Chapter 33 Inflammation and Fever

Question 1

Vasodilation

Answer 1

Heat, redness

Question 2

Vascular permeability

Answer 2

Edema

Question 3

cellular infiltration

Answer 3

Pus

Question 4

Thrombosis

Answer 4

Clots

Question 5

Stimulation of nerve endings

Answer 5

Pain

Question 6

Acute inflammation

Answer 6

Vasodilation, vascular permeability, stimulation of nerve endings, cellular infiltration, thrombosis

Question 7

Bradykinin

Answer 7

Present in an inactive form in plasma and mast cells; effects are similar to histamine; vasodilator that causes pain; broken down by ACE (angiotensin-converting enzyme)

Question 8

Complement

Answer 8

Series of 20 proteins that combine in a cascade fashion that destroy or neutralize an antigen; stimulates release of histamine from mast cell

Question 9

C-reactive protein

Answer 9

Protein found in plasma that is an early marker of inflammation

Question 10

Cytokines

Answer 10

Proteins produced by leukocytes, macrophages, and dendritic cells that mediate and regulate immune and inflammatory reactions

Question 11

Histamine

Answer 11

Stored and released by mast cells (located in tissue spaces under epithelial membranes, such as skin, bronchial tree, digestive tract, and along blood vessels); causes vasodilation, smooth muscle contraction, tissue swelling, itching

Chemical mediator for inflammation

Question 12

Leukotrienes

Answer 12

Stored and released from mast cells; effects are similar to histamine; contributes to symptoms of asthma and allergies

Question 13

Prostaglandins

Answer 13

Present in most tissues and stored and released by mast cells; increases capillary permeability, attract WBC to site of inflammation, cause pain, induce fever

Question 14

Tissue damage—> arachidonic acid—>COX-1 —>Cytoprotective prostaglandins

Answer 14

-Gastroprotection (decreasing acid production, increase mucus production)
- increased platelet aggregation
-renal (kidney) protection
-vasodilation
-bronchodilation

Question 15

Tissue damage—> arachidonic acid —> COX-2–> inflammatory prostaglandins

Answer 15

Formed after tissue injury and promotes inflammation
- inflammation
-pain
-fever
-decrease platelet aggregation

Question 16

NSAIDS MOA

Answer 16

-Bind to COX enzymes which prevents arachidonic acid from accessing catalytic site of enzyme
- COX enzymes cannot act upon arachidonic acid to synthesize prostaglandins, which are associated with symptoms like swelling and pain

Question 17

Ibuprofen (Advil, Motrin) MOA

Answer 17

Inhibits COX-1 and COX-2 (reversible) by binding to arginine molecule in both COX-1 and COX-2 enzymes to prevent arachidonic acid from entering the channel

Therefore, inhibiting prostaglandins —> NSAID reduces inflammation and relieves pain

Antipyretic—> effect on hypothalamus, by increasing blood flow, causing vasodilation and encouraging heart dissipation

Note: alternate to aspirin bc has less incidence of AE
Common SE N/V
Less incidence of gastric bleeding and ulceration compared to aspirin

Question 18

Aspirin for children under 18

Answer 18

Increased risk for Reye’s syndrome
Do not give when treat viral infection (influenza, varicella)
Do not give products that contain aspirin if they have flu symptoms, fever, chicken pox

Causes confusion, swelling in brain, and liver damage

Question 19

Salicylism

Answer 19

High doses of aspirin
Syndrome that include symptoms such as tinnitus (ringing in ears), dizziness, HA, excessive sweating , N/V
Buildup of aspirin in body to toxic levels, can occur if client ingest more aspirin than they excrete

Question 20

Reye’s syndrome

Answer 20

Rare but serious condition that causes confusion, swelling in brain, and liver damage

Question 21

is there an increase in thromboembolic event when taking non-aspirin NSAID

Answer 21

Yes

Question 22

Crushing Syndrome

Answer 22

Overtreatment of corticosteroids
Hallmark signs: fatty hump between your shoulders, rounded face, and pink or purple stretch marks on your skin
- body becomes accustomed to high doses of corticosteroids, patients must discontent drugs gradually
Abrupt withdrawal can result in adequate lack of adrenal function

Question 23

Indication for corticosteroids (Glucocorticoids)

Answer 23

Suppress severe/disabling inflammation but has potentially serious AE

Question 24

T/F acetaminophen, ibuprofen, and aspirin have equal efficacy in reliving pain and reducing fever

Answer 24

T

Question 25

MOA of acetaminophen (Tylenol)

Answer 25

Reduce fever by direct action on hypothalamus and dilation of peripheral blood vessels
Enables sweating and dissipation of heat
Not an anti-inflammatory agent

Question 26

Primary therapeutic usefulness of acetaminophen

Answer 26

Treatment of fever in children and for relief of mild and moderate pain when aspirin is contraindicated in the treatment of severe pain

May be combined with opioids

Question 27

T/F acetaminophen has an effect on platelet aggregation and cardio toxicity

Answer 27

FALSE