Mod 8- Anti-inflammatory, Antiarthritis, and Related Agents Flashcards
These should NEVER be used in children for viral infection/ chicken pox… why?
Salicylates d/t risk of rye syndrome
What are the actions of salicylates?
blocks inflammatory response antipyretic properties (fever blocking) analgesic properties (pain blocking)
Common salicylate medication
aspirin- treat inflammatory conditions, reduces CV complication b/c antiplatelet properties
Mesalamine- treats inflammation of the large intestine
Contraindications of Salicylates
known allergy, bleeding abnormalities, impaired renal function
ADE of Salicylates
effects on stomach, ulcers & bleeding, & clotting systems
Drug/ drug interactions of Salicylates
many other drugs by interfering w/ absorption; messes w/ liver
What would you assess for in a pt taking Salicylates
liver evaluation and monitor bowel sounds, check stool for GI bleeding
T/F maintaining hydration helps minimize the risk of Salicylate toxicity
TRUE
Salicylate prototype
Aspirin
Common NSAIDs
Propionic acids- ibuprofen, naproxen
Acetic acids- indomethacin, ketolorac
Osicam derivatives- meloxicam
Cyclooxygenase-2 inhibitors- celecoxib (celebrex)
Action of NSAIDs
Block 2 enzymes COX-1 and COX-2
provides strong anti-inflammatory and analgesic; antipyretic effects too
Contraindications for NSAIDs
allergy to NSAIDs or salicylates
Celecoxib is contraindicated in allergies to sulfonamide
CV dysfunction or hypertension, peptic ulcer, GI bleeding, pregnancy, lactation
Cautions for NSAIDs
renal/ hepatic dysfunction
ADE of NSAIDs
nausea, dyspepsia, GI pain, constipation, diarrhea; GI bleed, somnolence, platelet inhibition, hypertension, bone marrow depression
Drug/ Drug interactions for NSAIDs
decreased diuretic effects when taken w/ loop diuretics
potential for antihypertensive effects when taken w/ beta-blockers
Lithium toxicity when combined w/ ibuprofen
What is the action of acetaminophen?
acts directly on the thermoregulatory cells of the hypothalamus; mechanism is unknown but related to analgesic effect
used to treat pain/ fever; pain associated w/ arthritis
Contraindications for acetaminophen
known allergy, caution w/ pregnancy & lactation, hepatic dysfunction or chronic alcoholism, can be hard on liver w/ chronic use
Drug/ drug interactions w/ acetaminophen
oral coagulants increase bleeding
hepatotoxicity w/ barbiturates, carbamazepine, hydantoins, rifampin
What is the action of gold compounds?
they are absorbed by macrophages which results in inhibition of phagocytosis which means tissue destruction is decreased
Contraindications for Gold Compounds
Diabetes, CHF, renal/hepatic impairment, blood dyscrasias (increases toxicity), pregnancy/ lactation
ADE of gold compounds
stomatitis, glossitis, gingivitis, bone marrow depression, dermatitis, interstitial pneumonitis and anaphylactic shock
Drug/ drug interactions of gold compounds
pencillamine, antimalarials, cytotoxic drugs, immunosuppressive agents
Gold compound prototype
Auranofin
When are Disease Modifying Antirheumatic Drugs (DMARDs) used?
Early in dx prior to joint damage b/c it aggressively effects inflammation
side effects can be life-threatening
Common Tumor Necrosis Factor (TNF) Blockers
adalimumab- humira used for many autoimmune
etanercept
infliximab
Action of TNF blockers
Block TNF, a locally released cytokine that can cause the death of tumor cells and stimulate a wide range of proinflammatory activities
Contraindications for TNF blockers
have immunosupressive properties
no acute infection, cancer, sepsis, TB, hepatitis
Cautions for TNF blockers
pregnancy, lactation, renal/ hepatic impairment
ADE of TNF blockers
SERIOUS risk of fatal infections and lymphomas and other cancers
Drug/ drug interactions of TNF blockers
immune suppressants and live vaccines
TNF Blocker prototype
Etanercept
What important screening needs to be done with DMARDs
cancer screenings/ TB test
How are DMARDs administered?
Subcutaneous injections
