Week 1: Introduction to Analgesics/Antipyretics & Treatment of Pain Disorders Flashcards

1
Q

The brand names of Acetaminophen are ____.

A

Tylenol, Feverall

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2
Q

The brand names of Ibuprofen are ____.

A

Motrin, Advil

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3
Q

The brand name of Naproxen sodium is ____.

A

Aleve

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4
Q

The brand names of Acetylated salicylate are ____.

A

Aspirin, Bayer, St. Josephs, Ecotrin, ASA

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5
Q

The 2 types of non-acetylated salicylates are ____.

A
Magnesium salicylate (Doan's)
Sodium salicylate (Alka-seltzer)
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6
Q

The MOA of acetaminophen is ____.

A

central inhibition of prostaglandin synthesis

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7
Q

The MOA of ibuprofen is ____.

A
  • reversible inhibition of COX 1 and COX 2

- inhibition of prostaglandin synthesis

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8
Q

The MOA of naproxen sodium is ____.

A
  • reversible inhibition of COX 1 and COX 2 (Cyclooxygenase)

- inhibition of prostaglandin synthesis

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9
Q

The MOA of salicylates is ____.

A
  • irreversibly inhibits COX-1 and COX-2 (Cyclooxygenase)

- inhibits prostaglandin synthesis

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10
Q

The classes of acetaminophen are ____.

A

antipyretic , analgesic

for pain and fever - NOT an effective anti-inflammatory agent

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11
Q

The classes of NSAIDs (ibuprofen and naproxen sodium) include ____.

A

antipyretic, analgesis, AND ANTI-INFLAMMATORY

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12
Q

The therapeutic uses of salicylates include ____.

A
  • cardioprotective (inhibit platelet aggregation)
  • primary and secondary prevention of thromboembolism
    (stroke or heart attack prevention in high risk patients)
  • musculoskeletal pain (Topic or systemic)
  • headache
  • mild/moderate pain
  • fever (not in children less than 12 years old or teenagers with a viral illness)
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13
Q

The adult dosing (≥12 yo) for acetaminophen is _____.

A

325-1,000 mg Q 4-6 hr PRN

Regular strength: 325 mg
Extra strength: 500 mg

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14
Q

The FDA MAX/DAY adult dosing (≥12 yo) for acetaminophen is _____.

A

4 grams/day (or 4,000 mg)

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15
Q

The MANUFACTURER MAX/DAY adult dosing (≥12 yo) for acetaminophen is _____. Manufacturers voluntarily reduced max/day dose to reduce incidents of hepatotoxicity.

A

Regular strength: 3,250 mg/day

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16
Q

The OTC adult dosing (≥12 yo) for ibuprofen is _____.

A

(1-2 tab) 200 mg PO Q 4-6 hrs PRN

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17
Q

The OTC MAX/DAY adult dosing for ibuprofen is _____.

The PRESCRIPTION MAX/DAY adult dosing is ____.

A

1,200 mg (max 6 tablets/day)

3,200 mg

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18
Q

The OTC adult dosing (≥12 yo) for naproxen sodium is _____.

A

(1 tab) 220 mg PO Q 8-12 hrs PRN

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19
Q

The OTC MAX/DAY adult dosing (≥12 yo) for naproxen sodium is _____.

The PRESCRIPTION MAX/DAY adult dosing is ____.

A

660 mg (max 3 tablets/day)

1,500 mg

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20
Q

The adult dose for Aspirin (ASA) dosing used for cardioprotection is _____ daily.

A

81-162 mg

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21
Q

For an adult dose of Aspirin, you need ____ g/day for anti-inflammatory effect. Note that NSAIDS are a better choice for inflammatory conditions.

A

4-6

22
Q

The pediatric based on WEIGHT-BASED dosing for acetaminophen is _____

A

10-15 mg/kg/dose Q 4-6 hrs PRN

Maximum 5 doses/day

23
Q

The OTC pediatric dosing for Ibuprofen is ____.

Note: Naproxen is not indicated for children less than 12 years old.

A

5-10 mg/kg/dose Q 6-8 hrs

Maximum 4 doses/day

24
Q

The pediatric dosing for naproxen sodium is ____.

