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Pharm > Skeletal and pain meds > Flashcards

Skeletal and pain meds Flashcards

1
Q

NSAIDS:

A

*ibuprofen (Advil/Motrin)
*Stop prostaglandin synthesis
*Act on the periphery
*use: antipyretic, analgesic
*Adverse: GI bleeding, thrombotic events, MI, stroke

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2
Q

aspirin

A

-NSAID (except low-dose ASA)
-SALICYLATE
-may cause GI distress and bleeding

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3
Q

Centrally Acting Nonopioid antipyretic, anti-inflammatory, analgesic

A

*acetaminophen
*Not an NSAID, CNS med
*Black Box Warning: fatal liver injury
*monitor level <3,000mg/day
*Unlike aspirin and related drugs, it does not irritate the stomach.
*preferred drug for fever

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4
Q

Nursing considerations for NSAIDS, Steroids and Antipyretic Medications

A

*Pain assessment
*Monitor for GI bleeding
*Lab work: Liver enzymes, salicylate levels, blood sugar levels

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5
Q

NSAIDS decrease prostaglandin production in the stomach, increasing the client’s risk of __________

A

developing ulcers.

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6
Q

Neuropathic pain

A

*Caused by direct injury to the nerve
*Responds less successfully to conventional pain medications than nociceptor pain

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7
Q

what’s somatic pain?

A

sharp localized sensations

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8
Q

what’s visceral pain?

A

generalized dull and internal
throbbing or aching pain

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9
Q

Two major classes of drugs to manage pain:

NSAIDs act ____________

Opioids act ____________

A

NSAIDS: at the peripheral level

Opioids: within the CNS

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10
Q

Adjuvant analgesics (co-analgesics):

A

*Anti seizure drugs (gabapentin)
*Local anesthetics
*Anesthetic nerve blocking drugs

*Off-label medications: Tricyclic antidepressants (TCAs)

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11
Q

For pain management with opiods, ___________________ are most important

A

mu and kappa receptors

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12
Q

Opioid (Narcotic) Agonist

A

*Morphine
*MOA: binds with mu and kappa receptor sites to produce profound analgesia
*Use: analgesia & anesthesia
*Adverse: respiratory depression, sedation, N/V
*monitor kidney/liver function

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13
Q

systemic corticosteroids

A

*prednisone (betamethasone)
*MOA: suppress immune system to treat inflammation
*Adverse: Long-term therapy may result in Cushing syndrome, elevate blood glucose, mask infections
*taper on & off

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14
Q

Opioid Antagonists

A

*naloxone (Narcan)
*Use: to reverse respiratory depression and other acute symptoms of opioid addiction, toxicity, overdose

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15
Q

Selective COX-2 Inhibitors

A

*celecoxib
*MOA: similar to the NSAIDs
*Use: analgesic antipyretic, anti-inflammatory
*Adverse: mild and related to GI system

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16
Q

Centrally Acting Nonopioid Analgesics

A

*acetaminophen & tramadol

TRAMADOL
*MOA: weak opioid activity
*Use: a CNS-acting analgesic
*Adverse: CNS, GI and CV effects

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17
Q

Nursing Considerations for Opioid Use

A

*Pain Assessment
*Monitor use to avoid dependence
*Monitor depth and rate of respirations
*Have naloxone (Narcan) available
*Neuro assessment

Lab work
*Liver function
*Renal status

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18
Q

triptans

A

*sumatriptan
*First choice for migraines
*Constrict blood vessels in the brain
*Use: to abort migraines
*Adverse: GI upset, dizziness, drowsiness

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19
Q

Ergot alkaloids

A

*ergotamine tartrate
*migraine med for patients unresponsive to triptans
*Used to terminate ongoing migraines
*Adverse: : GI upset, weakness in the legs, myalgia, numbness and tingling in fingers and toes, angina-like pain, tachycardia

20
Q

Other migraine drugs

A

*Beta-blockers (propranolol)
*calcium channel blockers
*antidepressants
*antiseizure drugs
*neuromuscular blockers

21
Q

Parkinson’s:

s/s ________________________

meds to treat: _____________

A

*s/s: shaky, pill rolling, rigid muscles, masked face, bradykinesia, difficult to chew/swallow/speak, shuffling feet, humped posture, balance issues

*meds: dopaminergic (levodopa-carbidopa) & anticholinergics (benztropine)

22
Q

Dopaminergic agents:

A

*carbidopa–>levodopa–>(dopamine)
*treats Parkinson’s s/s
*MOA: increases biosynthesis of dopamine
*Adverse: hypotension, anorexia, N/V, depression
**educate to decrease protein consumption

23
Q

Anticholinergic agents:

A

*benztropine
*treats Parkinson’s s/s
*MOA: block ACh excitability
*Use: in early stages
*Adverse: dry mouth, blurred vision, photophobia, urinary retention, constipation, tachycardia, glaucoma

24
Q

*natural treatment for Alheimer’s

A

*Ginkgo Biloba
Improves mental functioning, stabilizes AD by increasing blood supply to the brain
****Can increase the risk for bleeding

25
Q

Alzheimer’s Disease (AD)

s/s: _______________________
meds: ____________________
natural treatments: _______

A

*s/s: cause unknown, ACh decreases
*Impaired memory and judgment, confusion or disorientation, inability to recognize family or friends, aggressive behavior, depression, paranoia, delusions, and anxiety

*meds: Cholinesterase Inhibitors - acetylcholinesterase inhibitors (donepezil)

