Lecture 18 Pharm Treatment Flashcards
Decrease stimulation of pain receptors
NSAIDS
APAP
What type of drug blocks conduction of pain signals?
anesthetics
What type of drug decreases pain reaction?
Narcotics
Pain is difficult to catch up with. When should analgesics be given?
Before pain increases
Corticosteroids increase or decrease blood sugar
increase
Corticosteroids increase or decrease sympathetic response
increase
Corticosteroids increase or decrease WBC’s
decrease
lower immune response
Corticosteroids increase or decrease cell injury
decrease
stabilize intracellular lysosomes
Corticosteroids increase or decrease inflammation
decrease
inhibit histamine, kinkins and prostaglandins
What is the prototype corticosteroid?
prednisone
Name 4 uses for Prednisone
Immunosuppressants
Decrease cell injury
Anti-inflammatory
Inhibit collagen synthesis - decrease scar tissue formation
What disease is prednisone used as replacement therapy?
Addison’s disease
What else are corticosteroids used to treat?
prevent organ transplant rejection auto-immune allergic reactions inflammation cerebral edema
Hydrocortisone is (more/less) potent than Dexamethasone and Betamethasone
LESS
What are some adverse effects of corticosteroids?
Hyperglycemia
Cushing’s syndrome
Decreased immune response
What glands will long term use will cause suppression of?
adrenal glands
What is important to remember when taking someone off long term use?
Taper with hydrocortisone
Can you administer live vaccines with corticosteroids?
NO bc decrease WBC’s
Why should you use caution when giving these to diabetics?
uncontrolled sugar levels
Name two negative effects of corticosteroids on the GI and skeletal systems
Peptic Ulcer Disease
Osteoporosis
Are corticosteroids safe for pregnant women?
no
How do NSAIDS work
Block production of prostaglandins via COX inhibition
What NSAID is the prototype and used for its cardiac benefits?
COX-1
ASA
irreversibly inhibits platelet aggregation
Name some diseases that NSAIDS are used to treat?
Rheumatoid arthritis
Osteoarthritis
Gout
Are NASIDS well absorbed?
yes
Do you need to monitor pt with renal and liver problems on NSAIDS?
yes
renal excretion
enterohepatic recycling
What is the main side effect of NSAIDS?
GI problems
nasuea, vomiting, GI bleeding, ulceration
Therapeutic dosing of NSAIDS for inflammation is (higher/lower) than over the counter dosing
much higher
What NSAIDS has opioid like effects but not addictive?
Ketorolac
Para-aminophenols
tylenol
2 uses of para-aminophenols:
fever reduction (antipyretic) pain reliever (analgesic)
Name 3 advantages of para-aminophenols over NSAIDS
no GI problems
no allergies
no bleeding
Name a disadvantage of para-aminophenols compared to NSAIDS and corticosteriods
poor anti-inflammatory action
What is the one major side-effect of para-aminophenols?
Liver toxicity
What is the prototype narcotic?
morphine
What type of receptors are activated in the thalamus and limbic system with narcotics?
mu
What are two major side effects of narcotics?
addiction
withdrawal
Why does someone have to keep increasing their dose to illicit the same effects of a narcotic?
tolerance build up
Why does codeine not have any affect on some people?
it is a pro-drug that some can’t metabolize into its active form
What opioid has a lot of side effects?
oxymorphone
What are the benefits of drug combinations with opioids?
antipyretic
less opiate given
What is one thing to watch out for in combination narcotic drugs?
APAP accumulation from multiple sorces
Methotrexate (MTX) falls under what category of DMARDs?
Non-biologics
What does MTX tx?
RA and some malignancies