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Pharm 2 > drugs and inflammation > Flashcards

drugs and inflammation Flashcards

1
Q

describe the inflammatory response

A

local reaction of the body to invasion or injury. ANY result to the body that injures cells or tissue will set off an inflammatory response

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2
Q

whats released when tissue/cells are injured

A
  • bradykinin
  • histamine
  • prostaglandins
  • leukocytosis
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3
Q

look at this thing

A
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4
Q

after the chemical mediators produce their reaction to destroy pathogens and protect the body, what are the symptoms?

A
  • swelling
  • fever
  • aches
  • pain
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5
Q

describe how cellular injury leads to the inflammatory cascade

A

cellular injury -> arachidonic acid -> COX-1 or COX-2 -> prostaglandins -> starts inflammatory response

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6
Q

describe COX-1

A
  • involved in many bodily functions (normal)
  • blood clotting, protecting stomch lining, kidneys

this is the good one

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7
Q

describe COX-2

A
  • active at site of trauma or injury (inflammation)
  • pain, inflammation, vasodilation, bleeding

this is the bad one

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8
Q

what are the differences in acute and chronic inflammation

A

acute:
- pain
- redness
- swelling
- exudate
- fever

chronic:
- tissue destruction
- scar tissue
- diminished function

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9
Q

what chemical are part of inflammatory response? select all that apply

1) bradykinin
2) prostaglandins
3) histamine
4) glucocorticoids

A

1) bradykinin
2) prostaglandins
3) histamine

these all play a part in the systemic reaction after tissue injury. glucocorticoid is a steroid hormone released by the adrenal gland

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10
Q

what is the most frequently used OTC med in children

A

acetaminophen

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11
Q

describe the action of acetaminophen

A

reduces fever and pain but has NO antiinflammatory effect

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12
Q

what is acetaminophen used for

A

reduce fever and treat minor pain in adults and children

good for osteoarthritis

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13
Q

what are some advers effects of acetaminophen

A
  • liver failure
  • renal failure
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14
Q

whats a contraindication of acetaminophen

A

liver dysfunction
- cirrhosis
- alcohol abuse
- fatty liver

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15
Q

what are some nursing considerations for acetaminophen

A
  • 4 grams is max daily dose
  • acetylcysteine is antidote for OD
  • be aware of other meds containing acetaminophen (percocet)
  • available multiple routes (PO, IV, rectal)
  • monito liver function
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16
Q

whats included in patient education for acetaminophen

A
  • many OTC drugs have acetaminophen
  • do no exceed recommended dose
  • avoid alcohol
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17
Q

what do anti-inflammatory agents do

A
  • block or alter the chemical reactions associated with the inflammatory response
  • stop one or more signs and symptoms of inflammation
  • systemically block inflammatory response
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18
Q

what are anti-inflammatory agents used to treat

A
  • pain
  • fever
  • many -itis conditions
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19
Q

give an example of a salicylate

A

aspirin

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20
Q

describe the action of salicylates

A
  • blocks prostaglandin production
  • antiplatelet
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21
Q

what are salicylates used for

A
  • pain relief
  • antipyretic
  • osteoarthritis
  • low dose (81mg) prevents CVA/MI
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22
Q

what are some adverse effects of salicylates

A
  • GI bleeding (blocking platelets and COX-1 which depletes stomach lining protection)
  • bleeding and bruising
  • toxicity
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23
Q

what are some contraindications of salicylates

A
  • children (reye syndrome)
  • renal failure
  • bleeding abnormalities
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24
Q

what are some nursing considerations for salicylates

A
  • vitals including temp
  • do not crush/chew EC
  • assess for s/sx of bleeding
  • follow up labs
  • give with food, encourage hydration
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25
Q

describe patient education for salicylates

A
  • do not overuse med
  • take with food
  • do not crush/chew EC tabs
  • call MD for s/sx of toxicity (ringing in the ears, hearing loss, bleeding)
  • hold at least 1 week before and after surgery
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26
Q

give examples of propionic acid derivatives

A

ibuprofen, noproxen

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27
Q

describe the action of propionic acid derivatives

A
  • blocks COX 1 and 2
  • blocks prostaglandin production
  • stops inflammatory cascade
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28
Q

what are propionic acid derivatives used for

A
  • mild pain relief (RA and OA)
  • fever reduction adults and kids
  • anti-inflammatory
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29
Q

what are some adverse effects of propionic acid derivatives

A
  • GI effects
  • GI bleeding
  • kidney damage
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30
Q

what are some contraindications for propionic acid derivatives

A
  • GI bleeding
  • renal dysfunction
31
Q

one more time… whats the action of anti-inflammatories (NSAIDs)

