NSAIDs/Analgesics Flashcards
Availability of an insurance company formulary is useful in selecting NSAID or steroidal agents.
a. True
b. False
a. True
Your patient may not be able to afford off-formulary drugs and so may not take the drug or the whole prescription.
All of the major OTC NSAIDs and acetaminophen (a non-NSAID) have anti-platelet properties.
a. True
b. False
b. False
Women who are breastfeeding their infants should avoid taking any NSAID.
a. True
b. False
b. False
Acetaminophen is not tecnically an NSAID, and can usually be taken during breastfeeding. Traditional NSAIDs are also considered safe during breastfeeding.
In addition, taking an NSAID after nurisng or before the infant’s longest sleep period is recommended, if not using acetaminophen.
Avoid aspirin - it does get into breastmilk and can cause a rash in infants.
NSAID anti-inflammatory effects may take as long as 3 weeks to occur.
a. True
b. False
a. True
Analgesia occurs almost immediately, but anti-inflammatory effects need larger doses and more sustained doses.
Patient-related drug-drug interactions, such as NSAIDs with respiratory agents used to treat asthma, include decreased renal function.
a. True
b. False
a. True
NSAIDs can exacerbate renal insufficiency, leading to altered excretion of some drugs. They can also alter hepatic function.
Other patient related risks for drug-drug interaction include acute medical condition (dehydration, infection, HF), age extremes, femal gender, metabolic or endocrine condition (especially hypothyroid), multiple med use, genetics
Some drug-related risks: narrow therapeutic index, multiple meds (4 seems to be the critical number of high alert for probably risk), drug formulation, diet, protein binding, inhibition or induction of CYP450 enzymes, and more.
Misc risks include work flow and work load (more errors/interactions when clinician is busy), too many computer alerts (no one pays attention when too many) and large numbers of clinicians or pharmacists involved with dispensing meds.
NSAID anti-inflammatory effects may take quite a while to achieve steady state in chronic inflammatory conditions and clinicians should not switch anti-inflammatory too quickly.
a. True
b. False
a. True
Analgesia occurs almost immediately, but anti-inflammatory effects need larger doses and more sustained doses
Patient-related factors and/or drug-drug interactions of concern with NSAIDs include risk for new or worsening decreased renal function.
a. True
b. False
a. True
NSAIDs can exacerbate renal insufficiency, leading to altered excretion of some drugs. They can also alter hepatic function.
Other patient related risks for drug-drug interaction include acute medical condition (dehydration, infection, HF), age extremes, femal gender, metabolic or endocrine condition (especially hypothyroid), multiple med use, genetics
Some drug-related risks: narrow therapeutic index, multiple meds (4 seems to be the critical number of high alert for probably risk), drug formulation, diet, protein binding, inhibition or induction of CYP450 enzymes, and more.
Misc risks include work flow and work load (more errors/interactions when clinician is busy), too many computer alerts (no one pays attention when too many) and large numbers of clinicians or pharmacists involved with dispensing meds.
Why prescribe a COX-2 inhibitor over aspirin?
a. COX-2s are less expensive
b. COX-2s may provide more specific and peripheral analgesia
c. COX-2s are more effective at relieving CNS pain like HA
d. Aspirin is less potent
b. COX-2s may provide more specific and peripheral analgesia
COX-2 work primarily on the periphery and are indicated for some specific conditions.
Aspirin is CHEAP.
Amitriptyline is indicated for treatment of chronic pain for at least some patients.
a. True
b. False
a. True
Which drug is included on the KIDS list as a potentially inappropriate drug for children?
a. Acetaminophen
b. Morphone
c. Codeine
d. Ibuprofen
c. Codeine
