Old dont studyAntiinflammatory, Antiarthritis, immune modulators and vaccines Flashcards by Shaniya Capre

What are anti-inflammatory agents that block or alter inflammatory process?

-NSAID’s
-Salicylates
-Anti-Arthritis

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What can be other inflammatory agents?

-Steroids
-Antihistamines, which block the release of histamine in response to antigen

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What do prostaglandins do ?

When our body is exposed to intruders prostaglandins are exposed and set off the inflammatory response
-Help increase blood flow to kidneys and helps increase clotting

-Mediate pain-sensitizing pain receptors
-Induce inflammation by vasodilation(bringing more blood in)
-GI inhibits acid secretion
-renal protection with perfusion and functions
-Involved with regulating platelet aggregation

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What is the generic name and brand names for NSAIDS?

Generic name: ibuprofen(generic name)
Brand name: Motrin, Advil

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What si the therapeutic actions for NSAIDS?

NSAIDS block two enzymes needed for prostaglandins synthesis and inflammation response

If prostaglandins are blocked they can’t help with inflammatory response
-Strong anti-inflammatory, analgesic effects, antipyretic

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What is are the two enzymes needed for prostaglandin synthesis and inflammation response?

COX 1: Needed for blood clotting, stomach protection, sodium/water balance in kidney
COX 2: Active when more prostaglandin are needed,thought to block vasodilation, found at site of injury

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What is a list for NSAIDS?

Ibuprofen(Know this one mostly!)
Indomethacin
Nabumetone
Ketorolac
naproxen

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What does cross sensitivity mean?

If you have an allergic reaction to a drug class you may have another allergic reaction to another drug class? DOUBLE CHECK

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What are adverse effects of NSAIDS?

-Bleeding
-Stomach ulcers
-Fluid retention

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Who shouldn’t NSAIDS be given to?

-People with allergy to salicylates , NSAIDs
-Celecoxib(Celebrex) cross sensiticy with sulfonamides
-Cardiac disease and HTN because due to fluid retention it will cause bp to go up and extra fluid will effects people with cardiac issues
-Bleeding disorders like thrombocytopenia(decrease in platlets) If they are given to someone who is already at risk it will increase their risk

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Who should be caution with when Giving NSAID’s?

Can give it to the following but should be cautious because there could be a risk
-Pregnancy/lactation
-Renal/hepatic disease

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What are drug -drug interactions to be careful about ?

-Decrease diuretic effect when taken with loop diuretics
-Decrease HTN effect when combined with beta blockers
-Caution with lithium
-Potentiate opiods

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What is salicylates also known as?

ASA, Aspirin, Ecotrin

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What is the therapeutic action of Salicylates ?

Inhibits synthesis of prostaglandins

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What are indications of salicylates? (What do they do)

-Antipyretic ( Acts on hypothalamus)
-Analgesic( medications that relieve pain)
-Anti-inflammatory
-inhibits platlets aggregation

Pharmacokinetics
-Absorbed quickly

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What are adverse affects of salicylates?

-Ototoxicity/ Tinnitus
-GI: nausea, heartburn, epigastric, discomfort
-Bleeding
-Salicylism

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What are contra/ cautions when taking salicylates?

-Allergy to salicylates, NSAIDs or tatrazine
-Bleeding abnormalities
-Impair renal function
-Surgery within one week
-Viral influenza/chicken pox in children/ adolescents (reyes syndrome) can lead to permanent brain damage
-Pregnancy/ lactation

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What are drug- drug interactions of Salicylates ?

Anti-coag use

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What is acetaminophen also known as?

Tylenol

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What is the therapeutic action of acetaminophen ?

Acts on the hypothalamus
mild to moderate pain relief and reduction of fever and is not a anti-inflammatory

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What is the adverse effecrs of tylenol?

Hepatotoxicity

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What are are the contra to acetaminophen?

Allergy to acetaminophen

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What are cautions you have when taking acetaminophen?

-Pregnancy/lactation
-Hepatic dysfunction/chronic ETOH. (should not take 3-4 grams a day)

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What is apart of the Disease modifying anti rheumatic drugs?

There are many drugs in this category but it’s important to know
-Etanercept(Enbrel)

What is the therapeutic actions of "Disease modifying anti rheumatic drugs?"

-Neutralizing the immune system -Depress overactive immune system, decrease inflammation, stop disease progression

What are adverse effects of "Disease modifying anti rheumatic drugs?"

It has a black box warning that mentions Fatal infections: Lymphomas/ other cancers

What are contras of "Disease modifying anti rheumatic drugs?"

