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Pharm > Ch. 25 - Antiinflammatory Drugs > Flashcards

Ch. 25 - Antiinflammatory Drugs Flashcards

1
Q

Inflammation

A
  1. ) Response to tissue injury & infection
  2. ) Vascular reaction
  3. ) Protective mechanism
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2
Q

Infection:

A

caused by microorganisms –> inflammation

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3
Q

5 Characteristics of Inflammation:

A
  1. ) Erythema
  2. ) Edema
  3. ) Heat
  4. ) Pain
  5. ) Loss of function
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4
Q

Prostaglandins:

A
  1. ) Released when cellular injury takes place

2. ) Injection of prostaglandins into body –> inflammatory process

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5
Q

Cyclooxygenase (COX):

A

COX1 = protects stomach lining & regulates platelets

COX2 = triggers inflammation & pain

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6
Q

Antiinflammatory Agents:

A
  • Nonsteriodal agents

- Steroidal agents

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7
Q

Nonsteriodal Antiinflammatory Drugs (NSAIDS):

A

Aspirin

-Aspirin like drugs –> inhibit COX2 enzyme

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8
Q

Nonsteriodal Antiinflammatory Drugs (NSAIDS): cont…

A

Salicylates & Nonsalicylates
1st generation NSAIDs
2nd generation NSAIDs (COX2 inhibitors)

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9
Q

Salicylates (ASA):

A

Strong prostaglandin inhibitor
—> reduces inflammatory process

Inhibits prostaglandin synthesis
—> COX1 & COX2 enzymes

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10
Q

Acetylsalicylic Acid (ASA) (1):

A

Antiplatelet drug:

  • Decrease platelet aggregation
  • Decrease blood clotting
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11
Q

Acetylsalicylic Acid (ASA) (2):

A

Low doses —> analgesic, antipyretic effect

Higher doses —> anti-inflammatory effect

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12
Q

Acetylsalicylic Acid (ASA) (3):

A

Most common adverse effects:

1. ) Gastric irritation
2. ) Occult Bleeding
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13
Q

Hypersensitivity to ASA

A
  1. ) Tinnitus
  2. ) Vertigo
  3. ) Bronchospasm
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14
Q

Tx of Headache (HA) / Fever:

A
  1. ) ASA
  2. ) Acetaminophen
  3. ) Ibuprofen
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15
Q

Tx of Inflammation / Swelling, Pain, Stiff Joints

A

NSAIDs = cost more than ASA

Contraindicted:
-allergic to ASA (asa is Aspirin)

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16
Q

Over the Counter (OTC) NSAIDs:

A
  1. ) Ibuprofen (Motrin, Advil)

2. ) Naproxen (Aleve)

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17
Q

Rx Drugs that Contain NSAIDs :

A
  • 1st Generation ——————*2ndGeneration
  • meloxican (Mobic) ———- celecoxib (Celebrex)
  • naproxen (Naprosyn)
  • nabumentone (Relafen)
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18
Q

Nursing Process (ASA):

A

Observe for signs of bleeding:

1. ) Dark Stools
2. ) Bleeding Gums
3. ) Petechiae
4. ) Ecchymosis

Bleeding from an IV site

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19
Q

Client Teaching (ASA) (1):

A
  1. ) DO NOT take with:
    • Alcohol
    • Anticoagulant Drugs
  2. ) Inform Dentist
  3. ) d/c 3-7 days before surgery
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20
Q

Client Teaching (ASA) (2):

A

Do not give to children for virus/flu symptoms

- Reye Syndrome

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21
Q

Client Teaching (ASA) (3):

A
  1. ) Take with:
    - Food/meals
    - Fluids

5.) Enteric coated

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22
Q

Other NSAIDs (1):

A

indomethacin (Indocin):

  1. ) Po/ rectal
  2. ) Arthritis
  3. ) Strong prostaglandin inhibitor
  4. ) Highly protein bound
  5. ) Very irritating to stomach
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23
Q

Other NSAIDs (2):

A

ketorolac (Toradol):

  1. ) IM / IV / po
  2. ) Greater analgesic properties
  3. ) Short-term pain relief
  4. ) Opiate level analgesia
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24
Q

SE /Adverse Reactions (1st Generation NSAIDs):

A
  1. ) Fewer SE than ASA
  2. ) GI irrigation (take with food)
  3. ) Sodium & water retention
  4. ) Alcohol —> increase gastric irritation
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25
Q

Selective COX2 Inhibitors:

A

2nd Generation
**Drug of choice for severe arthritis

-Does not inhibit COX1
Ex: Celecoxib (Celebrex)

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26
Q

Corticosteroids:

A

Steroid

Tx: inflammatory disorders

- Local
- Systemic
27
Q

Corticosteroids (1)

A
  1. ) Produced in adrenal cortex
  2. ) Anti-inflammatory properties (Glucocorticoid)
  3. ) Salt-retaining properties (Mineralcorticoid)
28
Q

Corticosteroids (2):

A

High doses / over long periods —>

-suppress hypothalamic pituitary adrenal hormone production

29
Q

Corticosteroids (3):

A

Glucocorticoid properties:

- alter CHO, protein, & lipid metabolism

30
Q

Corticosteroids (4):

A

Mineralcorticoid properties:

  • Enhance reabsorption of sodium
  • increase excretion of potassium & hydrogen ions —> effects fluid / electrolyte
31
Q

Side Effects:

A

Fluid retention
Altered glucose levels
Altered fat disposition
moon face , buffalo hump

32
Q

Corticosteroids (5):

A

Long term use:

