Pain, Inflammation, Gout Drug Therapy

Question 1

pain

Answer 1

5th vital sign
warning of disease/infection/injury
part of healing process

Question 2

analgesics

Answer 2

drugs to relieve pain

Question 3

nociceptors

Answer 3

nerve endings that respond to injury and pain

Question 4

substances that trigger nociceptors

Answer 4

prostaglandins, histamine, bradykinin, serotonin, substance p

Question 5

two elements of pain

Answer 5

local irritation (stimulation of peripheral nerves)
recognition of pain (CNS, anxiety and apprehension)

Question 6

types of pain duration

Answer 6

acute and chronic

Question 7

responses to pain

Answer 7

psychological-tired/irritable/insomina/anxiety/depression

physical- increased HR/decreased BP/weakened immune

Question 8

opioid analgesics

Answer 8

derived from opium, act on opioid receptors scheduled, monitor for tolerance/dependance

Question 9

nonopiod analgesics

Answer 9

NSAIDS, acetaminophen, silicates

treat mild pain

Question 10

MOA of opioids

Answer 10

react on opiod receptors, mimic analgesic peptides, decrease CNS, inhibits substance P and glutamate and nociceptors

Question 11

uses of opioids

Answer 11

moderate to severe pain, cough

Question 12

pt teaching.SE of opioids

Answer 12

sedation, respiratory depression, changes in mood, decreased peristalsis causing constipation, may be unable to operate vehicle, miosis, muscle spams, orthostatic hypotension, oliguria, bradycardia, dry mouth, do not drink alcohol

Question 13

MOA and use of narcotic “pure” agonists

Answer 13

block opiods from binding

used for addiction/overdose

Question 14

MOA of narcotic “partial” agonists

Answer 14

produce respiratory depression/mild pain relief

Question 15

uses for non-opioid analgesics

Answer 15

inflammation, arthralgia, HA, myalgia, fever, mild pain

Question 16

arachidonic pathway

Answer 16

formation of arachidonic acid via enzyme conversion of phospholipids
COX form prostaglandins

Question 17

MOA of salicylates

Answer 17

blocks COX 1 and 2, inhibit synthesis of prostaglandins, suppress heat center, inhibit aggregation of platelets

Question 18

uses and pt teaching for salicylates

Answer 18

analgesic, antipyretic, anti-inflmmatory, anti-coagulation

reyes syndrome tinnitus

Question 19

MOA of NSAIDS

Answer 19

treat inflammation by inhibiting pathway of prostaglandin synthesis, inhibit COX

Question 20

pt teaching of NSAIDS

Answer 20

ulcers/GI upset, disrupts stomach lining

Question 21

MOA of COX 2 selective inhibitor

Answer 21

alleviate pain and inflammation without gastric mucosal disruption

Question 22

MOA of acetominophen (Tylenol®)

Answer 22

acts on regulation center, inhibits prostaglandin synthesis and formation in CNS, not anti-inflam

Question 23

pt teaching of acetaminophen (Tylenol®)

Answer 23

hepatotoxicity, no alcohol

Question 24

antidote for tylenol

Answer 24

acetylcysteine

Question 25

combination drugs

Answer 25

narcotic + non narcotic

Question 26

gout

Answer 26

inflammatory condition causing joint pain, accumlation of uric acid in joint fluid attacked by phagocytes
avoid alcohol/beer/wine/cheese etc

Question 27

subcategories of drugs used for gout

Answer 27

acute anti-gout
hypouricemic agent
uricosuric agent

Question 28

MOA of acute anti-gout

Answer 28

alters ability of phagocytes to attack uric acid crystals

Question 29

prophylactic therapy- long term anti gout

Answer 29

hypouricemic agent

uricosuric agent

Question 30

MOA of hypouricemic agent

Answer 30

inhibits enzyme to produce uric acid

Question 31

MOA of uricosuric agent

Answer 31

enhances renal excretion of uric acid, prevents reabsoprtion of uric acid

Question 32

rheumatoid arthritis

Answer 32

autoimmune condition of joints

steroids, NSAIDS, analgesics, DMARDS

Question 33

MOA of local anesthetics

Answer 33

decrease NA influx, interfere with nerve conduction

Question 34

MOA of general anesthetics

Answer 34

increase GABA, inhibit glutamate

caution of malignant hyperthermia