Allergy -Active infection (wont be able to fight it off) -Pregnancy/ lactation

What are cautions for "Disease modifying anti rheumatic drugs?"

-Liver/renal( metabolism/ excretion) -Bone marrow suppression (Follow labs/follow cbc -Various CNS effects -Monitor for worsening of demyelinating disorders (MS) -Monitor for worensing of demyelinating disorders(MS)

What are drug to drug issues when dealing with "Disease modifying anti rheumatic drugs?"

No live vaccines (immune system wouldn't be able to fight it off"

What should you assess with Antiinflmmatory Antuarthritis "Disease modifying anti rheumatic drugs?

Co-morbidiites (anything would make me cautious) -Allergies -Pain -Ability to perform ADL -Baseline labs -Medication use

what are nursing diagnoses for NSAIDS, salicylates?

Risk for bleeding -acute pain r/t to GI effects

What are nursing diagnosis for DMARDS?

Risk for infection Acute pain r/t GI effects

What are nursing implementations for NSAIDS, DMARDS, and anti arthritis?

-Teaching signs of GI bleeding -Administer with food (decrease GI distress) -Salicytes Not to be given to children -DO not chew/crush enteric coated tablets -Monitor labortory results: Like renal and hepatic functions and PLT

What are immune modulators?

Used to modify actions of the immune system

What are immunes stimulates?

They basically excite the immune system -Interferons -Interleukins

What are immune suppressants?

-T and B cell suppressants -Monoclonal antibodies

***Immune modulator suppressants What are Cyclosporine(sandimmune)

-Usually used with steroids -Therapeutic action is T and B cell suppressors -Usually used post transplant with renal, hepatic, and cardiac, so it doesn't reject the new organ

What are adverse effects of immune modulators suppressants ?

-Infection -Development of neroplasms n/v, anorexia, bone marrow supression

What are contra of immune modulators suppresants?

Allergy to drug or components -pregnancy/lactation

What are cautions when taking immune modulators suppresants?

Renal/hepatic impairment malignancy

What are life span considerations when taking immune modulators suppressants?

Children -Cyclosporine used with caution Monitor bloods, GI, renal effects Adults /Older adult -Baseline and ongoing renal, hepatic, cardiac studies -Monitor for hypertension -Avoid others with active viral infections

What are nursing diagnosis for immune modulators?

Risk for infection related to immune suppression

What are implementations that can happen with people who are using immune modulators?

-Educate barrie contraception -Follow blood work as treatment proceeds -Monitor for HTN,renal,liver and cardiac compromise -Educate signs and symptoms of infection -Teach proper drug administration -Pre-medicate with acetaminophen to reduce flu like symptoms

What is immunization?

-Process of stimulating immunity by exposure to weakened proteins (antigens) of a specific disease

**What was the first vaccine to prevent cancer?

Gardisil Effect against HPV types 16 and 18 (cervical cancer) -Effective against type 6 and 11( genital warts) Does not provide protection if patient already infected with one of the HPV strains

What are adverse effects of vaccines?

-Pain -Redness -Swelling at injection site -Occasional syncopal episodes

What should you assess wiyj vaccines?

Acute illness, immunodeficiency -allergies -physical assessment of skin, vital signs, ROM of extremity

What are contras for vaccine?

Immune deficiency -Pregnancy and lactation -Known allergies to vaccine or components

What is nursing diagnosis for vaccines?

acute pain related to injection

What is the therapeutic action of immune globulin?

-Method is to provide passive immunity providing preformed antibodies to a specific antigen -Immune sera contains antibodies to specific bacteria, virus and venom

**Immune sera What is immune globulin?

Plasma pooled from multiple donor blood

What is the indication of immune sera? (who used them? and what is the therapeutic actions ?

Used as prophylaxis or to lessen reaction to specific disease after exposure -Method to provide passive immunity providing preformed antibodies to specific antigen -Immune sera – contain antibodies to specific bacteria, virus and venom

What are adverse effects to Immune sera?

-Fever, rash,chest tightess -Local reactions at injection site

What are contras of immune sera?

History of reaction

What are cautions of Immune sera?

-Pregnancy -Thrombocytopenia, coagulation disorders

What are drug to drug reactions for immune sera?

Any immune suppressant drug

What is nursing diagnosis with immune sera?

Acute pain related to injection

What to assess for immune sera?

-Allergies exposure to serum -pregnancy status -Physical assement with skin and vital signs

Old dont studyAntiinflammatory, Antiarthritis, immune modulators and vaccines Flashcards

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