Week 3 Anti-inflammatory Flashcards
Salicytes prototype drug
Aspirin
NSAIDs prototype drug
Ibuprofen
What drug is its own class and prototype
Acetaminophen (tylenol)
Salicylates therapeutic action
inhibits prostaglandin activity, antipyretic- blocks pyrogens at hypothalamus
- all dosing affects platelet inhibitation
NSAIDs therapeutic action
inhibits prostaglandin by blocking COX-1 and COX-2> antiinflammatory effect, analgesia, and antipyretic effect
Tylenol therapeutic action
- antipyretic effect> acts as thermoregulatory cells in the hypothalamus to release heat and lower fever
- analgesic effect
Indication for tylenol
- pain and fever
- safer for children
Indication for NSAIDs
- mild to mod pain
- fever, chronic inflammatory process, primary dysmenorrhea
Indication for salicylates
- mild to mod pain
- fever, inflammatory conditions( RA, osteo)
- reduction for stroke/ heart attack
Pharmacokinetic of salicylates
- Absorbed from the stomach
- peak 5-30min
- metabolized liver, excreted urine
- crosses placenta/ milk
Pharmacokinetic of NSAIDs
- oral> onset 30 min, peak 1 hr, duration 4-6hr
- IV> onset at start of infusion, peak minutes, duration 4-6hrs
Pharmacokinetic of tylenol
- oral> peak 30min to 2hrs
- IV for persons > 2yrs
- extensively metabolized in liver
Adverse effects of Salicylates
- direct irritation to stomach
- Salicylate toxicity> dizziness, ear ringing, confusion
Adverse effects of NSAIDs
- Direct GI > d/n/v
- increased CV events, death, GI bleeds
Adverse effects of Tylenol
- Hepatoxicity; chronic use
- renal dysfunction
Contradictions of salicylates
- children> reyes syndrome
- stop med 1 week prior to surgery
- impaired renal function
Contradictions of NSAIDs
- CV dysfunction or HTN
- peptic ulcer/ GI bleed
- caution w/ renal and hepatic function
Contradictions of Tylenol
- hepatic dysfunction
- chronic alcoholism
- Allergy
Drug to drug interactions of Salicylates
- interact w/ many drugs> alteration in absorption and effects on liver are harsher
Drug to drug interactions of NSAIDs
- loop diuretic> decreased effect
- beta-blockers> decreased HTN effect
- lithium> toxicity
Drug to drug interactions of tylenol
- anticoags> risk of bleeding
- chronic alcohol ingestion> toxic effects on liver
- Hepatotoxicity common with other drugs
Nursing considerations for Salicylates
GI> monitor GI, watch for s/s bleeding
CNS> obtain baseline
- take w/ food
- avoid other OTC meds
- hydrate!
Nursing considerations for NSAIDs
- response to each pt different
- very commonly used in US
Nursing considerations for Tylenol
- used instead of NSAIDs
- do NOT contain antiinflammatory effects
- GI> assess GI bleed/ peptic ulcer
- careful measurement w/ children
Anti-inflammatories across lifespan
- 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
