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Pharm > Pain and inflammation > Flashcards

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
Q

nonopioid analgesic administration

A

PO, IV, or rectally (DO NOT exceed 4000mg in 24 hours)
325 mg tablets
Adult dose: 325-650mg
500 mg tablets (extra strength)

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26
Q

nonopioid analgesic ADRs

A

hepatotoxicity and HTN

27
Q

nonopioid analgesic contraindications and interactions

A

Alcohol use disorder
Liver and kidney disease

28
Q

nonopioid analgesic RN intervention and client education

A

Do not exceed recommended dose
Have BP checked regularly

29
Q

centrally acting nonopioid prototype

A

tramadol (Ultram)

30
Q

centrally acting nonopioid therapeutic use

A

treat moderate to severe pain

31
Q

centrally acting nonopioid EPA

A

binds to select opioid receptors and blocks reuptake of norepinepherine and serotonin in the CNS

32
Q

centrally acting nonopioid administration

33
Q

centrally acting nonopioid ADRs

A

sedation, dizziness and resp. Depression is rare

34
Q

centrally acting nonopioid contraindications and interactions

A

seizure disorders, resp depression

35
Q

centrally acting nonopioid RN intervention and client education

A

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
Q

opioid agonist prototype and other drug names

A

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
Q

opioid agonist therapeutic use

A

Treat moderate to severe pain.

38
Q

opioid agonist EPA

A

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
Q

opioid agonist administration

A

PO, IM, IV, SC, rectally, or epidurally

40
Q

opioid agonist ADRs

A

Respiratory depression, lightheadedness, dizziness, constipation, and potential for abuse along with tolerance.

41
Q

opioid agonist contraindications and interactions

A

Resp depression
Pregnancy
Older adults, infants
Hepatic or kidney disease

42
Q

opioid agonist RN intervention and client education

A

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
Q

opioid agonist-antagonist prototype

A

buprenorphine (Buprenex)

44
Q

opioid agonist-antagonist therapeutic use

A

analgesia for moderate to severe pain. Anesthesia adjunct. Also used to treat opioid use disorder (OUD)

45
Q

opioid agonist-antagonist EPA

A

MU receptor antagonist and kappa receptor agonist. Fewer mu-related adverse effects, such as resp. Depression, euphoria, and dependence. Produces milder analgesic effects

46
Q

opioid agonist-antagonist administration

A

PO, IM, IV, or intranasally

47
Q

opioid agonist-antagonist ADRs

A

respiratory depression (limited), nausea, constipation, increased cardiac workload

48
Q

opioid agonist-antagonist contraindications and interactions

A

Resp depression
Acute MI
Hepatic or kidney disease

49
Q

opioid agonist-antagonist RN intervention and client education

A

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
Q

opioid antagonist prototype

A

naloxone (Narcan)

51
Q

opioid antagonist therapeutic use

A

reversal of opioid effects, overdose

52
Q

opioid antagonist EPA

A

block opioid receptors, effectively reversing or antagonizing the effects of opioids

53
Q

opioid antagonist administration

A

IM, IV, SQ, and intranasally

54
Q

opioid antagonist ADRs

A

ventricular arrhythmias, increase in HR and RR, can cause withdrawal symptoms (HTN, vomiting, and tremors)

55
Q

opioid antagonist contraindications and interactions

A

Opioid dependence
Cardiac irritability

56
Q

opioid antagonist RN intervention and client education

A

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
Q

antigout/antihyperuricemic prototype and other drug names

A

allopurinol (Zyloprim)
Others: colchicine

58
Q

antigout therapeutic use

A

management of the signs and symptoms of gout to reduce uric acid concentration

59
Q

antigout EPA

A

inhibits the enzyme that is responsible for the conversion of the purines to uric acid, therefore reducing uric acid production

60
Q

antigout administration

61
Q

antigout ADRs

A

Gi disturbances (N/V/D), bone marrow depression, and agranulocytosis

62
Q

antigout contraindications and interactions

A

Interferes with warfarin
Bone marrow depression
Liver or kidney dysfunction

63
Q

antigout RN interactions and client education

A

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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