A
  • block COX 1&2
  • block prostaglandin production
  • stops inflammatory cascade
32
Q

give and example of oxicam derivatives

A

meloxicam

33
Q

descirbe the action of oxicam derivatives

A
  • blocks cox 1 and 2
  • blocks prostaglandin production
  • stops inflammatory cascade
  • more specific to bone and cartilage
34
Q

what are oxicam derivatives used for

A
  • osteoarthritis
  • rheumatoid arthritis
35
Q

what are some adverse effects of oxicam derivatives

A
  • bleeding, platelet inhibition
  • black box warning for GI bleeding and MI
36
Q

what are some contraindications of oxicam derivatives

A
  • GI bleeding
  • recent MI
37
Q

name some acetic acid derivatives

A

indomethacin, ketorolac

38
Q

describe the action of acetic acid derivatives

A
  • inhibits mainly cox-1
  • stronger anti-inflammatory effects
39
Q

what are acetic acid derivatives used for

A
  • anti-inflammatory (RA, OA, gout)
  • analgesia
  • antipyretic
40
Q

what are some adverse effects of acetic acid derivatives

A
  • GI bleeding
  • bleeding
  • renal failure
    black box warning for GI bleeding and MI
41
Q

what are some contraindications of acetic acid derivatives

A
  • GI bleeding
  • recent surgery
  • bleeding disorders
  • recent MI
  • renal failure
42
Q

give and example of a selective COX-2 inhibitor

A

celecoxib

43
Q

describe the action of selective COX-2 inhibitors

A

blocks cox 2 without blocking cox 1s protective effects

44
Q

what are selective COX-2 inhibitors used for

A

acute and long term treatment of RA, OA, and juvenile RA

45
Q

what are some adverse effects of selective COX-2 inhibitors

A
  • renal failure
  • black box warning for risk for MI or CVA
46
Q

what are some contraindications for selective COX-2 inhibitors

A
  • renal failure
  • recent MI or CVA
47
Q

what are some nrusing considerations for NSAIDS

A
  • give after meals to decrease GI effects
  • monitor for s/sx of bleeding (nose bleeds, bruising, bloody urine/stool)
  • use caution with other blood thinners
48
Q

describe patient education for NSAIDS

A
  • take after meals
  • report signs and symptoms of bleeding to MD
  • only take as directed
49
Q

a toddler is running a fever or 103F. which of the following meds is alternated to treat a fever in children?

1) aspirin and acetaminophen
2) acetaminophen and ibuprofen
3) naproxen and ibuprofen
4) aspirin and ibuprofen

A

2) acetaminophen and ibuprofen

aspirin is contraindicated in children for the risk for reye syndrome. naproxen and ibuprofen are the same type of med so should not be given together

50
Q

antigout meds

give an example of an mitotic agent

A

colchicine

51
Q

antigout meds

describe the action of colchicine

A

decreases inflammatory reaction from the crystals

52
Q

what is colchicine used for

A
  • most common gout med
  • treatment and prevention of gout
53
Q

antigout meds

what are some adverse effects of colchicine

A
  • GI upset
  • hepatotoxicity
54
Q

antigout meds

whats a contraindication of colchicine

A

hepatic failure

55
Q

antigout meds

give an example of uricosuric agents

A

allopurinol

56
Q

antigout meds

describe the action of allopurinol

A

reduces uric acid production

57
Q

what is allopurinol used for

A

treatment of gout

58
Q

antigout meds

what are some adverse effects of allopurinol

A
  • drowsiness, HA
  • GI upset
59
Q

what are some nursing considerations for antigout meds

A
  • drug to drug interactions with many antibiotics
  • give with food
  • avoid grapefruit juice
  • encourage hydration
60
Q

describe patient education for antigout meds

A
  • avoid alcohol
  • avoid grapefruit juice
  • increase fluid intake
  • take with food to decrease GI upset
61
Q

a patient is scheduled for surgery tomorrow. which meds may increase the risk of bleeding? select all that apply:

1) aspirin
2) acetaminphen
3) indomethacin
4) meloxicam

A

1) aspirin
3) indomethacin
4) meloxicam

acetaminophen is the only drug on the list that will not effect bleeding. generally these meds should be held at least one week before and after surgery

62
Q

describe the physiology of corticosteroids

A
  • released by adrenal glands
  • regulated by hypothalamus
  • 3 main steroid hormones (glucocorticoids, mineralcorticoids, androgens)
63
Q

what are the effects of corticosteroids

A
  • suppress inflammatory hormones
  • reduce capillary permeability
  • impairs phagocytosis
  • inhibits tissue repair
  • impairs lymphocytes
  • decrease inflammatory and immune response
64
Q

give and example of corticosteroid therapy

A

prednisone

(-one is important)

65
Q

describe the action of prednisone

A

decerase inflammatory and immune response

66
Q

what is prednisone used for

A

symptom control but not cure

treat broad spctrum of inflammatory and immune conditions like…
- allergic reactions
- autoimmune disorders (lupus, RA, crohns)
- skin conditions
- endocrine disorders
- neurologic disorders
- resp disorders

67
Q

what are some adverse effects of prednisone

A
  • adrenocortical insufficiency/excess
  • CNS: dizziness, insomnia
  • cardiac: dysrhythmias
  • decreased immunity
  • hyperglycemia
  • fluid retention
  • thin skin, delayed wound healing
  • osteoporosis
68
Q

what are some contraindications of prednisone

A
  • live vaccines
  • kidney/liver/endocrine disease
  • immunosuppression
69
Q

what are some nursing considerations for corticosteroid therapy

A
  • tapering off doses is necessary
  • give locally is possible (topical or inhalation)
  • many med interactions
  • give in AM if for repleacement therapy to simulate normal body functions
  • may need increased replacement doses in times of stress
70
Q

describe patient education for corticosteroid therapy

A
  • do NOT stop abruptly, must wean off
  • is using inhaler, rinse mouth out
  • avoid exposure to sick people
  • weight gain/fluid retention is likely
  • may need additional dose in times of stress or illness
  • corticosteroids are not the same as muscle building steroids
71
Q

a nurse is teaching a petient about taking acetaminophen for arthritis pain. which of the following statements is most appropriate?

1) it will only help relieve pain but not the inflammation from arthritis
2) it is appropriate for the treatment of inflammation from arthritis
3) your PCP should consider a narcotic prescription
4) the acetaminophen should be taken on an empty stomach

A

1) it will only help relieve pain but not the inflammation from arthritis

acetaminophen is commonly taken for ateoarthritis, it works as an analgesic but does NOT have any anti-inflammatory properties

72
Q

a patient is taking systemic corticosteroids. which of the following nursing interventions is the most important?

1) assess for s/sx of adrenocortical excess
2) hold cortisone before surgery
3) assess for fluid volum deficit
4) decrease intake of vitamin C

A

1) assess for s/sx of adrenocortical excess

these are stronger and will influence the entire body. s/sx of excess are skin probs (poor wound healing), high BP (fluid retention), bone weakness (osteoporosis), and high glucose. remember you would want to give steroids in times of stress like surgery

73
Q

a patient is receiving prednisone 10mg orally every day to reduce the sx of crohns. which of the following side effects is associated with daily prednisone?

1) atrophy of adrenal gland
2) decrease serum glucose
3) weight loss
4) fluid volume deficit

A

1) atrophy of adrenal gland

taking daily corticosteroids will make the adrenal glands stop producing their own hormones leading to shrinking of the gland. thats why its important to taper off the steroid doses down gradually

Pharm 2 (34 decks)

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