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Pain and inflammation Flashcards

1
Q

First Gen NSAIDS (COX-1 and COX-2 inhibitors prototype (aspirin)

A

aspirin (ASA)

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2
Q

first gen NSAIDS (aspirin) therapeutic use

A

relieves mild to moderate pain, fever, inflammation, dysmennorrhea and reduces the risk of TIAs, CVAs, and MIs

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3
Q

first gen NSAIDS (aspirin) EPA

A

inhibits the actions of COX-1 and COX-2
Analgesic - acts both centrally and peripherally to block pain impulses
Antipyretic - reduces fever by acting on the hypothalamus
Antiplatelet - suppress platelet aggregation, blocks the synthesis of thromboxane A2

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4
Q

first gen NSAIDS (aspirin) adminsitration

A

PO or rectally
81 mg (low-dose)
325 mg (high-dose)

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5
Q

first gen NSAIDS (aspirin) ADRs

A

nausea, epigastic discomfort, heartburn, GI bleed and hemorrhage, petechiae and bruising
Acute toxicity: metabolic acidosis, respiratory failure, renal failure and cardiac collapse
Salicylism: toxicity due to chronic use. Characterized by dizziness, tinnitus, and mental confusion

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6
Q

first gen NSAIDS (aspirin) contraindications and interactions

A

Known risk for bleeding
Pregnancy - teratogenic
Anyone 18 years of age or less should not take b/c of risk of Reye’s syndrome
Black Box Warning: children or teenagers should not take b/c of risk of Reye’s Syndrome

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7
Q

first gen NSAIDS (aspirin) RN intervention and client education

A

Take with food or after meals
Watch for bleeding or hearing loss
Avoid alcohol
Avoid aspirin for approx. 1 week before or after major surgeries or dental procedures

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8
Q

first gen NSAIDS (ibuprofen) prototype and other drug names

A

ibuprofen (Advil and Motrin)
Other drugs naproxen (Aleve) and ketorolac (Toradol) - given IV

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9
Q

first gen NSAIDS (ibuprofen) therapeutic use

A

relieves mild to moderate pain, fever, inflammation, dysmenorrhea

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10
Q

first gen NSAIDS (ibuprofen) EPA

A

inhibits the actions of COX-1 and COX-2, but slightly more selective with COX-2

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11
Q

first gen NSAIDS (ibuprofen) adminsitration

A

PO (tablet or liquid)

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12
Q

first gen NSAIDS (ibuprofen) ADRs

A

GI effects-dry mouth, nausea, heartburn and GI ulceration with blood loss
Nephrotoxic

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13
Q

first gen NSAIDS (ibuprofen) contraindications and interactions

A

Known risk for bleeding
Pregnancy-teratogentic
Renal disease
BLACK BOX WARNING: should not be given to pt after coronary artery bypass surgery to treat pain

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14
Q

first gen NSAIDS (ibuprofen) RN intervention and client education

A

Take with food
Drink 2-3 courts of fluid daily
Watch for bleeding
Avoid alcohol

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15
Q

second generation NSAIDs prototype

A

celecoxib (Celebrex)

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16
Q

second gen NSAIDs therapeutic use

A

given to treat swelling in joints caused by (RA and OA) by suppressing inflammation

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17
Q

second gen NSAIDS EPA

A

inhibits COX-2 enzymes to decrease inflammation, it does not affect the COX-1 enzyme, thus protecting the lining of the GI tract and not inhibiting clotting factors

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18
Q

second gen NSAIDS adminsitration

A

PO

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19
Q

second gen NSAIDS ADRs

A

gastric upset, kidney dysfunction, cardiovascular and cerebrovascular events
BLACK BOX WARNING: increased risk for MI and CVA

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20
Q

second gen NSAIDS contraindications and interactions

A

Kidney disease
Anyone with known bleeding disorder
Allergy to sulfa or sulfonamides
Hx of CVA or MI
Recent CABG surgery

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21
Q

second gen NSAIDS RN intervention and client education

A

Give with food
Give 2 hr before or after magnesium or aluminum based antacids
Report chest pain or symptoms of a CVA

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22
Q

nonopioid analgesic prototype

A

acetaminophen (Tylenol)

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23
Q

nonopioid analgesic EPA

A

to reduce fever, acts directly on hypothalamus to increase vasodilation and sweating. Inhibits COX to decrease pain but has no anti inflammatory or anticoagulant effects

