Drug Slides - Week 3 (Part 1)- Exam 1

Question 1

Ibuprofen

Answer 1

therapeutic class:
analgesic, anti-inflammatory drug, antipyretic

pharmacologic class:
NSAID

Pharmacokinetics:
onset: 30-60 min
peak: 1-2 hours
duration: 4-6 hours

actions & uses:
- older drug, treatment of mild to moderate pain, fever, and inflammation.
- inhibits prostaglandin synthesis.
- commonly used for pain associated with RA, headache, dental pain

adverse effects:
generally mild, nausea, heartburn, epigastric pain, dizzy
- high doses: may cause gi ulceration with occult or gross bleeding
- chronic use: may lead to renal impairment

BLACK BOX WARNING:
- NSAIDS may increase risk of thrombotic events, MI, stroke
- risk of serious gi adverse events such as bleeding, ulceration, and perforation of stomach or intestines

interations:
drug-drug: avoid if using anticoagulants and other coagulation modifiers.
- used with other NSAIDS may cause adverse gi events

lab tests:
may increase bleeding time

treatment of overdose:
no specific treatment; admin of alkaline drug may increase urinary excretion of ibuprofen

contraindications:
active peptic ulcers, significant renal or hepatic impairment

Question 2

Prednisone

Answer 2

therapeutic class: anti-inflammatory drug

pharmacologic class: corticosteroid

• when using drug for more than 10 days, the dose must be slowly tapered, remember how lazy the adrenal glands are to start working on their own again?

actions and uses:
corticosteroid, used for inflammation commonly limited 4 to 10 days.
when used for long-term therapy alternate day dosing is used.

adverse effects:
1. short-term use - few serious side effects
2. long term use - may result in cushings syndrome (look up pictures, signature “moon face”)
may cause gastric ulcers

drug to drug:
can raise blood glucose levels, patients with diabetes may require an adjustment on insulin doses

contraindications:
active viral, bacterial, fungal infections

overdose:
no treatment

Question 3

Acetaminophen (Tylenol)

Answer 3

therapeutic class: antipyretic, analgesic

pharmacologic class:
centrally acting COX inhibitor

pharmacokinetics:
onset: 30-60 min
peak: 0.5-2 hours
duration: 4-6 hours

action and uses:
1. reduces fever
2. NO anti inflammatory properties
3. treatment of fever in children or when aspirin is contraindicated
4. may be combined with opioids
5. no effect on platelet aggregation
6. ** does NOT cause gi bleeding or ulcers (versus NSAIDS)

adverse effects:
1. generally safe
2. not recommended for malnourished patients
3. acute toxicity may lead to renal failure, nausea, vomiting, chills
4. **high dose risk for liver damage

black box warning:
potential to cause severe and fatal liver injury

drug to drug:
1. inhibits warfarin
2. consumed with alcohol may cause liver failure

overdose:
oral or iv administration of Acetadote

contraindications:
hypersensitivity to acetaminophen and alcoholism

Question 4

Ibuprofen
Therapeutic class?

Answer 4

Analgesic, anti-inflammatory, antipyretic

Question 5

Ibuprofen
Pharmacologic class?

Answer 5

NSAID
non-steroidal anti-inflammatory drug

Question 6

Ibuprofen:
Actions and uses?

Answer 6

treatment of mild to moderate pain, fever, and inflammation

common indications: pain associated with chronic musculoskeletal disorders such as RA, headache, dental pain, and dysmenrrhea

Question 7

Ibuprofen:
mechanism of action?

Answer 7

inhibition of prostaglandin synthesis

Question 8

ibuprofen: Adverse effects?

Answer 8

generally mild: nausea, heart burn, epigastric pain, and dizziness. GI ulceration with occult or gross bleeding may occur, especially when taken in high doses for a long time

chronic use of ibuprofen may lead to kidney impairment

Question 9

Ibuprofen: Black Box Warnings

Answer 9

serious thrombotic events, MI, stroke

GI adverse events: bleeding, ulceration, perforation of stomach or intestines

Question 10

Ibuprofen: Drug-drug interations

Answer 10

ibuprofen can affect platelet formation -> avoid when pt taking anticoagulants and other coagulation modifiers.

use with other NSAIDS, alcohol, or corticosteroids may cause adverse GI events

Question 11

Ibuprofen: Lab tests

Answer 11

may increase bleeding time, AST, ALT

Question 11

Ibuprofen: Contraindications

Answer 11

• active peptic ulcers
• renal or hepatic impairment
• nasal polyps
• HF, serious HTN, hx of stroke or MI

Question 12

Prednisone: Therapeutic class?

Answer 12

anti-inflammatory drug

Question 13

Prednisone: Pharmacologic class?

Answer 13

corticosteroid

Question 14

Prednisone: Actions & uses

Answer 14

synthetic corticosteroid; when used for inflammation duration of therapy 4 to 10 days

Question 15

Prednisone: Adverse Effects?

Answer 15

short term use few adverse effects;

long term use cushings syndrome, gastric ulcers

Question 16

Prednisone: Drug to Drug interactions?

Answer 16

can raise blood glucose levels, diabetic may require adjustment in dose of insulin

Question 17

Prednisone: Lab tests

Answer 17

may increase blood glucose, may inhibit antibody response

Question 18

Prednisone: Contraindiations?

Answer 18

pts with active viral, bacterial, fungal, or protozoan infections

Question 19

Acetaminophen: therapeutic class?

Answer 19

antipyretic and analgesic

Question 20

Acetaminophen: pharmacologic class?

Answer 20

centrally acting COX inhibitor

Question 21

Acetaminophen; actions and uses

Answer 21

1 therapeutic class: treatment of fever in children for relief of mild to moderate pain when aspirin in contraindicated

reduces fever, dilates peripheral blood vessels

no anti inflammatory processes

does NOT cause GI bleeding or ulcers as do NSAIDS

Question 22

acetaminophen: adverse events?

Answer 22

generally safe

not recommended for malnourished patients, acute toxicity may occur

high doses risk for liver damage

Question 23

Acetaminophen: BBW

Answer 23

severe or fatal liver injury

Question 24

Acetaminophen: Drug to drug interactions

Answer 24

inhibits warfarin metabolism, causing warfarin to accumulate to toxic levels

Question 25

acetaminophen: lab tests

Answer 25

may increase serum bilirubin, AST, ALT

Question 26

Acetaminophen: Contraindications?

Answer 26

hypersensitivity to acetaminophen and chronic alcoholism