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Pharmacology Exam #3 > Pain and Inflammation > Flashcards

Pain and Inflammation Flashcards

1
Q

What are NSAIDs?

A

Nonsteroidal Anti-inflammatory Drugs

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2
Q

What do first generation and second generation NSAIDs block?

A
  • First generation NSAIDS: Block COX-1 and COX-2
  • Second generation NSAIDs: Block only COX-2
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3
Q

aspirin (ASA): class

A

first generation NSAIDS cox-1 & cox-2 inhibitor

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4
Q

aspirin (ASA): Use

A

Relieves mild to moderate pain, fever, inflammation, dysmenorrhea and reduces the risk of TIAs, CVAs and MIs

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5
Q

aspirin (ASA): EPA

A
  • Inhibits the actions of COX-1 & 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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6
Q

aspirin (ASA): administration

A

baby dose - 81 mg
adult dose - 325 mg

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7
Q

aspirin (ASA): ADRs

A

Nausea, epigastric discomfort, heartburn, GI bleed and hemorrhage, petechiae and bruising, acute toxicity, salicylism

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8
Q

What is acute toxicity of Aspirin?

A

Metabolic acidosis, respiratory failure, renal failure and cardiac collapse.

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9
Q

What is salicylism?

A

toxicity due to chronic use of aspirin Characterized by dizziness, tinnitus and mental confusion

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10
Q

aspirin (ASA): contraindications

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

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11
Q

aspirin (ASA): BLACK BOX WARNING

A

Children or teenagers should not take b/c of risk of Reye’s Syndrome

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12
Q

aspirin (ASA): RN Interventions

A

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

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13
Q

ibuprofen (Advil & Motrin): class

A

first generation NSAIDS (cox 1 and cox 2 inhibitor

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14
Q

ibuprofen (Advil & Motrin): other medication

A

naproxen (Aleve) & ketorolac (Toradol)-given IV

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15
Q

ibuprofen (Advil & Motrin): Use

A

Relieves mild to moderate pain, fever, inflammation, dysmenorrhea.

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16
Q

ibuprofen (Advil & Motrin): EPA

A

Inhibits the actions of COX-1 & COX-2, but slightly more selective with COX-2.

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17
Q

ibuprofen (Advil & Motrin): ADR

A

GI effects-dry mouth, nausea, heartburn and GI ulceration with blood loss, nephrotoxic (Kidney)!!

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18
Q

ibuprofen (Advil & Motrin): Contraindications

A

Known risk for bleeding
Pregnancy-teratogenic
Renal disease
BLACK BOX WARNING

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19
Q

ibuprofen (Advil & Motrin): BLACK BOX WARNING

A

Should not be given to patients after coronary artery bypass surgery to treat pain

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20
Q

ibuprofen (Advil & Motrin): RN Interventions

A

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

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21
Q

celecoxib (celebrex): class

A

second generation NSAIDS cox-2 inhibitor

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22
Q

celecoxib (celebrex): Use

A

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

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23
Q

celecoxib (celebrex): EPA

A

Inhibits COX-2 enzyme 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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24
Q

celecoxib (celebrex): ADR

A

Gastric upset, kidney dysfunction, cardiovascular & cerebrovascular events, BLACK BOX WARNING

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25
Q

celecoxib (celebrex): BLACK BOX WARNING

A

increased risk for MI and CVA

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26
Q

celecoxib (celebrex): contraindications

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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27
Q

celecoxib (celebrex): RN Interventions

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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28
Q

acetaminophen (Tylenol): class

A

Nonopioid Analgesics

29
Q

acetaminophen (Tylenol): 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.

30
Q

acetaminophen (Tylenol): Use

A

reduce fever and decrease minor pain

31
Q

acetaminophen (Tylenol): administration

A

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

32
Q

acetaminophen (Tylenol): ADR

A

hepatotoxicity and HTN

33
Q

acetaminophen (Tylenol): contraindications

A

alcohol use disorder, liver and kidney disease

34
Q

acetaminophen (Tylenol): RN Intervention

A

do not exceed recommended dose, have BP checked regularly

35
Q

tramadol (Ultram): class

A

centrally acting nonopioid

36
Q

tramadol (Ultram): Use

A

treat moderate to moderately severe pain

37
Q

tramadol (Ultram): EPA

A

Binds to select opioid receptors and blocks reuptake of norepinephrine and serotonin in the CNS

38
Q

tramadol (Ultram): ADR

A

sedation, dizziness, and resp. depression is rare

39
Q

tramadol (Ultram): contraindication

A

seizure disorder, respiratory depression

40
Q

tramadol (Ultram): RN Intervention

A

Take with food
Take med only when needed and for short-term
Do not take prior to driving or activities that require mental awareness

41
Q

What are the different opioid receptors in the body?

