week 6 pharm Flashcards
which drugs are first generation NSAIDS
ibuprofen and naproxenwh
which drugs are second generation NSAIDS
celecoxib (slightly more GI protection)
how is aspirin different from the other NSAIDS
thins the blood and prevents MI and stroke
what is the MOA of NSAIDS
block prostaglandin via COX1 and COX2
which disease do we usually treat with NSAIDS first
rheumatoid arthritis
why is aspirin contraindicated in patients under 18 years
it can cause Reyes syndrome
whats the difference between first generation and second generation NSAIDS
first generation: inhibits both COX1 and COX2
second generation: Inhibits only COX 2
what happens when you inhibit COX 1
usually the harmful effects (gastric erosion and ulceration, bleeding, renal impairment)
what happens when you inhibit COX2
not too many adverse effects, it does all the good things.
it may cause renal impairment and promotion of MI and stroke due to the fact that it suppresses vasodilation (to stop swelling)
are NSAIDS safe for pregnancy
no
what is prednisones mechanism of action
it mimics natural cortisol which is an immunosuppressant and anti-inflammatory hormone.
can you use prednisone for a long period of time
no
prednisone indication
autoimmune disorders like Rheumatoid arthritis
what does cortisol do
reduces inflammation, increases blood sugar, increases blood pressure
how can you decrease the adverse effects of prednisone
you can give as an injection to the affected area
what are the major adverse effects of prednisone ad how are they all related
think about what cortisol does:
- fluid retention which will cause hypokalaemia, high BP, weight fain
- it will cause hyperglycemia which can increase risk for infection and slow wound healing
and it overall suppresses immune system
- it also causes mood issues because its a stress hormone
which drug should you not give with prednisone
NSIADS
what are the symptoms of adrenal deficiency
anorexia, N/V, weakness, fatigue, dyspnea, low BP, hypoglycemias.
what drug class is methotrexate (rhrumatrex)
it is a disease modifying anti rheumatic drug (DMARD)
It kills reply dividing cells
what is the MOA of methotrexate
it blocks folic acid, which is important in cell division. it inhibits DNA synthesis and cell reproduction and suppresses the immune system.
what is the indication for rheumatrex/methotrexate
rheumatoid arthritis.
what is the fastest acting RA drug
methotrexate, therapeutic effects seen within 3-6 weeks
which RA drug slows its disease progression
methotrexate
what are the adverse effects of methotrexate
since it kills rapidly devising cells, were going to see bone marrow suppression, GI ulceration, hepatic fibrosis, inflammation of the lung tissue (pneumonitis)
what is the main contraindication with methotrexate
pregnancy and breastfeeding
whats the difference between infliximab and Methotrexate
Both are DMARDs but infliximab is a runout necrosis factor antagonist.
what is tumour necrosis factor
a protein in out body that coordinates and signals inflammatory response that is in overdrive in RA
which drug do we usually give with infliximab
methotrexate
why does infliximab cause immunosuppression
because TNF plays a role in responding opportunistic infection, so without it there is large room for infection
what is a unique issue that infliximab may cause, what should nurses monitor for
heart failure, nurses should monitor for edema, weight gain, SOB, crackles
how does allopurinol help with gout
gout is accumulation of uric acid in the joints which causes pain. allopurinol is a xanthine oxidase inhibitor.
xanthine oxidase is an enzyme required for uric acid formation.
how would kidney disease cause gout
Kidney disease will result in the kidneys having a harder time processing uric acid, which will make it accumulate in the body
what is a unique hypersensitivity reaction with allopurinol;
rash, fever, liver and kidney dysfunction
what does calcium do in the body
required for the structural integrity of homes. It helps with bone reabsorbtion and bone formation
what does alendronate do
it reduces the number and activity of osteoclasts. its mimics a chemical compound found in the bone
what is the indication for alendronate
Osteoporosis
how long does alendronate usually work for
it is often used for less than 5 Yeats, but the effects can last up to 10 years
why would alendronate cause esophagitis
it would usually occur with prolonged contact with the esophegeal musosa if the drug fails to pass completely into the esophagus. (too much contact with the mucosa)
should you stop taking alendronate if the patient experiences musculoskeletal pain?
no
what are some rare adverse effects with alendronate
ocular inflammation, weird femur fractures
how should you instruct a patient to take alendronate
take in the am on an empty stomach and don’t eat for 30 mins after
take with a full glass of water and sit upright for at least 30 mins after to avoid esophagitis
