Ch 24 Pain Meds Flashcards
What is fever the result of
It is the result of fever inducing substances called pyrogens
What does fever activate
Fever causes activation of monocytes/ macrophages, which in turn secrete cytokines, which increase the synthesis and secretion of prostaglandin in the hypothalamus, this in turn causes the hypothalamus to reset the body temp
What are the classic signs of inflammation
Swelling, heat, redness, pain, loss of function
What do prostaglandins modulate
They modulate some components of inflammation, body temp, pain transmission, platelet aggregation, and many other body actions.
Cox 1
Synthesizes prostaglandins that are involved in the regulation of. Oral cell activity
Cox 2
Appears to produce prostaglandins mainly at sites of inflammation
Where does the sensation of peripheral pain begin
It begins in averted neurons called nociceptors, these receptors are activated by chemical mediators, such as prostaglandins, histamine,bradykinin, and serotonin.
The risk of platelet aggregation increases in who
Patients who smoke and have hypercholesterolemia
What are the 2 major types of migraine headaches
Migraine with aura
Migraine without aura
How do migraine headaches begin
It is postulated that migraines begin when intracranial blood vessels dilate.
What is the drug treats inflammation and fever
acetylsalicylic acid ( Aspirin)
salicylates are used in managing conditions ranging from a simple headache to MI
they are used primarily as anti inflammatory drugs but are also used extensively as analgesics.
What is the Pharmacotherapeutics of aspirin
Treats mild to moderate pain, prevents platelet aggregation
What are contraindications and precautions of aspirin
Hypersensitivity
peptic ulcer disease
Bleeding disorders
Children with illness
What are adverse effects of aspirin
Renal failure Abnormal bleeding GI upset Drowsiness Confusion
During what stage in pregnancy is aspirin contraindicated
In the last trimester
When giving aspirin for its cardiovascular properties, what type of aspirin should you use
Use uncoated aspirin
What is aspirin contraindicated in children with illness
It is contraindicated in children with varicella or flu like illness because it is assoc with the occurrence of REYE SYNDROME
What are NSAIDS
They are grouped by chemical class
They all inhibit COX and prostaglandin synthesis
They all carry a black box warning stating that they increase the risk if MI and stroke
What is the prototype NSAID
Ibuprofen
What is ibuprofen used for
Arthritis Mild to moderate pain Primary dysmenorrhea Migraine headaches Fever
When does ibuprofen peak
1-2 hours
What is the paharmacodynamics of ibuprofen
It inhibits synthesis or release Of prostaglandins
Ibuprofen is contraindicated in who
GI DISEASE
What are adverse effects of ibuprofen
GI upset & bleeding
Hepatotoxicity
Acute renal failure
Increased risk of CVA or MI with prolonged use
How can one maximize the therapeutic effects of Ibuprofen
Give with milk or food to decrease gastric distress
What is a para-aminophenol derivative
It is an analgesic and antipyretic avail in the U.S
What is the prototype para-amino phenol derivative
Acetaminophen (Tylenol)
What is acetaminophen used for
Fever or mild pain
When does acetaminophen peak
In 60 min
What are contraindications and precautions of acetaminophen
Hepatic disease
Viral hepatitis
Alcoholism
What are drug interactions of acetaminophen
Activated charcoal Antacids Ethanol Hydantoins Warfarin Sulfinpyrazone
What specific lab tests should be coordinated with .ong term use of acetaminophen
Coordinate periodic CBC
Platelet count
Liver and renal function tests
Who is acetaminophen contraindicated in
A person with hepatitis C, it is contraindicated in ppl with impaired liver/ hepatic function.
What are serotonin selective drugs
They are used to relieve pain and inflammation related to migraine headache
They are NOT useful for other types of headache or inflammation that occurs anywhere else in the body
These drugs are called “Tristan’s” because the generic names end in such
What is the prototype serotonin selective drugs
Sumatriptan ( imitrex)
They are considered the first line in therapy for acute migraine headaches and cluster headaches
How is sumatriptan administered
Orally
Intranasally
SC
Metabolized in the liver and excreted in the kidneys
What are contraindications and precautions of sumatriptan
CAD
Ischemic cardiac disease
What are adverse effects of sumatriptan
Coronary artery vasospasm Cardiac dysrhythmias Angina Myocardial ischemia Dizziness
What are drug interactions of sumatriptan
SSRI
MAOI
Where is temperature regulation controlled
Temp regulation is a function of the hypothalamus