A
  • Mu receptor: feelings of euphoria, respiratory depression, dependence, & sedation
  • Kappa receptor: pupil constriction, total sedation, dysphoria
  • Delta receptor: enables body to feel pain relief
42
Q

morphine: class

A

opioid agonists

43
Q

morphine: other medications

A

fentanyl, codeine, oxycodone, & methadone

44
Q

Methadone EPA and Use

A

Methadone-chemically like morphine but blocks the euphoric effects of opioids and reduces cravings. Used to treat Opioid Use Disorder (OUD).

45
Q

morphine: use

A

treat moderate to severe pain

46
Q

morphine: 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.

47
Q

morphine: ADR

A

lightheadedness, dizziness, constipation, and potential for abuse along with tolerance.
M: miosis
O: out of it
R: respiratory depression
P: pneumonia (aspiration/ cough suppression)
H: hypotension
I: Infrequent stools
N: Nausea
E: euphoria

48
Q

morphine: contraindications

A

Resp. depression
Pregnancy
Older adults, infants
Hepatic or kidney disease

49
Q

morphine: RN Interventions

A
  • Antidote: naloxone (Narcan)
  • Monitor respiratory 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 meds
50
Q

buprenorphine (Buprenex): class

A

opioid agonist- antagonist

51
Q

buprenorphine (Buprenex): Use

A

Analgesia for moderate to severe pain. Anesthesia adjunct. Also used to treat Opioid Use Disorder (OUD)

52
Q

buprenorphine (Buprenex): EPA

A

Mu receptor antagonists and kappa receptor agonists. Fewer mu-related adverse effects, such as resp. depression, euphoria, and dependence. Produces milder analgesic effects.

53
Q

buprenorphine (Buprenex): ADR

A

Respiratory depression (limited), nausea, constipation, increased cardiac workload.

54
Q

buprenorphine (Buprenex): contraindications

A

Resp. depression
Acute MI
Hepatic or kidney disease

55
Q

buprenorphine (Buprenex): RN Interventions

A
  • Antidote: naloxone (Narcan)*May need repeated doses
  • Monitor respiratory status
  • Schedule IV 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
56
Q

naloxone (Narcan): class

A

opioid antagonists

57
Q

naloxone (Narcan): Use

A

Reversal of opioid effects, overdose

58
Q

naloxone (Narcan): EPA

A

Block opioid receptors, effectively reversing or antagonizing the effects of opioids.

59
Q

naloxone (Narcan): ADR

A

Ventricular arrythmias, increase in HR and RR, can cause withdrawal symptoms (HTN, vomiting, & tremors)

60
Q

naloxone (Narcan): Contraindications

A

Opioid dependence
Cardiac irritability

61
Q

naloxone (Narcan): RN Interventions

A

Monitor vital signs
Be aware-drug can increase pain because it is reversing the opioid effects
Prepare to administer every 2 to 3 minutes until reversal of undesirable effects.
Observe for nausea, vomiting, tachycardia, and diaphoresis (indications of opioid reversal)

62
Q

allopurinol (zyloprim): class

A

antigout/antihyperuricemic

63
Q

allopurinol (zyloprim): other medication

A

colchicine

64
Q

allopurinol (zyloprim): use

A

Management of the signs and symptoms of gout to reduce uric acid concentrations

65
Q

allopurinol (zyloprim): EPA

A

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

66
Q

allopurinol (zyloprim): ADR

A

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

67
Q

allopurinol (zyloprim): Contraindications

A

Interferes with warfarin (Coumadin)
Bone marrow depression
Liver or kidney dysfunction

68
Q

allopurinol (zyloprim): RN Intervention

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

Pharmacology Exam #3 (10 decks)

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