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Pharm 1 Exam 3 > Inflammation > Flashcards

Inflammation Flashcards

1
Q

What is the goal of treatment for inflammation?

A

— To prevent or decrease the intensity of the inflammatory response
— To reduce fever

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2
Q

What is cyclooxygenase-1?

A

(COX-1)
- Present in all tissues
—— Reduces gastric acid secretion, promotes renal blood flow, promotes platelet aggregation.
—— Inhibition of COX-1 results in bleeding, gastric upset, reduced renal function.

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3
Q

What is Cyclooxygenase-2?

A

(COX-2)
- Formed only after tissue injury
—— Promotes inflammation, sensitizes pain receptors, mediates fever in brain.
- Inhibition of COX-2 results in suppression of inflammation

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4
Q

Ibuprofen mechanism of action, primary use, and side effects?

A

Mechanism of action: To inhibit prostaglandin synthesis
Primary use: For musculoskeletal disorders such as rheumatoid arthritis and osteoarthritis, mild to moderate pain, reduction of fever, primary dysmenorrheal pain.
Side effects: Nausea, heartburn, epigastric pain, dizziness.

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5
Q

What are the effects of systemic corticosteroids?

A

— Effective in treating severe inflammation; can inhibit immune system to reduce inflammation
— Naturally released from adrenal cortex; suppress histamine and prostaglandins
— Serious side effects:
——Suppression of adrenal gland function, hyperglycemia, electrolyte imbalances, osteoporosis
—— Mood changes, cataracts, peptic ulcers
— Can mask infections
—— Existing infection grows rapidly and undetected
—— Contraindicated in active infections

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6
Q

What is the treatment with corticosteroids?

A
  • used for short-term treatment of acute inflammation
  • Long-term treatment
    —— Keep dose as low as possible
    —— Use alternate-day dosing
    —— Cushing syndrome may result
    —— Discontinue gradually
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7
Q

What does gout cause, what is primary and secondary gout, symptoms, cause?

A

— A form of acute arthritis caused by a buildup of uric acid (urate) crystals in the joints and other body tissues
— Primary gout: hereditary defect in uric acid metabolism
— Secondary gout due to:
——— Certain drugs: (thiazide diuretics, aspirin, alcohol)
——— Diseases that affect uric acid metabolism (diabetic ketoacidosis, kidney failure, leukemia)
— Symptoms of acute attacks:
——— Red, swollen tissue; in big toes, ankles, fingers, wrists, knees, elbows.
— Triggered by ingestion of alcohol, dehydration, injury, stress
— Attacks often occur at night

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8
Q

Pharmacotherapy of gout?

A

— Goal: Termination of acute attacks; prevention of future attacks
— NSAIDs for pain and inflammation; corticosteroids for severe pain and inflammation
— Prophylactic therapy:
——— Uricosurics increase excretion of uric acid by blocking reabsorption in the kidney
——— — Probenecid
———Drugs that inhibit formation of uric acid
———— Allopurinol (Zyloprim) or Febuxostat (Uloric)
——— Drugs that convert uric acid into a less toxic form
———— Rasburicase or pegloticase

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9
Q

Salicylates drugs, action, side effects, and nursing interventions?

A

Drugs: Acetylsalicylic acid (aspirin)
Action: Bind w/ COX-1 & COX-2 blocking inflammatory prostaglandins
Side effects: Epigastric pain, bleeding, heartburn
Nursing interventions: Assess for bleeding, Give w/ food, Do not give to anyone under age 19 - Reye’s syndrome

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10
Q

NSAIDs drugs, action, side effects, nursing interventions?

A

Drugs: Ibuprofen, meloxicam, Naproxen, Ketorlac
Action: Bind w/ COX-1 & COX-2 blocking inflammatory prostaglandins
Side effects: N & V
Nursing interventions: Assess for bleeding, Give w/ food, Risk of bleeding lower than aspirin, Renal impairment - give acetaminophen

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11
Q

Cox-2 inhibitors drugs, action, side effects, nursing interventions?

A

Drugs: Celecoxib
Action: Blocks COX-2 only (no effect on coagulation)
Side effects: No common
Nursing interventions: Monitor for GI bleeding, Monitor for thrombotic events, Monitor for fluid retention & edema, Monitor Hct/Hgb, LFT, BUN/Creatinine & electrolytes

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12
Q

Corticosteroids drugs, action, side effects, nursing interventions?