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24
Q

nonopioid analgesic therapeutic use

A

reduce fever and decrease minor pain

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25
nonopioid analgesic administration
PO, IV, or rectally (DO NOT exceed 4000mg in 24 hours) 325 mg tablets Adult dose: 325-650mg 500 mg tablets (extra strength)
26
nonopioid analgesic ADRs
hepatotoxicity and HTN
27
nonopioid analgesic contraindications and interactions
Alcohol use disorder Liver and kidney disease
28
nonopioid analgesic RN intervention and client education
Do not exceed recommended dose Have BP checked regularly
29
centrally acting nonopioid prototype
tramadol (Ultram)
30
centrally acting nonopioid therapeutic use
treat moderate to severe pain
31
centrally acting nonopioid EPA
binds to select opioid receptors and blocks reuptake of norepinepherine and serotonin in the CNS
32
centrally acting nonopioid administration
PO
33
centrally acting nonopioid ADRs
sedation, dizziness and resp. Depression is rare
34
centrally acting nonopioid contraindications and interactions
seizure disorders, resp depression
35
centrally acting nonopioid RN intervention and client education
Take with food Take med only when needed nd for short term Do not take prior to driving or activities that require mental awareness
36
opioid agonist prototype and other drug names
morphine Other drugs: fentanyl, codeine, oxycodone, & methadone (Methadone-chemically like morphine but blocks the euphoric effects of opioids and reduces cravings. Used to treat Opioid Use Disorder (OUD))
37
opioid agonist therapeutic use
Treat moderate to severe pain.
38
opioid agonist EPA
Mimics the action of naturally occurring opioids, endorphins, and enkephalins. Does this by binding with the mu receptors at the opioid receptor sites. Stimulation of these receptors causes analgesia, sedation, euphoria, and respiratory depression.
39
opioid agonist administration
PO, IM, IV, SC, rectally, or epidurally
40
opioid agonist ADRs
Respiratory depression, lightheadedness, dizziness, constipation, and potential for abuse along with tolerance.
41
opioid agonist contraindications and interactions
Resp depression Pregnancy Older adults, infants Hepatic or kidney disease
42
opioid agonist RN intervention and client education
Antidote: naloxone (Narcan) Monitor resp status Schedule II controlled substance Take med only when needed and for short term Do not take prior to driving or activities that require mental awareness Change positions gradually Encourage bowel movements
43
opioid agonist-antagonist prototype
buprenorphine (Buprenex)
44
opioid agonist-antagonist therapeutic use
analgesia for moderate to severe pain. Anesthesia adjunct. Also used to treat opioid use disorder (OUD)
45
opioid agonist-antagonist EPA
MU receptor antagonist and kappa receptor agonist. Fewer mu-related adverse effects, such as resp. Depression, euphoria, and dependence. Produces milder analgesic effects
46
opioid agonist-antagonist administration
PO, IM, IV, or intranasally
47
opioid agonist-antagonist ADRs
respiratory depression (limited), nausea, constipation, increased cardiac workload
48
opioid agonist-antagonist contraindications and interactions
Resp depression Acute MI Hepatic or kidney disease
49
opioid agonist-antagonist RN intervention and client education
Antidote: naloxone (Narcan) may need repeated dose Monitor resp status Schedule IV controlled substance Take med only when needed for short term Do not take prior to driving or activities that require mental awareness Change positions gradually
50
opioid antagonist prototype
naloxone (Narcan)
51
opioid antagonist therapeutic use
reversal of opioid effects, overdose
52
opioid antagonist EPA
block opioid receptors, effectively reversing or antagonizing the effects of opioids
53
opioid antagonist administration
IM, IV, SQ, and intranasally
54
opioid antagonist ADRs
ventricular arrhythmias, increase in HR and RR, can cause withdrawal symptoms (HTN, vomiting, and tremors)
55
opioid antagonist contraindications and interactions
Opioid dependence Cardiac irritability
56
opioid antagonist RN intervention and client education
Monitor VS Be aware-drug can increase pain because it is reversing the opioid effects Prepare to administer every 2-3 min until reversal of undesirable effects Observe for nausea, vomiting, tachycardia, and diaphoressi (indications of opioid reversal)
57
antigout/antihyperuricemic prototype and other drug names
allopurinol (Zyloprim) Others: colchicine
58
antigout therapeutic use
management of the signs and symptoms of gout to reduce uric acid concentration
59
antigout EPA
inhibits the enzyme that is responsible for the conversion of the purines to uric acid, therefore reducing uric acid production
60
antigout administration
PO or IV
61
antigout ADRs
Gi disturbances (N/V/D), bone marrow depression, and agranulocytosis
62
antigout contraindications and interactions
Interferes with warfarin Bone marrow depression Liver or kidney dysfunction
63
antigout RN interactions and client education
Take after meals to ensure absorption Ingest at least 3L/day of fluid Report decreased urine output or cloudy urine, which could be signs of a uric acid stone formation Low purine diet, avoid: beer, alcohol, meat, sardines, anchovies, scallops, asparagus, spinach, peas

Pharm (13 decks)

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