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Pharm unit 1 > Pain and Inflammation > Flashcards

Pain and Inflammation Flashcards

1
Q

NSAID action- NONselective

A

Block COX (cyclooxygenase) 1+2 enzymes which is necessary for the production of prostaglandins, which interferes with prostaglandin synethis at the nociceptor level

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2
Q

Which is stronger tylenol or ibuprofin

A

Ibuprofen

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5
Q

What is nociceptive pain

A

Injury to tissues. Includes:

Somatic= musculoskeletal

Visceral= internal organs

Includes transduction, transmission, perception, and modulation

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6
Q

Neuropathic pain

A

Can affect peripheral or CNS nerves

Burning, tingling, shooting, electric

Causes= infection, ischemia, damage to nerves

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7
Q

Transduction

A

Tissue damage causes nociceptors to release chemical mediators ( prostaglandins, serotonin, histamine)

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9
Q

Transmission

A

Pain impulse is transmitted from the nociceptor to the spinal cord then brain

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10
Q

Modulation

A

Pain is modulated in the brain to either increase or decrease transmission of pain impulse

Inhibitory neurotransmitters block pain transmittion

Excitatory neurotransmitters increase transmission

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11
Q

Chronic pain management goals

A

Restore function

Limit pain

Avoid opioids if possible

Prevent secondary consequences of pain

Learn to live with some amount of pain

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12
Q

Nonopioids include

A

NSAIDS

Acetaminophen

Antigout agents

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13
Q

Interfering with prostaglandins effects?

A

Gastric mucosa

Renal function

Smooth muscle contractions

Normal platelet aggregation

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14
Q

Selective NSAID

A

Inhibits COX 2 activity only

Many cardio side effects

Celecoxib ( Celebrex) only med

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15
Q

NSAID side effects

A

GI irritation(nausea,heart burn, dyspesia), gastric ulcers and bleeding (nonselective nsaid)

Increased bleeding time(nonselective nsaid)

Increased risk of MI or stroke (selective nsaid)

Renal failure

Contraindicated allergy to aspirin

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16
Q

Morphine sulfate

A

Sch 2

PO IM SC IV EPIDURAL INTRATHECAL

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17
Q

NSAID uses

A

Analgesia mild-mod

Anti inflammatory

Antipyretic

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18
Q

Tylenol

A

APAP, paracetamol, acetaminophen

Inhibits prostaglandin synthesis by a dif mechanism

“Cet” suffix= tylenol ingredient in meds

Antipyretic and analgesic
Analgesic effect similar to ASA

Max ceiling dose- 3000-4000 mg/24hr

Hepatoxicity

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20
Q

indomethacin

A

Indocin (NSAID)

mild-mod pain

Common uses= inflammatory conditions such as arthritis, bursitis, tendonitis
IV to promote closure of patent ductus arteriosus

Treat preterm labor

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22
Q

What does pain impact

A

Sleep, mobility, ability to eat, family and relationships

Chronic pain- spiritual crisis; hopelessness

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23
Q

NSAID contraindications/ extreme cautions

A

Active peptic ulcer

CV disease (except aspirin)

Chronic alcohol use

Renal or liver impairment

Do not give concurrently with other NSAIDS

24
Q

celecoxib

A

Celebrex (COX2 NSAID)

Primarily for anti inflammatory effects (osteoarthritis, rheumatoid arthritis)

Higher risk for CV events

Lower risk for GI effects

Little effect on platelet function

Contr with sulfa allergy

25
Q

Demerol

A

meperidine

Opioid

26
Q

aspirin

A

ASA
salicylate/NSAID

Anti inflammatory similar to NSAIDS
Analgesic effect similar to tylenol- mild/mod

Salicylate poisoning = tinnitus, hearing loss— treated with dialysis if severe

Reyes syndrome kids teens with viral illness or fever

Antiplatelet effect greater

Prophylaxis of CV events 81-325 mg daily, rx of acute MI

27
Q

Dietary supplements to treat arthritis pain

A

Glucosamine and chondroitin

Adv effects largely GI- N/D, gas, heartburn

Caution in
diabetics- need higher insulin doses
Enhances coagulation effects

28
Q

Tylenol #3

A

codeine with acetaminophen

29
Q

allopurinol

A

Zyloprim

Xanthine oxidase inhibitor- prevents hyperuricemia by inhibiting the enzyme essential to production of uric acid

Does not relieve acute gout attack

Skin rashes common

30
Q

Aspirin and tylenol

A

Equal analgesic effects

Least potent

31
Q

ibuprofen

A

Motrin, Advil

PO or IV

Mild-Mod pain

Commonly used for musculoskeletal, dysmenorrhea, arthritis, dental pain

Otc= 200mg PO
prescription= 300-800mg PO
33
Q

Gout

A

Painful form of arthritis caused by hyperuricemia and deposits of uric acid crystals in joints(usually LE)

Rx symptomatically with NSAIDS

allopurinol to prevent attacks

36
Q

Opioid agonists effects

A 
Analgesia
Sedation
Euphoria 
Respiratory depression 
Miosis
Vasodilation 
Decreased GI peristalsis 
Stimulates vomiting center
Supresses medullary cough center
37
Q

Transdermal opioids uses

A

Severe chronic pain in opioid tolerant patients

avoid using heat on patch

Gloves to put on

Switch sites

38
Q

sublimaze

A

Fentanyl

39
Q

Percodan

A

oxycodone with aspirin

40
Q

Ketorolac strength

A

Same as morphine

41
Q

Fentanyl vs dilaudid

A

Fentanyl

42
Q

Percocet

A

oxycodone with acetaminophen

43
Q

Opioids nursing

A

Rescue before respiratory depression- downward trend in VS

OHTN fall risk change positions slowly
Premedicate for itching and nausea and constipation

Have narcan ready

46
Q

Opioids adv effects

A

Cns depression= sedation, drowsiness, euphoria, respiratory depression (<10/min)

Vasodilation = OHTN, dizzyness

N/V, constipation, pruritis

Tolerance, dependency

48
Q

NSAID teaching

A

If upset GI, take with food or milk

Avoid alcohol

Report S/S of GI bleeding ( dark stools, vomiting blood , anemia)

S/S peptic ulcers= pain, nausea

Review CV events

Dont take 2+ NSAIDS at same time

49
Q

Oxycontin

A

oxycodone

Opiod

51
Q

Codeine

A

Opioid agonist

Cough

52
Q

Perception

A

Multiple areas in the brain respond to produce pain perception and response

54
Q

hydromorphone

A

Dilaudid

Sch 2

7x more potent than morphine

Severe pain

62
Q

Toradol

A

ketorolac(NSAID)

Primarily for analgesic effect

Mod-severe acute pain

Effects similar to morphine

Max use 5 days

Coadmin with opiods= additive analgesic effect, less opioid use

64
Q

Goals for acute pain management

A

To provide relief or control of pain

Facilitate recovery from underlying source of pain

Minimize impact of pain on recovery activities

Reduce physiologic stress from catecholamines

Pharm unit 1 (3 decks)

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