inflammation drugs Flashcards
what drugs treat inflammation
recombivant dna (IL-1 antagonists) monoclonal Abs (infliximab) antipyretics NSAIDs glucocorticoids antihistamines
fever response
macrophages release PG2
hypothalamus increases set point
conservation of heat: vasoconstriction, less sweating
production of heat: shivering, muscle contractions
antipyretic drug types
acetaminophen
why do we need to decrease fever in children
febrile seizure occurs in children who have a prolonged fever of more than 38.5
what should we NOT treat fever with
NSAIDS like ASA because it can cause reyes syndrome in children and teens
why should we treat fever in adults
can have very adverse side effects (tissue wasting, delirium, coma, less mental activity, more E needed, more effect in older adults
reyes syndrome
caused by NSAIDS used to treat viral infections/fever
lethargy, confusion, brain damage
diarrhea, liver failure
mostly in children who cannot oxidize fatty acids
measures to take before we treat with acetaminophen
confirm fever
check renal and hepatic function
monitor fluids/electrolytes
discomfort, pain, malaise, other symptoms
acetaminophen interactions
alcohol– liver function problems
acetaminophen adult limit
4g/day (be careful that you’re not getting too much does from OTC meds)
acetaminophen side effects
can cause liver dysfunction when abused or taken with alcohol inhibits warfarin (anticoagulant) so bleeding can occur
NSAID types
COX I and COX II inhibition: ibuprofen, naproxen, diclofenac, ASA
COX II inhibition only: celecoxib/celebrex
NSAID COX I inhibition
inhibits:
gastric mucous secretion
renal perfusion
platelet aggregation
NSAID COX II inhibition
alleviates:
fever
pain
inflammation
NSAID adverse effects
GI irritation– pain, bleeding ulcers, heartburn (so take with food/milk)
kidney perfusion problems (abuse leads to renal failure)
ASA can cause tinnitus/hearing damage in adults
increase action with oral coagulants
reyes syndrome in children when used to treat viruses/fever
NSAID purpose
inflammation, pain, fever
safe
OTC
NSAID interactions
alcohol can cause liver/renal impairment
don’t overdose with OTCs
oral anticoagulants increase effect
endogenous cortisol
glucocorticoid
increases blood glucose via catabolism of glycogen, fatty acids, and protein
immune system suppression
(suppress histamine, PGs via cox II, phagocytes/lymphocytes)
glucocorticoid types
hydrocortisone
prednisone
turn to cortisol in liver, then are metabolized
glucocorticoid purpose
anti inflammatory for SEVERE (asthma, arthritis) or acute inflammation-- functions at HIGHER THAN NORMAL PHYSIOLOGICAL LEVELS ONLY adrenal insufficiency (addison's disease-- must administer normal dose of mineralo/glucocorticoids)
glucocorticoid use
short term (4-10d) due to adverse side effects
take in the morning
take at the same time every day
do not stop abruptly (adrenal crisis)
take with food to avoid gastric irritation (can also take anti-ulcer meds)
guard against infection
have some on hand in case you cannot reach the pharmacy
don’t take herbs (interactions)
monitor weight daily
glucocorticoids pharmacokinetics
1/2 life = 3.5h
adrenal suppression lasts 30-36 h
-titrate dose
adrenal crisis
caused when you abruptly stop taking glucocorticoids
since your body stopped producing endogenous cortisol, when you stop supplying it with EXOGENOUS cortisol, there will be extreme problems
shock, flu, seizures, HTN
glucocorticoid adverse effects
cushings syndrome delayed healing higher risk of infection hyperglycemia electrolyte imbalance (mineralocorticoid effects)-- therefore check body weight for retention of H2O and Na+, K+ release masks infection (no inflam response)-- immunosuppression peptic ulcers (damages epithelia) osteoporosis (inhibits osteoclasts) fragile skin easy bruises mood changes (prednisone psychosis) gastric upset and bleeding