A

NOT indicated for children less than 12 years old

25
Q

____ is under pregnancy category B (considered safe in pregnancy & lactation).

A

acetaminophen

26
Q

_____ is under pregnancy category B in the 1st and 2nd trimester BUT is under pregnancy category D in the 3rd trimester. It is safe to use if breastfeeding (lactation)

A

NSAIDS: Ibuprofen and Naproxen sodium

27
Q

List some factors (precautions) that increase risk of liver damage with acetaminophen.

A
  • liver disease
  • chronic use of APAP of more than 4g/daily
  • ingest more than 3 alcoholic drinks
  • take other drugs containing APAP (using other hepatotoxic drugs)
28
Q

NSAID (ibuprofen and naproxen) precautions and contraindications include ____.

A
  1. Renal impairment (decreased kidney blood flow)
  2. Stomach bleeding/bleeding disorders by:
    - if you are age 60 or over
    - consuming for than 3 alcoholic drinks
    - taking other drugs containing NSAIDS
    - taking blood thinner or steroid
    - having a history of stomach ulcers/bleeding
  3. Increased risk of cardiovascular disease and cerebrovascular events with long term use
29
Q

What are the treatments for acetaminophen toxicity/overdose?

A
  • acetylcysteine (Mucomyst) reduces NAPQI by replenishing GSH
  • activated charcoal
30
Q

What is the toxic metabolite in acetaminophen?

A

NAPQI

31
Q

When the product labeling is for infants 2-3 years old, ____ dosing is SAFE to use even in children 0-24 months with recommendation of a healthcare provider.

A

acetaminophen

32
Q

The strength of FeverAll infant suppositories are ____.

A

80mg/suppository

33
Q

The liquid concentration of Children’s Tylenol Suspension (age 2-11) is ____.

A

160 mg/5 mL

34
Q

Name 2 drug interactions with acetaminophen.

A
  1. alcohol (liver toxicity/hepatotoxicity)

2. warfarin (increased bleeding)

35
Q

____ is a dosage form of salicylates that is absorbed in the small intestine to reduce GI toxicity. It is a preferred dosage form for patients requiring chronic therapy.

A

enteric coating

36
Q

____ is a dosage form of salicylates that is absorbed more rapidly but little effect on therapeutic onset.

A

buffered (tablet and effervescent)

37
Q

____ is a dosage form of salicylates that is prolonged duration of action by slowing dissolution and absorption.

A

sustained-release

38
Q

The counseling points for Aspirin dosing is “_____”

A

take with food

39
Q

Salicylates precautions and contraindications include ___.

A
  1. gastritis and ulceration of upper GI tract
  2. bleeding
  3. avoid in pregnancy during 3rd trimester
  4. avoid in patients with gout or hyperuricemia
  5. there is an increased risk of bronchospasm in patients with asthma
40
Q

Discontinue Aspirin ____ days prior to surgery

A

2-7

41
Q

Salicylates and Drug interactions that may increase the risk of GI ulcers and/or bleeding are?

A
  1. NSAIDS
  2. Warfarin
  3. Alcohol
42
Q

Salicylates and Drug interactions that may lower the antiplatelet effect of Aspirin are?

A
  1. ibuprofen

2. take Aspirin at least 30 minutes before or 8 hours after ibuprofen

43
Q

Children less than 12 years old or teenagers that may have a possible viral illness should NOT TAKE ____.

A

salicylates

44
Q

One of the symptoms of salicylate toxicity is _____ which is a ringing in the ear.

A

tinnitus

45
Q

The dose for Children’s Advil and Motrin (Ages 2-11) is ____. Note that ibuprofen is not to be used in children less than 6 months old (because they have not yet developed a Kidney)

A

100mg/ 5mL

46
Q

Some NSAID adverse effects include ____.

A
  • GI upset
  • fluid retention (edema)
  • increased bleeding
47
Q

Some important (bolded terms) NSAID Counseling Points include?

A
  1. Take with food
  2. Monitor blood pressure in patients with high b.p.
  3. Do not use for more than 10 days
  4. Do not drink with alcohol while taking NSAIDS
48
Q

Name 2 drug interactions with NSAIDS.

A

Warfarin and Aspirin

49
Q

NSAID drug interactions that increase GI bleeding are ____.

A
  1. Bisphosphonates, Alcohol

2. Warfarin

50
Q

NSAID drug interactions can lower the effect of _____.

A

Antihypertensive medications