Pharmacology for mobility: musculoskeletal Flashcards
NSAIDS MOA
Block prostaglandin via Cox1 and Cox2
Indications for NSAIDS
Inflammation, pain, fever
First generation NSAIDS
Ibuprofen (Advil) and Naproxen (Aleve)
Second generation NSAIDS
Celecoxib (Celebrex)
Slightly more GI protection
Related to Sulfa
ASA description
Aspirin
Prevention of MI/ stroke via interrupting platelet aggregation
Contraindicated in <18 yrs → Reye’s Syndrome
Harmful effects of inhibition of COX-1
Gastric erosion and ulceration
Bleeding tendencies
Renal impairment
Harmful effects of inhibition of COX-2
Renal impairment
Promotion of MI and stroke (secondary to suppressing vasodilation)
Nursing considerations for NSAIDs
Best administered with food
Monitor kidney function
Monitor for adverse effects of HTN
Monitor for signs of bleeding
All NSAIDs contraindicated in pregnancy
Steven Johnson Syndrome description
Blistering of the skin and mucous membranes
What does cortisol do?
Reduces inflammation
Increases blood sugar
Increases blood pressure
Prednisone (Deltasone) classification
Corticosteroid also called steroids or glucocorticoids
MOA of prednisone (Deltasone)
Mimics Cortisol (a hormone produced by our adrenal glands)
Potent anti-inflammatory and immunosuppressant
Works rapidly and is often only used for a short period of time
Indication for prednisone
Used to treat autoimmune disorders (like rheumatoid arthritis)
Therapeutic effects of prednisone
Suppression of the inflammatory and immune responses in autoimmune disorders
Adverse effects of prednisone (Deltasone)
Fluid retention
Hypokalemia
High blood pressure
Mood swings, psychological and behavioural changes
Weight gain
Hyperglycemia
Increased risk of infection
Slow wound healing, bruising
Peptic ulcers
Osteoporosis
Contraindications and precautions of prednisone
Presence of active infection should not take (prednisone will mask symptoms of infection)
Peptic ulcer
Hypersensitivity
Should not be taken long term → will cause adrenal suppression so taper dose over time
Nursing considerations and assessment of prednisone
Monitor intake/ output
Assess for: edema, weigh daily, auscultate lungs, skin assessment
Monitor serum electrolytes and glucose
Administer with meals to prevent GI irritation
Stopping doses abruptly can cause adrenal insufficiency → anorexia, nausea/ vomiting, weakness, fatigue, dyspnea, low blood pressure, hypoglycemia. Patients should not skip doses
Patient should increase foods with calcium and potassium
Monitor for improvement of disorder symptoms
What does the nurse identify as possible complications of glucocorticoid therapy? Select all that apply:
a. Impaired carbohydrate and glucose tolerance
b. Increased production of glucocorticoids from the adrenals
c. Predisposition to gastrointestinal ulceration
d. Decrease in serum sodium and glucose levels
e. Increase in plaque development in coronary arteries
a. Impaired carbohydrate and glucose tolerance
c. Predisposition to gastrointestinal ulceration
methotrexate (Rheumatrex) classification
Disease Modifying Antirheumatic Drug (DMARD)
methotrexate (Rheumatrex) MOA
Interferes with folic acid metabolism → inhibits DNA synthesis and cells reproduction, also immunosuppressive → suppresses T and B lymphocyte activity
Kills rapidly dividing cells (skin, nails, hair, GI mucosa, bone marrow, reproductive cells)
Indications for methotrexate (Rheumatrex)
Rheumatoid arthritis, psoriasis, different types of cancer