Chapter 33 Inflammation and Fever Flashcards
Vasodilation
Heat, redness
Vascular permeability
Edema
cellular infiltration
Pus
Thrombosis
Clots
Stimulation of nerve endings
Pain
Acute inflammation
Vasodilation, vascular permeability, stimulation of nerve endings, cellular infiltration, thrombosis
Bradykinin
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)
Complement
Series of 20 proteins that combine in a cascade fashion that destroy or neutralize an antigen; stimulates release of histamine from mast cell
C-reactive protein
Protein found in plasma that is an early marker of inflammation
Cytokines
Proteins produced by leukocytes, macrophages, and dendritic cells that mediate and regulate immune and inflammatory reactions
Histamine
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
Leukotrienes
Stored and released from mast cells; effects are similar to histamine; contributes to symptoms of asthma and allergies
Prostaglandins
Present in most tissues and stored and released by mast cells; increases capillary permeability, attract WBC to site of inflammation, cause pain, induce fever
Tissue damage—> arachidonic acid—>COX-1 —>Cytoprotective prostaglandins
-Gastroprotection (decreasing acid production, increase mucus production)
- increased platelet aggregation
-renal (kidney) protection
-vasodilation
-bronchodilation
Tissue damage—> arachidonic acid —> COX-2–> inflammatory prostaglandins
Formed after tissue injury and promotes inflammation
- inflammation
-pain
-fever
-decrease platelet aggregation
NSAIDS MOA
-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
Ibuprofen (Advil, Motrin) MOA
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
Aspirin for children under 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
Salicylism
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
Reye’s syndrome
Rare but serious condition that causes confusion, swelling in brain, and liver damage
is there an increase in thromboembolic event when taking non-aspirin NSAID
Yes
Crushing Syndrome
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
Indication for corticosteroids (Glucocorticoids)
Suppress severe/disabling inflammation but has potentially serious AE
T/F acetaminophen, ibuprofen, and aspirin have equal efficacy in reliving pain and reducing fever
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