Medications For Pain And Inflammation Flashcards
List 3 skeletal muscle relaxations
Carisoprodol
Cyclobenzaprine (Flexeril)
Methocarbamol
Side effects of skeletal muscle relaxants
Drowsiness Sedation Dizziness Drug dependence HA GI distress
Nursing implementations/ patient teaching for skeletal muscle relaxants
Take with food Check vs Don’t drive Don’t take longer than 3 weeks then taper over 1 week to avoid rebound spasms Avoid alcohol & other depressants
Carisoprodol
A skeletal muscle relaxant
Action of Cox 1 vs cox 2 enzymes
Cox 1 protects stomach linings & regulates blood platelets
Cox 2 triggers inflammation & pain
Classes of anti-inflammatory drugs
NSAIDs
Corticosteroids
Disease modifying antirheumatic drugs
Antigout drugs
Nursing implementations for patients taking cox 1 or 2 inhibitors
Bleeding precautions
Take with food
Action of anti-inflammatory drugs
Inhibit cox 1 and 2 Inhibit biosynthesis of prostaglandins Analgesic effects Antipyretic effects Inhibit platelet aggregation Mimic effects of corticosteroids
What class of drug does aspirin fall under
Salicylates- cox 1 and 2 inhibitors
Use of aspirin
Antiinflammatory
Antiplatelet
Antipyretic
Possible drug interactions of aspirin (contraindications)
Drug interactions: increase action of anticoagulants and increase gastric ulcer risk when taken with glucocorticoids
Lab interactions of aspirin
Aspirin increases PT, bleeding time, INR
Aspirin precautions/ patient teaching
Do not take with other NSAIDs
Avoid during third trimester of pregnancy
Do not give to children with flu or virus symptoms (Reye’s syndrome)
Food interactions with aspirin
Foods containing salicylates
Prunes, raisins, licorice
Side effects of aspirin
Tinnitus, peptic ulcer, thrombocytopenia, leukopenia, agranulocytosis, hepatotoxicity
Examples of propionic acid derivatives
Ibuprofens (motrin/ advil)
Naproxen (Naprosyn)
Side effect of propionic acid derivatives
Gastric distress (take with food)
Give an example of a cox2 inhibitor
Celecoxib (Celebrex)
Use of Celebrex
Decrease inflammation and pain without causing GI upset & bleeding
Auranofin classification and use
Gold drug therapy
Used to treat rheumatoid arthritis
Action of Auranofin
Decrease leukocyte migration
Suppress prostaglandin activity
Stop progression of joint degeneration
Side effects of Auranofin
Stomatitis (mouth ulcers), photosensitivity, metallic taste, severe rash, corneal gold deposits, bradycardia, profound hypotension, hematuria, proteinuria, nephrotoxicity, agranulocytosis, thrombocytopenia
Contraindications for taking auranofin
Severe real or hepatic disease
Pregnancy, blood dycrasias, colitis
Systemic lupus erythematous
List examples of immunomodulators (tumor necrosis factor (TNF) blockers)
Entanercept (Enbrel)
Infliximab (Remicade)
Adalimumab (Humira)
Action of TNF blockers
Neutralize TNF
Disrupt the inflammatory process
Delay disease progression
Use of TNF blockers/ immunomodulators
Used to treat rheumatoid arthritis
Patient teaching for persons with gout (food considerations)
Avoid/ reduce intake of purine containing foods: salmon, liver, sardines, steak, shrimp…
List examples of antigout drugs
Colchicine
Uric acid inhibitors
Uricosurics
Action of colchicine
Inhibit the migration of leukocytes to inflamed site
When is colchicine given
In acute gout episodes
Contraindications for taking colchicine
Severe renal, cardiac, or GI problems
Uric acid inhibitors example
Allopurinol
Action of allopurinol
Decrease uric acid levels
Prophylactic to prevent gout attacks
Nursing implications for persons taking allopurinol
Monitor CBC, liver enzymes, renal function
Increase fluid intake to increase uric acid excretion
Examples of uricosurics
Probenecid
Action of probenecid
Blocks reabsorption of uric acid & increases uric acid excretion
Use of probenecid
Prophylactic- prevention of uric acid buildup
Nursing implications for persons taking probenecid
Not to be given with other highly protein bound drugs
Increase fluid intake to increase uric acid excretion
Acetaminophen is a _________. And it’s used for_____, _____, and _____.
Acetaminophen is non-opioid pain reliever. It’s used to relieve pain, discomfort, and fever.
Adverse effect of acetaminophen
Toxic effects/ OD: hepatotoxicity, thrombocytopenia
Acetaminophen is contraindicated in___.
Individuals with liver disease
Max daily dose of acetaminophen
3 g/day
Acetaminophen OD antidotes
Mucolytics
Morphine, codeine, meperidine, and hydromorphone are all examples of:
Opioid analgesics
Which opioid analgesic is not used as an antitussive?
Meperidine.
Morphine, codeine, and hydromorphone can all be used as antitussives
Primary side effects of opioid analgesics and major adverse reactions
Respiratory depression, hypotension, sedation, confusion, constipation, urinary retention, dizziness, tolerance, dependence, withdrawal symptoms
In what persons would opioid analgesics be contraindicated
Head injuries, increased ICP, respiratory disorders, shock, and hypotension
Nursing implications for persons taking opioid analgesics
Dont take with alcohol
Don’t operate heavy machinery
Assess pain levels
Check vs including respiratory rate
Give an example of an opioid agonist- antagonist
Nalbuphine HCl
Action of opioid agonist- antagonists such as Nalbuphine HCl
Binds with opiate receptor and increased pan threshold
Use of Nalbuphine HCl
Decrease used of narcotic abuse
Can be given to someone who has a history of drug abuse
Safe to use during labor
Side effects of Nalbuphine
Confusion, restlessness, abdominal cramps, & respiratory depression
Contraindications of Nalbuphine
Not to be given to those with renal or hepatic dysfunction, head injuries, increases ICP, or decreased respirations
(Tip: think about the side effects of this drug to help you rule out individuals for which this drug would be contraindicated)
Use of Naloxone (Narcan)
Antidote for opiate OD
Reverses the effects of opiates including respiratory depression, sedation & hypotension
Respiratory distress/ respiratory depression
Side effects of Narcan
Tremors, sweating, HTN, tachycardia, excitement
Nursing implications for Narcan
Monitor vital signs
Assess for bleeding
Probenecid, Allopurinol, and Colchicine are all ____.
Which is prophylactic and which is for acute cases?
Antigout drugs
Probenecid is a prophy
Colchicine is for acute flareups
Drugs like aspirin and NSAIDs inhibit cox 1, what does this mean?
If they inhibit cox1 then it blocks that enzyme from protecting the stomach lining and will also stop clotting.
This is why these drugs are irritating to the stomach and why bleeding is a concern.
If a drug blocks the cox2 enzyme, what will happen?
Pain will be reduced and inflammation will be suppressed