  • Wasting of muscle tissue in extremities
  • Delayed growth in children
33
Q

Corticosteroids (6):

A
  • Prevent or suppress inflammatory signs & symptoms
  • Underlying cause of S/S may still remain
  • May mask disease S/S
34
Q

Corticosteroids (7):

A

Po, IM, IV, SQ, topical

-Adm DIRECTLY into inflamed site
Ex: joint, skin
*Avoid systemic side effects

35
Q

Examples:

A
  1. ) betamethasone (Celestone) = po, IM, IV
  2. ) dexamethasone (Decadron) = po
  3. ) Hydrocortisone (Cortef) = po, SQ, IM, IV
  4. ) Solu-cortef = (IM, IV)
  5. ) prednisone = po
  6. ) prednisolone = po, IM, IV
36
Q

Avoid Abrupt D/C of Drug —>

A

Adrenal insufficiency

  • Fatal if untreated
  • Medical Emergency

D/C drug gradually

37
Q

Corticosteroids^:

A

Protect from infection altered response to wound healing

38
Q

Nursing Dx:

A

Excess fluid volume r/t fluid rentention secondary to effect of corticosteroid

39
Q

Disease-Modifying Antirheumatic Drugs:

A

DMARDs

-Gold therapy = Chrysotherapy

40
Q

Gold Therapy (1):

A

Use:

1. ) Stop progression of rheumatoid arthritis 
2. ) Prevents deformities
41
Q

Gold Therapy (2):

A

Action:

3. ) Depress migration of leukocytes 
4. ) Suppress prostaglandins
42
Q

Gold Therapy (3):

A

Palliative = not curative

Results:

* may take up to mos (IV)
* may take 3-6mos (PO)
43
Q

auranofin (Ridaura):

A

Po, Gold sakt

Common SE:

 1. ) Skin Problems
 2. ) Blood Dyscarsias
 3. ) GI Irritation
44
Q

Nursing Process Health Teaching:

A
  1. ) Dental hygiene
  2. ) Adhere to scheduled blood tests
  3. ) Metallic taste / pruritus —> early symptom of possible gold toxicity
45
Q

Nursing Process:

A
  1. ) Avoid direct sunlight

2. ) Assess improvement in joint pain & motion

46
Q

Gout:

A

1.) Inflammatory condition
2.) Chronic metabolic disease —>
Hyperuricemia (abnormally elevated amounts of uric acid in blood

47
Q

Gout – Hyperuricemia (1):

A

D/T:

  1. ) Decreases renal elimination of uric acid
  2. ) Increase uric acid production
48
Q

Gout – Hyperuricemia (2):

A
  1. ) Uric acid precipitates as crystals (tophi) –>

4. ) Deposit on tissues & joints –> gouty arthritis

49
Q

Gouty Arthritis (1):

A
  1. ) Inflammation at site of crystal deposits (tophi)
  2. ) Acte joint pain
  3. ) Most susceptible site —> Metatarsophalangeal joint of great toe
50
Q

Gouty Arthritis (2):

A
  1. ) Metatarsal bone

2. ) Phalanges

51
Q

Gouty Arthritis (3):

A
  1. ) Increase fluid intake —>
    • Promotes uric acid excretion
    • Prevents renal calculi
  2. ) Avoid foods high in purine
    • alcohol
52
Q

Anti-inflammatory Gout Drugs:

A

Colchine:

  1. ) Inhibits migration of leukocytes to inflamed site
  2. ) Alleviates acute symptoms
    - take at first sign of attack
53
Q

Colchicine (1):

A

DOES NOT:

  1. ) Inhibit uric acid synthesis
  2. ) Promote uric acid excretion
54
Q

Colchicine (2):

A

Common SE = gastric irritation

High doses = n/v, diarrhea, abdominal pain

55
Q

Management:

A

After acute attack is over:

  1. ) Begin therapy to control hyperuricemia
  2. ) Reduce serum urate levels to
56
Q

Uric Acid Inhibitor:

A

allopurinol (Zyloprim)

- Prevents formation of uric acid in body

57
Q

allopurinol (Zyloprim) (1):

A
  1. ) Interferes w/ conversion of purines to uric acid —–>
  2. ) Inhibits enzyme xanthine oxidase —->
  3. ) Good for clients w/ renal obstruction d/t uric acid secretions
58
Q

allopurinol (Zyloprim) (2):

A
  1. ) Prevents attack

5. ) Increase fluid intake —> promote diuresis & alkalization of urine

59
Q

Uricosurics:

A

probenecid (Benemid)

  • Increases urinary excretion of uric acid
  • Prevents reabsorption in renal tubules
60
Q

probenecid (Benemid):

A
  1. ) Initially increases concentration of uric acid in urine —-> @ risk: KIDNEY STONES
  2. ) Drink large amounts of water
  3. ) ASA decreases the effect of probenecid
61
Q

Nursing Process – Nsg Dx:

A

Impaired skin integrity r/t inflammation of great toe

Acute pain r/t tissue swelling

62
Q

Client Teaching (1):

A
  1. ) Initiate tx at first sign of attack
  2. ) Avoid certain foods
  3. ) Encourage fluids
  4. ) DO NOT use ASA while taking probenecid
63
Q

Client Teaching (2):

A

allopurinol (Zyloprim)

*Monitor lab tests = renal, liver function, CBC

64
Q

Client Teaching:

A

Annual eye exams

Report:

 - Anorexia, n/v, diarrhea, stomatitis
 - Dizziness, rash, pruritis, metallic taste

Pharm (18 decks)

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