Medications For Pain And Inflammation Flashcards by Devin Leonard

List 3 skeletal muscle relaxations

Carisoprodol
Cyclobenzaprine (Flexeril)
Methocarbamol

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Side effects of skeletal muscle relaxants

Drowsiness
Sedation
Dizziness
Drug dependence 
HA 
GI distress

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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

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Carisoprodol

A skeletal muscle relaxant

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Action of Cox 1 vs cox 2 enzymes

Cox 1 protects stomach linings & regulates blood platelets

Cox 2 triggers inflammation & pain

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Classes of anti-inflammatory drugs

NSAIDs
Corticosteroids
Disease modifying antirheumatic drugs
Antigout drugs

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Nursing implementations for patients taking cox 1 or 2 inhibitors

Bleeding precautions

Take with food

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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

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What class of drug does aspirin fall under

Salicylates- cox 1 and 2 inhibitors

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Use of aspirin

Antiinflammatory
Antiplatelet
Antipyretic

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Possible drug interactions of aspirin (contraindications)

Drug interactions: increase action of anticoagulants and increase gastric ulcer risk when taken with glucocorticoids

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Lab interactions of aspirin

Aspirin increases PT, bleeding time, INR

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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)

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Food interactions with aspirin

Foods containing salicylates

Prunes, raisins, licorice

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Side effects of aspirin

Tinnitus, peptic ulcer, thrombocytopenia, leukopenia, agranulocytosis, hepatotoxicity

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Examples of propionic acid derivatives

Ibuprofens (motrin/ advil)

Naproxen (Naprosyn)

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Side effect of propionic acid derivatives

Gastric distress (take with food)

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Give an example of a cox2 inhibitor

Celecoxib (Celebrex)

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Use of Celebrex

Decrease inflammation and pain without causing GI upset & bleeding

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Auranofin classification and use

Gold drug therapy

Used to treat rheumatoid arthritis

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Action of Auranofin

Decrease leukocyte migration
Suppress prostaglandin activity
Stop progression of joint degeneration

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Side effects of Auranofin

Stomatitis (mouth ulcers), photosensitivity, metallic taste, severe rash, corneal gold deposits, bradycardia, profound hypotension, hematuria, proteinuria, nephrotoxicity, agranulocytosis, thrombocytopenia

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Contraindications for taking auranofin

Severe real or hepatic disease
Pregnancy, blood dycrasias, colitis
Systemic lupus erythematous

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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