Week 3 Anti-inflammatory

Question 1

Salicytes prototype drug

Answer 1

Aspirin

Question 2

NSAIDs prototype drug

Answer 2

Ibuprofen

Question 3

What drug is its own class and prototype

Answer 3

Acetaminophen (tylenol)

Question 4

Salicylates therapeutic action

Answer 4

inhibits prostaglandin activity, antipyretic- blocks pyrogens at hypothalamus
- all dosing affects platelet inhibitation

Question 5

NSAIDs therapeutic action

Answer 5

inhibits prostaglandin by blocking COX-1 and COX-2> antiinflammatory effect, analgesia, and antipyretic effect

Question 6

Tylenol therapeutic action

Answer 6

• antipyretic effect> acts as thermoregulatory cells in the hypothalamus to release heat and lower fever
• analgesic effect

Question 7

Indication for tylenol

Answer 7

• pain and fever
• safer for children

Question 8

Indication for NSAIDs

Answer 8

• mild to mod pain
• fever, chronic inflammatory process, primary dysmenorrhea

Question 9

Indication for salicylates

Answer 9

• mild to mod pain
• fever, inflammatory conditions( RA, osteo)
• reduction for stroke/ heart attack

Question 10

Pharmacokinetic of salicylates

Answer 10

• Absorbed from the stomach
• peak 5-30min
• metabolized liver, excreted urine
• crosses placenta/ milk

Question 11

Pharmacokinetic of NSAIDs

Answer 11

• oral> onset 30 min, peak 1 hr, duration 4-6hr
• IV> onset at start of infusion, peak minutes, duration 4-6hrs

Question 12

Pharmacokinetic of tylenol

Answer 12

• oral> peak 30min to 2hrs
• IV for persons > 2yrs
• extensively metabolized in liver

Question 13

Adverse effects of Salicylates

Answer 13

• direct irritation to stomach
• Salicylate toxicity> dizziness, ear ringing, confusion

Question 14

Adverse effects of NSAIDs

Answer 14

• Direct GI > d/n/v
• increased CV events, death, GI bleeds

Question 15

Adverse effects of Tylenol

Answer 15

• Hepatoxicity; chronic use
• renal dysfunction

Question 16

Contradictions of salicylates

Answer 16

• children> reyes syndrome
• stop med 1 week prior to surgery
• impaired renal function

Question 17

Contradictions of NSAIDs

Answer 17

• CV dysfunction or HTN
• peptic ulcer/ GI bleed
• caution w/ renal and hepatic function

Question 18

Contradictions of Tylenol

Answer 18

• hepatic dysfunction
• chronic alcoholism
• Allergy

Question 19

Drug to drug interactions of Salicylates

Answer 19

• interact w/ many drugs> alteration in absorption and effects on liver are harsher

Question 20

Drug to drug interactions of NSAIDs

Answer 20

• loop diuretic> decreased effect
• beta-blockers> decreased HTN effect
• lithium> toxicity

Question 21

Drug to drug interactions of tylenol

Answer 21

• anticoags> risk of bleeding
• chronic alcohol ingestion> toxic effects on liver
• Hepatotoxicity common with other drugs

Question 22

Nursing considerations for Salicylates

Answer 22

GI> monitor GI, watch for s/s bleeding
CNS> obtain baseline
- take w/ food
- avoid other OTC meds
- hydrate!

Question 23

Nursing considerations for NSAIDs

Answer 23

• response to each pt different
• very commonly used in US

Question 24

Nursing considerations for Tylenol

Answer 24

• used instead of NSAIDs
• do NOT contain antiinflammatory effects
• GI> assess GI bleed/ peptic ulcer
• careful measurement w/ children

Question 25

Anti-inflammatories across lifespan

Answer 25

• children> aspirin- reyes syndrome, no ibuprofen < 6y.o., tylenol most used
• adult> careful about OD, avoid while pregnant, use nondrug measures first, can cause miss diagnosis
• Elder> increased susceptibility to CNS and GI effects, some NSAIDs may need geriatric dosing adjustments