A

Drugs: Prednisone, betamethasone, hydrocortisone, dexamethasone.
Action: Inhibit the biosynthesis of prostaglandins
Use: Hyperglycemia, mood changes, cataracts, peptic ulcers, electrolyte imbalances, osteoporosis
Nursing interventions: Give w/ food, mask infection.

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13
Q

Classification of Meloxicam (Mobic)?

A

NSAID

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14
Q

Contraindications of Meloxicam?

A

GI bleeding
hepatic disease

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15
Q

Uses/action of meloxicam (mobic)?

A

Inhibits COX-1 & COX-2 necessary for synthesis of prostaglandins, part of the inflammatory response
Uses: Analgesic, anti-inflammatory, RA

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16
Q

Before/after giving meloxicam?

A

Before: Assess for bleeding (inhibition of COX-1 can interfere with coagulation)
After: Continue to assess for bleeding

17
Q

Interactions with meloxicam?

A

ACE inhibitors
Diuretics
Aspirin
Anticoagulants
feverfew
garlic
Ginger
Ginkgo

18
Q

Side effects of meloxicam?

A

None common

19
Q

Nursing interventions for meloxicam?

A

Monitor for S/S of GI ulceration or bleeding
Kepatotoxicity
Skin rash
Weight gain
Edema
Monitor for S/S of CV thrombotic events
Monitor Hct/Hgb, CBC w/ diff, LFTs, electrolytes, BUN/creatinine within 3 months of beginning therapy & every 6-12 months thereafter
Take w/ milk or food

20
Q

Classification of Ketorolac (Toradol)?

A

NSAID

21
Q

Contraindications of Ketorolac?

A

Labor/delivery, surgery
Renal impairment
Hemorrhage
GI bleeding
Peptic ulcer

22
Q

Uses/action of Ketorolac?

A

Inhibits COX-1 & COX-2, peripherally acting analgesic, inhibits platelet aggregation
Uses: Short-term management of pain, ocular itching

23
Q

Interactions with Ketorolac?

A

Methotrexate
ACE inhibitors
Feverfew
Garlic, ginger, ginkgo

24
Q

Side effects of Ketorolac?

A

Drowsiness
Nausea

25
Q

Nursing interventions for Ketorolac?

A

Monitor for urine output
Monitor for S/S GI distress including bleeding
Monitor for S/S of CV thrombotic events
Monitor for fluid retention & edema
Monitor electrolytes, LFTs, urinalysis w/ long-term use
CNS side effects: dizziness, drowsiness, light-headedness
Do not use w/ other NSAIDs

26
Q

Classification of prednisone?

A

Corticosteroid

27
Q

Contraindications of prednisone?

A

Fungal infections
Cataracts
Live attenuated vaccines

28
Q

Uses/action of prednisone?

A

Synthetic hydrocortisone w/ corticosteroid properties
Uses: in conjunction w/ antineoplastics, MG, inflammatory conditions, immunosuppressant, ARDS, Addison’s disease, gouty arthritis, hemolytic anemia, sarcoidosis, anemia

29
Q

Interactions with prednisone?

A

Barbiturates
Rifampin
Amthotericin B
Diuretics (K+ loss)

30
Q

Side effects of prednisone?

A

Few common w/ short term use
Long term use: hyperglycemia, osteoporosis, muscle weakness, bruising
Often given w/ PPI or H2 receptor blockers

31
Q

Nursing interventions of prednisone?

A

Monitor BP, I&O, weight, FBS, sleep patterns
Monitor for hypocalcemia, electrolytes
Monitor for masked infection & delayed healing
Extended therapy - oral candida
Monitor bone density
Watch for changes in mood, behavior, psychotic episodes
Do not abruptly discontinue
Avoid alcohol
Report GI distress, give w/ food
Do not use aspirin or OTC drugs w/o approval of HCP

32
Q

Classification of allopurinol (Zyloprim)?

A

Anti gout

33
Q

Contraindications of allopurinol?

A

None

34
Q

Uses/action of allopurinol?

A

Reduces amount of uric acid synthesis
Uses: Hyperuricemia, gout, nephrolithiasis, renal calculus, uric acid nephropathy

35
Q

Interactions with allopurinol?

A

Alcohol
Ampicillin
Amoxicillin
Warfarin
Thiazide diuretics
ACE inhibitors
Vitamin C

36
Q

Nursing interventions for allopurinol?

A

Monitor loft acute gout attack - 1st 6 weeks
Monitor renal function
Report rash or fever immediately
Monitor serum uric acid levels, CBC, liver, renal function monthly & every few months
Drink 3 L fluids daily
Minimize sun exposure

Pharm 1 Exam 3 (5 decks)

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