Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Clinical Pharmacy > Fever and Intro to Pain > Flashcards

Fever and Intro to Pain Flashcards

1
Q

What is a fever?

A

Physiologic response where the core temp of the body is increased
Generally defined as a rectal temp > 38°C, oral temp 37.5°C, axillary temp > 37.3°C, tympanic temp > 38°C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the recommended techniques for measuring temp in an infant aged 0-2yrs?

A

1) rectal

2) axillary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the recommended techniques for measuring temp in children aged 2-5yrs?

A

1) rectal

2) axillary, tympanic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the recommended techniques for measuring temp in patients aged over 5yrs?

A

1) Oral

2) Axillary, tympanic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what is the chemical responsible for producing fever? What are the two different kinds?

A

Pyrogens

Endogenous and exogenous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what are endogenous pyrogens?

A

proteins that induce fever including such chemicals as IL-1, tumor necrosis factor alpha, IL-6, neurotropic factor and IF-gamma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what are exogenous pyrogens?

A

chemicals produced by bacteria or by components of the organism that stimulate the release of endogenous pyrogens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what occurs in response to circulating pyrogens?

A

prostagladin E2 is produced and elevate the thermoregulatory set point of the hypothalamus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what are 3 ways the body temp is increased?

A

1) vasoconstriction of peripheral blood vessels
2) shivering to increase heat production
3) behavioural changes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what part of the body controls fever?

A

hypothalamus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

why is the hypothalamus important in fever?

A

it is the thermoregulatory center, which balances heat production and dissipation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is hyperthermia?

A

increase in body temperature not due to the hypothalamus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what are 4 risk factors of fever?

A

bacterial/viral infection
cancer
multisystem diseases
medications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

name 10 red flags for fever

A

1) babies under 6 months old
2) fever lasting longer than 72 hours
3) Fever longer than 24 hours without obvious cause
4) fever over 40.5°C
5) Child appears very ill, excessively cranky or irritable, cries inconsolably
6) patient has persistent wheezing and cough
7) patient has a rash with fever
8) patient is difficult to arouse, confused or delirious, has recently received chemotherapy or has serious underlying disease
9) patient had recent surgery or dental procedures, recently travelled or eaten raw/poorly cooked meat or fish, or recently started a new drug
10) child has any other symptoms that bother the parents

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are 6 signs and symptoms associated with fever?

A

1) sweating, dehydration
2) headache
3) malaise, fatigue
4) backache, myalgia, arthalgia
5) discomfort
6) febrile seizures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what are 4 goals of therapy for fever?

A

1) provide patient comfort
2) reduce parental anxiety
3) reduce metabolic demand caused by fever in patients with cardiovascular or pulmonary disease
4) prevent or alleviate fever-associated mental disfunction in the elderly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what are 4 non-pharms for fever?

A

1) remove excess clothing, blankets, and bedding to keep the person cool and comfortable
2) increase fluid intake to replace water loss from fever-produced sweating
3) avoidance of extreme physical exertion
4) maintain normal room temperature

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what are the two medications that can be used to treat fever in children?

A

acetaminophen

ibuprofen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what is acetaminophen’s MoA?

A

reduces fever by inhibiting the formulation and release of prostaglandins in the CNS and by inhibition of endogenous pyrogens at the hypothalamic thermoregulator centre

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what is the onset of acetaminophen?

A

oral: 30 min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what is the time of peak for acetaminophen? duration?

A

time of peak: 3hr

duration: 4-6 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what are some SE’s with acetaminophen?

A

allergic reaction
nausea and upper GI discomfort
serious skin reactions
all of these are rare

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what are 3 important drug interactions with acetaminophen? what is the resulting effect?

A

1) alcohol - increased risk of hepatotoxicity
2) enzyme inducers - decrease acetaminophen levels
3) chronic use can occasionally enhance warfarin’s anticoagulant effect

24
Q

what is the adult dosing for acetaminophen? what is the max dose?

A

325-650mg q4-6hr

max 4g per day

25
Q

what is the pediatric dosing for acetaminophen? what is the max dose?

A

10-15mg/kg/dose given q4-6h prn

max: 65mg/kg/day (max 5 doses/24 hour)

26
Q

what is ibuprofen’s MoA?

A

inhibits the COX enzyme in the periphery and CNS and thereby inhibits prostaglandin synthesis

27
Q

what is the onset for ibuprofen? (3 points)

A

antipyretic -

28
Q

what is the time of peak for ibuprofen? duration?

