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Nursing I > Pharm: anti-inflammatories and analgesics > Flashcards

Pharm: anti-inflammatories and analgesics Flashcards

1
Q

______ can come from trauma, surgery, extreme heat or cold, caustic chemical agents, infection

A

inflammation

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2
Q

what are the 2 inflammatory phases?

A

vascular phase and delayed phase

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3
Q

vessels vasodilate allowing blood and fluid to move to the site of injury (swelling)

A

vascular phase

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4
Q

Leukocytes move into the site of injury

A

delayed phase

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5
Q

cyclooxygenase enzyme

A

COX

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6
Q

converts arachidonic acid into prostaglandins which causes inflammation and pain at injury site (histamine, kinin, and prostaglandin (cause inflammation))

A

COX

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7
Q

What are the 2 forms of COX enzymes?

A

COX-1 and COX-2

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8
Q

protects stomach lining and regulates blood platelets

A

COX-1

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9
Q

triggers inflammation and pain

A

COX-2

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10
Q

cardinal signs of inflammation

A

redness, warmth, swelling, pain, loss of function

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11
Q

nonsteroidal antiinflammatory drugs

A

NSAIDs

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12
Q

NSAIDs do what?

A

-decrease inflammation
-antipyretic properties (prevent/reduce fever)

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13
Q

-inhibit COX enzyme needed for prostaglandin synthesis
-relieve pain
-reduce elevated body temp
-inhibit platelet aggregation
-mimic effects of corticosteroids

A

NSAIDs

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14
Q

common 1st generation NSAIDs (nonspecific inhibitor of COX enzymes)

A

-aspirin
-ibuprofen

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15
Q

second generation NSAID (selective and only inhibits COX-2) not as much effect on GI (ulcer risk/history may benefit)

A

celecoxib (Celebrex)

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16
Q

true or false: NSAIDs increase the risk of bleeding

A

true

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17
Q

acetylsalicylic acid (ASA): antiinflammatory, antiplatelet, antipyretic effects

A

aspirin

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18
Q

Why no give children aspirin?

A

Reye’s syndrome

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19
Q

toxic serum salicylate lvl?

A

> 300 mcg/mL

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20
Q

Why take NSAIDs w/ food?

A

can cause GI upset

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21
Q

What kind of coating protects GI tract because it does not absorb until small intestine?

A

enteric coated

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22
Q

2 issues that need to be watch when patient is on NSAIDs

A

-watch for bleeding
-increased risk of hypoglycemia when on ORAL DIABETIC MEDS

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23
Q

adult aspirin

A

325mg

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24
Q

baby aspirin

A

81mg

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25
Q

aspirin changes what lab values

A

-prolonged prothrombin time
-decrease cholesterol and potassium

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26
Q

foods that contain salicylates

A

-prunes, raisins, licorice
-certain spices (curry, paprika)

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27
Q

DO NOT take other NSAIDs with _____ (unless ordered)

28
Q

Is Reye’s syndrome a side effect or an adverse reaction?

A

adverse reaction

29
Q

side effects of aspirin?

A

-dizziness
-lethargy
-headache
-GI upset

30
Q

why would we monitor serum salicylate lvl?

A

overdose (x10 therapeutic lvl)

31
Q

why warn parents not to give aspirin for virus or flu symptoms to children to avoid risk of ______?

A

Reye’s syndrome

32
Q

para-chlorobenzoic acid

A

indomethicin

33
Q

indomethicin inhibits what enzyme/enzymes

A

COX-1 and COX-2

34
Q

what is para-chlorobenzoic acid (indomethicin) used for?

A

arthritis (rheumatoid, osteo, and gouty)

35
Q

propionic acid derivative

36
Q

ibuprofen inhibits which enzyme/enzymes

A

COX-1 and COX-2 (blocking arachidonate binding)

37
Q

what is ibuprofen used for?

A

pain, osteo and rheumatoid arthritis, febrile illness

38
Q

where are NSAIDs metabolized and secreted?

A

metabolized in liver and excreted by kidneys

39
Q

what labs would you want to monitor when patient is on NSAID therapy

A

LFTs, BUN, and creatinine

40
Q

propionic acid derivatives (ibuprofen) increases bleeding with which drug?

A

warfarin (Coumadin)

41
Q

onset of ibuprofen is around _____

42
Q

selective COX-2 inhibitors are _____ and ______

A

nabumetone and meloxicam

43
Q

Selective COX-2 inhibitors have fewer ___ side effects

44
Q

analgesics are used for ____

45
Q

the fifth vital sign is ____

46
Q

level of stimulus required to create a painful sensation

A

pain threshold

47
Q

amount of pain one can endure w/o interfering with ADLs (different from one person to the next)

A

pain tolerance

48
Q

2 forms of analgesics

A

-opioid
-nonopioid

49
Q

used to relieve moderate-severe pain

A

opioid (e.g. morphine)

50
Q

used to relieve mild-moderate pain

A

nonopioid (NSAIDs)

51
Q

pain receptors from tissue injury

A

nociceptors

52
Q

injury to nerves

A

neuropathic pain

53
Q

distraction (close gate on pathways then pain can be controlled)

A

gate theory

54
Q

effect of unrelieved pain

A

depression

55
Q

why do 80% of patients have unrelieved pain in the US

A

-pts don’t like to report pain
-narcotic crisis

56
Q

less potent than opioid analgesics

A

nonopioid analgesics (mild - moderate pain)

57
Q

nonopioid analgesic: no antiinflammatory properties (not NSAID), inhibits prostaglandin synthesis (pain and fever)

A

acetaminophen (Tylenol)
max dose (4g/day) frequently taken (2g/day)

58
Q

take acetaminophen and ibuprofen _____ apart

59
Q

antidote to opioid overdose

A

naloxone (Narcan)

60
Q

antidote for acetaminophen

61
Q

moderate to severe pain, act on CNS (antitussive and antidiarrheal effects)

A

opioid anagesics

62
Q

main side effects of opioids

A

-constipation
-dyspnea/respiratory depression

63
Q

how can morphine be given?

A

-suspension
-tablet
-IM
-IV (rapid onset)

64
Q

when giving morphine IV, what may occur?

A

itching along vein

65
Q

PCA

A

patient-controlled analgesia

66
Q

what does PCA do?

A

give patient button to get drugs PRN (there is a cap to avoid OD)

Nursing I (10 decks)

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