic ulcer disease

Question 20

NSAID adverse effect

Answer 20

a. GI: heartburn to severe GI bleeding
h. Tinnitus, hearing loss
b. Acute renal failure
c. Noncardiogenic pulmonary edema
d. Increased risk of MI and stroke
e. Altered hemostasis
f. Hepatotoxicity
g. Skin eruption, sensitivity reaction

Question 21

Disruption of prostaglandin function by NSAIDs is sometimes strong enough to

Answer 21

precipitate acute or chronic renal failure

Question 22

Renal toxicity can occur in patients with

Answer 22

dehydration, heart failure, liver dysfunction, or use of diuretics or angiotensin-converting enzyme (ACE) inhibitors

Question 23

COX 1 & 2 examples

Answer 23

ibuprofen

Question 24

in the management of RA, OA, primary dysmenorrhea, gout, dental pain, musculoskeletal disorders, antipyretic actions

Answer 24

NSAIDS

Question 25

i. Irreversible inhibitor of COX-1 receptors within the platelets themselves ii. Other NSAIDs lack these antiplatelet effects iii. Inhibits platelet aggregation

Answer 25

Salicylic acid (aspirin)*

Question 26

used in the treatment of MI and other thromboembolic disorders

Answer 26

Antithrombotic effect (asprin)

Question 27

i. First and only remaining COX-2 inhibitor

Answer 27

Celecoxib (Celebrex)

Question 28

ii. Indicated for OA, RA, acute pain symptoms, ankylosing spondylitis, and primary dysmenorrhea

Answer 28

Celecoxib (celebrex)

Question 29

include headache, sinus irritation, diarrhea, fatigue, dizziness, lower extremity edema, and hypertension

Answer 29

adverse effects of COX 2

Question 30

a. All NSAIDs (except aspirin) share a black box warning regarding an increased risk of

Answer 30

Adverse cardiovascular thrombotic events (MI & stroke)

Question 31

a. Reduce inflammation by preventing inflammatory mediator (usually histamine or leukotriene) from binding to its receptor

Answer 31

Antihistamines

Question 32

i. Avoid if they have glaucoma, high blood pressure, prostate enlargement

Answer 32

antihistamines

Question 33

i. Blood vessels do not dilate; reduced swelling; mucus, other nasal, eye, respiratory secretions are reduced; narrowed airways widen; hives decrease in size, itchiness

Answer 33

intended responses of antihistamines

Question 34

i. Sleepiness, dry mouth, blurred vision, tachycardia, urinary retention

Answer 34

side effects of antihistamines

Question 35

b. Diphenhydramine- Oral, IV, IM

Answer 35

Benadryl