26
Q

Cholinesterase Inhibitors
(aka Ach inhibitors)

A

*donepezil (Tacrine)
*slows progression of AD
*MOA: Intensify effect of acetylcholine at cholinergic receptor
*Adverse: N/V, chest pain, diarrhea, HA, abnormal dreams, irritability, darkened urine, hepatotoxicity, renal toxicity
*ineffective in late stages

27
Q

multiple sclerosis

etiology:

treatment:

drugs:

A

*etiology: unknown, no cure
*Possible causes:
Genetics, microbial factors, colder regions

*strategies for treatment: Reduce inflammation, prevent attacks on nervous system, address impairment of movement

*Drugs: Immune system modulators, steroids

28
Q

centrally acting skeletal muscle relaxants

A

*for muscle spasms
*cyclobenzaprine
*provides short term relief by depressing motor activity in brainstem - ALTERS REFLEXES
*adverse: drowsiness, blurred vision, dry mouth

29
Q

direct acting muscle relaxers

A

*for muscle spasms
*dantrolene sodium
*blocks the release of calcium from muscle tissue to stop the muscle fiber from contracting
*muscle weakness, dry mouth, dizziness, photosensitivity
*avoid driving, report palpitations or slurred speech

30
Q

muscle spasms

Define: _______________

Treatment: _______________

A

*they are involuntary contractions of muscles leading to diminished level of functioning

  1. Tonic spasm - single prolonged contraction
  2. Clonic spasm - jerking or twitching

*Drugs: centrally acting skeletal muscle relaxants (cyclobenzaprine), direct acting antispasmodics (dantrolene sodium)

31
Q

Bone and Joint Disorders

A

*Osteoporosis
*Osteomalacia
*Paget’s Disease
*Arthritis
*Gout

32
Q

Osteomalacia

what is it?

most frequent cause of it?

who is affected?

A

*An abnormality of new bone formation (osteoid) causing bones to become increasingly soft, flexible, brittle, and deformed
*deficiency of vitamin D and calcium in the diet
*prevalent in the older adult, preemies, ppl on strict vegetarian/vegan diets
*in children it is called rickets

33
Q

Pharmacotherapy of Osteomalacia

A

*Calcium supplements, Vit D
*Calcitriol for rickets (usually in combination with calcium supplements)

34
Q

Vitamin D Therapy

A

*calcitriol
*MOA: its the active form of vitamin D, promotes absorption of calcium, reduces bone reabsorption, elevates serum levels of calcium
*Use: for impaired kidney function, hypo-parathyroidism, treating rickets
*Adverse: hypercalcemia, HA weakness, dry mouth, thirst, polyuria, muscle/bone pain

35
Q

Role of the Nurse: Calcium Supplement Therapy

A

Assess for signs and symptoms of hypercalcemia:
Drowsiness, lethargy, weakness, HA, anorexia, N/V, thirst, polyuria

36
Q

Bisphosphonates

A

*alendronate
*for osteoporosis
*MOA: Lowers serum alkaline phosphate, an enzyme important to bone turnover
*Use: to prevent and treat osteoporosis & Paget disease
*Adverse: diarrhea, N/V, GI irritation, metallic- or altered-taste perception; pathologic fractures with long-term use (fracture that occurs w/out trauma)

37
Q

Selective Estrogen Receptor Modulators (SERM)

A

*reloxifene
*for osteoporosis prevention
*MOA: decreases bone resorption, Increases bone mass and density r
*Adverse: hot flashes, migraines, flu-like symptoms; endometrial disorder, breast pain, vaginal bleeding; may cause fetal harm if pregnant

38
Q

natural therapies for arthritis

A

*Glucosamine/Chondroitin

*Helps build cartilage

39
Q

Gout

Goals: _________________

Treatment: _____________

A

*Goals: termination of acute attacks; prevention of future attacks

*NSAIDS for pain and inflammation

*Corticosteroids for more severe pain and inflammation

40
Q

uric acid inhibitor

A

*allopurinol
*reduces gout inflammation
*MOA: inhibits synthesis of uric acid
*Adverse: rashes, Stevens-Johnson syndrome, hypersensitivity syndrome, drowsiness, HA, vertigo, N/V, abdominal discomfort, malaise, diarrhea, retinopathy, thrombocytopenia

41
Q

Nursing Considerations for Bone and Joint Medications

A

*Lab work (Electrolytes and uric acid level

*Radiology: X-rays, Dexascan

*Educate: avoid foods high in purine and get plenty of calcium and Vitamin D

42
Q

Centrally Acting Skeletal Muscle Relaxants

A

*cyclobenzaprine
*MOA: inhibits upper-motor-neuron activity, causes CNS depression, alters simple spinal reflexes
*Use: to treat localized spasms
*Adverse: CNS depression, hepatic toxicity, physical dependence, anticholinergic effects

43
Q

Rheumatoid Arthritis (RA) Treatments

A

*Analgesics and anti-inflammatories
*Short-term therapy with corticosteroids and glucocorticoids if inflammation is severe
*Disease-modifying antirheumatic drugs (DMARDs) like hydroxychloroquine

44
Q

Oxycodone Hydrochloride vs Combination Acetaminophen and Codeine (Mild Opioid)

A

Oxycodone Hydrochloride =Strong Opioid

Acetaminophen and Codeine =Mild Opioid

45
Q

parkinsons

A

dopamine being destroyed in CNS & Ach (stimulatory) takes over

Pharm (8 decks)

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