A

time of peak: 2-4 hours

duration: 6-8 hours

29
Q

what are some SE’s for ibuprofen?

A 
abdominal pain with cramps
dizziness
heartburn
nausea
skin rash
Rare SE's: sodium and water retention, diarrhea, GI bleeding, headache, nervousness, allergic reactions, reduced renal function, acute renal failure
30
Q

what are some CI/precautions for ibuprofen?

A 
PUD
GI performation or bleeding
hypersensitivity
bleeding disorders
concominant alcohol use
patients relying on vasodilatory renal prostaglandins for renal function
31
Q

what are some cautions for using ibuprofen?

A

caution in CHF, hypertension deydration, decreased renal or hepatic function patients

32
Q

is acetaminophen compatible in pregnancy and breastfeeding?

A

yes

33
Q

is ibuprofen compatible in pregnancy and breastfeeding?

A

breastfeeding: yes
preg: suggested risk in 1st and 3rd trimester

34
Q

what is the adult dosing of ibuprofen? max dose?

A

200-400mg/dose q4-6h prn

max: 1.2g/day

35
Q

what is the child dosing of ibuprofen? max dose?

A

5-10mg/kg q6-8h prn

max: 40mg/kg/day or 4 dose per 24h

36
Q

what are some drug interactions with ibuprofen?

A

1) ASA - decreases ASA antiplatelet effect
2) alcohol and corticosteroids - increased risk of GI pain/ulceration
3) antihypertensive agents - antihypertensive effect inhibited. possible hyperkalemia
4) anticoagulants - increased risk of bleeding
5) cylcosporine - increased level of nephrotoxicity
6) lithium, methotrexate - increased levels

37
Q

what is ASA’s MoA?

A

inhibits the COX enzyme in the periphery and CNS

38
Q

what is the onset for ASA?

A

within 1 hour

39
Q

what is the time of peak and duration for ASA?

A

time of peak: 3 hours

duration: 4-6 hours

40
Q

what age can you start taking ASA?

A

patients 18y.o and older

avoid in children

41
Q

what are some SE’s for ASA?

A

frequent: same as ibuprofen including dypsepsia
rare: same as ibuprofen, including platelet dysfunction

42
Q

what are the CIs/precautions with ASA?

A
43
Q

should ASA be taken with or without food?

A

always take with food

44
Q

is ASA compatible with pregnancy and breastfeeding?

A

preg: risk in 1st and 3rd trimester with full dose; compatible with low doses
breastfeeding: limited data suggests potential toxicity

45
Q

what are some drug interactions with ASA?

A

same as ibuprofen

also, probenicid and sulfinpyrazone - decrease therapeutic effect of these agents

46
Q

what is reye’s syndrome?

A

rapidly progressive encephalopathy with cerebral edema, hepatic dysfunction, and metabolic derangements which begins several days after apparently recovery from a viral illness

47
Q

what are some symptoms of reye’s syndrome?

A

vomiting
confusion
quickly evolves to seizures and coma

48
Q

what is the importance of reye’s syndrome?

A

salicylate (found in ASA) is identified as a major precipitating factor

49
Q

what is ASA-induced asthma?

A

clinical syndrome characterized by the onset of asthma 30min-3hr post ingestion of ASA

50
Q

what is the MoA for naproxen?

A

same as ibuprofen

51
Q

who can use naproxen?

A

patients over the age of 12

52
Q

what is the dosing for patients aged 12-65y.o? what is the max dose?

A

1 tab q8-12h

max: 2 tabs/day

53
Q

what is the dosing for patients over 65y.o with renal insufficiencies?

A

1 tab q12h

54
Q

how should you take naproxen?

A

with food and full glass of water

55
Q

is naproxen compatible with pregnancy and breastfeeding?

A

preg: risk factor C

not recommended in breastfeeding

56
Q

in what situations is acetaminophen first line therapy?

A

1) ASA-sensitive asthma
2) PUD or gastritis
3) increased risk of bleeding
4) patients with renal dysfunction
5) CV or hypertensive patients
6) multiple concurrent drug therapy
7) preggo or breastfeeding

57
Q

what are the monitoring parameters for fever?

A

1) watch for development of rashes or allergic reaction
2) monitor patients with pre-existing co-morbid conditions (CHF, CV, pulmonary insufficiencies)
3) improvement should be seen within 24-72 hours
4) treatment should not be used for more than 3 days without referral to determine underlying cause
5) comfort is the goal
6) monitor for dehydration and seizures in children at risk

Clinical Pharmacy (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions