Exam III pt. 1 Flashcards
What are 3 non-opioid analgesics?
NSAID non selectives, NSAID selectives, Acetominophen
What are NSAID non-selectives?
Salicylates, ibuprofen, naproxen
What is a noteable side effect of Aspirin?
Reye’s syndrome
What are some noteable side effects of Ibuprofen, Naproxen?
Electrolyte imbalances, hemorrhages
What condition is overall a risk factor for NSAIDs?
Severe stomach bleeding
What is a common name for NSAID, selective Cox-2 inhibitor?
Celecoxib (Celebrex)
What is the comparable GI toxicity between Celebrex (celecoxib) and other NSAIDs?
Does not block COX-1, so less GI toxicity
What is the common use for Celebrex (celecoxib)?
Mild pain such as arthritis
What are some noteable side effects of Celebrex?
GI perforation and bleeding, thrombosis, Stevens-Johnson syndrome, liver and renal failure
What nutrient interactions are noted with NSAIDs?
Depletes vitamin C, folate, iron, zinc.
What kind of supplements should you avoid if you’re taking NSAIDS?
Anticoagulant supplements (e.g. garlic, ginger, ginko, ginseng, fish oil, vitamin E, etc, etc, etc)
Does acetaminophen work DIRECTLY to inhibit a COX pathway in protaglandin synthesis?
No, it acts directly on the hypothalamus, which then inhibits prostaglandin synthesis
T/F
Acetaminophen is known for it’s analgesic, antipyretic, and anti-inflammatory properties
False,
Acetaminophen has no anti-inflammatory activity, regardless of it’s usage by the general populus.
What side effects are reported with excessive dosing of acetaminophen? What doses are considered excessive?
Hepatotoxicity. >4g/day (adults) or large doses (6g in adults).
What are some examples of opioid analgesics?
Morphine, oxycodone, several combination drugs, etc.
What are it’s common uses and draw backs?
Relieves virtually any type of pain. High risk for tolerance, dependence and abuse
What are side effects associated with opioid analgesics?
Sedation, constipation. Respiratory and CNS depression/death
What drugs are a combination of hydrocodone + acetaminophen?
Vicodin, Narco
What combination drug comes from oxycodone + acetaminophen
Percocet
What combination drug comes from propoxyphene + acetaminophen?
Darvocet
What combination drug comes from codeine + acetaminophen?
Tylenol 2,3,4
What are 4 natural supplements with strong evidence of analgesic activity?
Capsicum, clove, comfrey, willow bark.
Migraines come from what kind of activity in the brain?
Arise from neurovascular disturbance in the brain (cortical spreading depression elicits a trigeminovascular reflex).
What NTs may cause inflammation/pain in migraine headaches?
Dopamine and serotonin release
What are Triptans?
Serotonin 5-HT1 receptor agonists
What are some natural migraine prophylactics that are supported by strong evidence?
Feverfew, butterbur, peppermint (topical). CHIROPRACTIC!!!
What is an example of an immediate immunologic reaction triggered by antibiotics?
Anaphylaxis or hives
What is an exmaple of a delayed immunologic reaciton triggered by antibiotics?
Rahes, serum sickness, drug fever
What antibiotic drugs are most notorious for triggering immunologic reactions?
Beta-lactam drugs (penicillins, cephalosporins
What are the 4 antiobiotic mechanisms of action?
Inhibition of cell wall synthesis
Inhibition of protein synthesis
Inhibition of general metabolic pathways
Inhibition of RNA/DNA synthesis
What is the main mechanism of action of penicillins?
Beta lactam ring binds to and inhibits cell wall synthesis, eventual bacterial death.
What are the noted side effects of penicillins?
N/V diarrhea Hypersensitivity reactions (Rashes -> anaphylaxis)
What kind of penicillins have a broad spectrum use?
2nd generation. Amoxicillin, ampicillin, augmentin.
T/F
Cephalosporins are one of the smallest classes of antibiotics
False,
One of the largest
When would a patient want to use particular caution when taking cephalosporins?
If patient is allergic to a penicillin.
What is the mechanism of action for cephalosporins?
Same mechanism as penicillins except broader spectrum
What is the mechanism of action of aminoglycosides?
Inhibits protein synthesis
What are the common uses of aminoglycosides?
For life threatening infections
What is the mechanism of action of tetracyclines?
Reversibly bind to ribosomes, inhibiting protein synthesis
What are the common uses of tetracyclines?
Broad spectrum
What are some noteable side effeccts of tetracyclines?
Photosensitivity, dizziness, tooth discoloration
What is the mechanism of action for sulfonamides?
compete with pathogenic bacteria for PABA (needed to synthesize folate)
What is important to do when taking sulfonamides to prevent interactions?
Drink at least 3 quarts of water
What is the mechanism of action for macrolides?
Inhibits bacterial protein synthesis
What kind of side effects are noted with macrolides?
Allergic reactions
What are the uses of fluoroquinolones?
Broad spectrum
What are some noted side effects of fluoroquinolones?
Crystalluria; possible cartilage or tendon damage
What is an important factor in preventing interactions with fluoroquinolones?
Drink plenty of water
What is the mechanism of action of antimycobacterial agents?
Inhibits RNA synthesis
What are side effects noted with antimycobacterial agents?
N/V, cramps, rash, fever, drowsiness, RED-ORGANGE BODY FLUIDS, elevated liver function tests. Hyper sensitivity, hyperbilirubinemia, thrombocytopenia
What is another mechanism of action of antimycobacterial agents?
Inhibits the synthesis of mycolic acids, an essential component of the mycobacterial cell wall
What are some other noteable side effects of antimycobacterial agents?
PERIPHERAL NEUROPATHY, anorexia, N/V, abdominal pain. SLE, hepatitis, anemia.
What would you supplement with antimycobacterial agents to prevent PN?
Vitamin B6
What is the mechanism of action for vancomycin?
Inhibits cell wall synthesis.
What is one of the most commonly used antibiotics in hospitals?
Vancomycin. Due to MRSA. As a results we are seeing strains known as VRSA
What are some noted side effects of vancomycin?
Red man syndrome (rash, flushing, tachycardia, hypotension). Ototoxicity, nephrotoxicity, anaphylaxis
What are some noted antibacterial natural supplements with high evidence of efficacy?
Iodine, probiotics, colloidal silver
