Module 2 - Anti-inflammatory and Anti-pyretic Drugs

Question 1

Anti-inflammatory

Answer 1

reduces inflammation

Question 2

Anti-pyretic

Answer 2

reduces temperature

Question 3

NSAIDS examples

Answer 3

voltaren, aspirin (causes bleeding), advil/ motrin, naprosyn, celebrex

Question 4

NSAID Classification

Answer 4

1) Acetic Acid Derivatives
2) Carboxylic Acid
3) COX-2 Inhibitors
4) Fenamates
5) Napthylalkanones
6) Oxicams
7) Propionic

Question 5

NSAID:

Mechanism of Action

Answer 5

1) Inhibit COX-1 and COX2 enzymes
- released from injured tissue
- A few drugs selectively inhibit COX-2
2) COX-1 enzymes lead to physiologic prostaglandin production
3) COX-2 lead to pathologic prostaglandin production

**analgesic, anti-inflammatory and antipyretic properties

Question 6

where do prostaglandins come from?

Answer 6

released from injurred tissue

Question 7

common uses of NSAIDS

Answer 7

Mild to moderate pain
Fever
Rheumatoid arthritis (RA) pain
Osteoarthritis (OA) pain
Primary dysmenorrhea
Acute gout
Bursitis
Tendinitis

Question 8

diclofenac (Voltaren)

Answer 8

oral: inflammatory disorders
topical: osteoarthritis

Question 9

indomethacin (Indocid)

Answer 9

-Used to treat inflammatory disorders, such as ankylosing, spondylitis, arthritis, acute gout attacks

Question 10

Gout

Answer 10

a form of arthritis marked by the deposition of monosodium urate crystals in joints and other tissues.(usually starts in knee or metatarsalphalangeal joints)

Symptoms: moderate pain which increases in intensity; also possibly low-grade fever and joint inflammation (hot, tender, dusky-red or cyanotic joints).

Question 11

ketorolac (Toradol)

Answer 11

short term pain management (

Question 12

Propionic Acid Derivatives Examples

Answer 12

Ibuprofen

Naproxen

Question 13

Propionic Acid Derivatives Uses

Answer 13

• mild-moderate pain

- Work well for menstrual cramps

Question 14

COX-2 Inhibitors

Answer 14

• inhibit cyclooxygenase-2 enzymes which are involved in inflammatory processes
• osteoarthritis and rheumatoid arthritis (bone pain)
• Prescription only
• good because do not inhibit COX-1: which would block the prostaglandins responsible for maintaining an intact gastrointestinal mucosa

Question 15

acetylsalicylic acid (ASA) – (Aspirin)

Answer 15

• mild-moderate pain and fever in adults
• Should never be used for fever with children due to increased risk of Reye’s syndrome
• 81 mg daily or 325 mg daily in an enteric coated form

Question 16

Reye’s syndrome

Answer 16

• acute encephalopathy and fatty infiltration of the liver and often the pancreas, heart, kidney, spleen and lymph nodes
• seen in children

Question 17

how does ASA work?

Answer 17

• Inhibits prostaglandins
• decreasing platelet aggregation (decreases clotting)
• indicated for TIA/MI prophylaxis
• Aspirin also used when patient experiencing new onset chest pain

Question 18

NSAID contraindications

Answer 18

• allergy
• risk for bleeding: rhinitis, stuffy nose, peptic ulcer disease, it K deficiency, Active GI bleeding, severe kidney/ liver disease, pregnancy

Question 19

If you are allergic to one NSAID are you allergic to all NSAIDS?

Answer 19

most likely

Question 20

NSAID side effects

Answer 20

Dyspepsia (upset stomach)
heartburn
epigastric distress
nausea
Tinnitus (ringing in ears)

Question 21

NSAID Adverse Effects

Answer 21

GI bleeding**
Acute reversible hepatotoxicity
Acute tubular necrosis with kidney failure
Stevens –Johnson syndrome- (Slough off skin)

Question 22

how should NSAIDS be taken?

Answer 22

with food to decrease stomach upset

exception: Colchicine for gout should be taken on empty stomach.

Question 23

what should people taking ASA daily ensure?

Answer 23

tabs are enteric coated. DO NOT CRUSH

Question 24

Which NSAID can be administered through an IV

Answer 24

toradol

Question 25

IV

Answer 25

fasted method of pain relief

Question 26

IM

Answer 26

not used often

Question 27

PO

Answer 27

provides steady blood levels when drug taken around clock, easy and painless for pt

Question 28

rectal

Answer 28

used when pt NPO

Question 29

topical

Answer 29

relief right at site

Question 30

transdermal

Answer 30

steady levels, east to administer, good for NPO

Question 31

SC

Answer 31

good when no IV access esp with palliative

Question 32

antiinflammatories and antipyretics:

Assessment

Answer 32

• allergies, related drugs, head to toe, vitals, labs for kidney and liver f(x), age (ASA not for children or teens)
• do not administer with people with asthma, wheezing,
• duration, onset, location and type of inflammation, pain or fever, swelling of joints. Assess for history of GI distress

Question 33

Which of the following will the nurse perform to check for the presence of the most common adverse effect of opioids?

A. a respiratory assessment
B. a bladder scan or palpation
C. an assessment of the level of pruritus
D. an assessment of the patient`s bowel function

Answer 33

A

Question 34

True/ False:

The most serious adverse effect of NSAIDs is GI bleeding.

Answer 34

A. true can kill you if you ensanguate

Question 35

A patient has acute pain following a fractured ankle. The physician’s order is: Tylenol #3, 1-2 tablets q4h PRN. Although the last dose (of 2 tabs) given was one hour ago, the patient reports severe pain. What nursing action is most appropriate?

A. consult the nurse in charge
B. reassess the patient’s pain in 15 minutes
C. notify the physician of the patient’s pain level
D. administer an additional dose while awaiting a new order

Answer 35

C