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Antiinflammatorys
NSAID's
| Question | Answer |
|---|---|
| Anti=Antiinflammatory= | Against inflammation |
| Inflammation= | Body’s response to tissue injury & infection |
| S/S of inflammation | Painr, redness (Bc of increased blood flow), heat (more blood flow the warmer it will be), swelling (Bc of increased capillaries) |
| Examples of local and systemic infections | cat scratch OR systemic, you will have fever, and lab changes |
| Classification of Antiinflammatory drudges: | NSAIDS, Corticlsteroids, Antirhematic drugs, Antigout drugs |
| COX 1 enzyme does what? | protects the stomach lining and regulates blood platelets |
| COX 2 enzyme does what? | Increases inflammation & pain |
| NSAIDSNonsteroidal anti-inflammatory drugs | Inhibit cyclooxygenase, which is needed to make prostaglandins (which causes inflammation) |
| What is called a prostaglandin inhibitor? | NSAID’s |
| NSAID’s | The dose for pain is higher, than for inflammation. -They can treat swelling, joint pain, or fever.-Bought OTC |
| Examples of NSAID’s | -ASA (Salicylate)-COX 2 inhibitors-indomethiacin, ibuprofen, ketorolac, naproxen |
| NSAID’s :: SalicylatesEx. of what aspirin is in…. | -Aspirin -BC -Excedrin -Bayer ASA |
| NSAID’s :: SalicylatesContraindications: | -GI bleeding/bleeding disorders (s/s bleeding gums, blood in the stool) -Children younger than 12 take Tylenol, not aspirin -Children w/flu like symptoms should not take aspirin (Reye Syndrome) |
| NSAID’s :: SalicylatesS/E | -Main one gastric irritation (Take aspirin w/food) -Notify the doctor before any surgeries or procedures. Will bleed out. |
| NSAID’s :: SalicylatesInhibits COX 1 & COX 2Advantages & disadvantages | : -Advantages -Decreases inflammation -Decreases temperature -Decreases risk of clot formation (antithrombotic)-Disadvantages: -Decreases protection of the stomach lining -Prolongs bleeding time |
| NSAID’s :: SalicylatesS/S of hypersensitivity | -Ototoxicity -Tinnitus-ringing in the ears -Vertigo-If you can’t hear it can affect the balance |
| Other common NSAID’s Indomethacin | Used for gout & rheumatoid also osteoarthritis. It helps with the inflammation of connective tissue. -Also, promotes closure to patent ductus arteriosus (heart defect in infants). -Very irritating to the stomach (Take w/foods) |
| Other common NSAID’sibuprofen (Motrin, Advil) | -Most widely used NSAID -Helps w/pain, arthritis, & dysmonorrhea-medium/long term |
| Other common NSAID’sketorolac (Toradol) | -Powerful analgesic effect -Perscription -Short term (no longer than 5 days) |
| Other common NSAID’snaproxen (Naprosyn, Anaprox, Aleve) | -used for pain relief arthritis dysmenorrhea -OTC |
| NSAID’s :: COX 2 Inhibitorsexamples…. | rofecoxib (Vioxx), celecoxib (Celebrex)-dont give if allergic to Sulfa or ASAvaldecoxib (BEXTRA) |
| NSAID’s :: COX 2 Inhibitors does what? -Good for pt who needs a high dose of? What are some things to asses for? | -produces less GI & irritation problems -antiinflammatorys -GI upset & peripheral edema (which is a common S/E) |
| NSAID’s :: pt teach- What are you watching for? -When is the best time to give them?What do you not take them with?What are some things to avoid while taking NSAID’s? Why notify the Dr you are taking them? -Do not take if you have a history of what? | -bleeding (Stools, gums)-with food-Alcohol, taking w/pregnancy-risk of bleeding-ulcer disease |
| Antiiflammatory Drugs: Corticosteroids Examples…. | prednisone (Deltasone) dexamethasone (Decadron) methylprednisolone (Medrol) betamethasone (Celestone) |
| Corticosteroids does what? | Suppress or prevent many steps of inflammatory process |
| Corticosteroids come in 2 forms: | Topically or Systemically |
| What is the better form and why? | Topically, it has fewer S/E |
| Corticosteroids: Topically is used for what? | local inflammatory effects |
| Corticosteroids: Systemically is used for what? | Systemic inflammatory effect (fever) |
| Corticosteroids: Systemically Block what? Decreases what? Increases what? | -inflammation/immune system -resistance to infection -blood sugar |
| What do you not stop them abruptly? | It can shut the adrenal system down*Taper off over 5-10 days |
| Antirheumatic Drugs: Used when? Takes how long to work? | Is more toxic than other anti-inflammatory drugs used to treat arthritis -Used when other drugs fail -Takes 2-3 months before you see results |
| Antirheumatic Drugs:Examples…. | Gold therapy (chrysotherapy) -Immunosuppressive agents (imuran, cytoxan) -antimalarial drugs |
| Gold therapy (chrysotherapy) does what? What lab work should you monitor? | Inhibits phagocytosis, and decreases tissue destruction -Can cause lab problems, monitor CBC |
| Immunosuppressive agents (imuran, cytoxan) does what? | Suppresses lymphocyte activity |
| Antigout Drugs used to do what? | Treat gout. |
| What is gout? Where does it most often attack first? | An inflammatory condition that attacks joints, tendons, and other tissues. -Big Toe (Red, swollen, pain) |
| Gout is a metabolic disorder of what? | Purine metabolism that causes hyperuricemia (increases uric acid levels) -Urate crystals are deposited in SQ tissue causing sever pain & inflammation |
| Why should fluid intake be increased? (Water or cranberry juice) | To prevent renal calculi (stones) |
| To reduce crystal formation what should the urine be? | alkaline |
| Antigout drugs work how? | -Decrease S/S -Decrease uric acid levels by enhancing excretion of uric acid by the kidneys -Decrease uric acid levels by decreasing production of uric acid |
| Antigout drugs ::- Decrease S/S | -NSAID’s such as indomethiacin (w/inflammation)-Colchicine-inhibits migration of leukocytes into the inflamed site (w/inflammation) |
| Colhicine is used when? IT does not effect what? High doses cause what? | -during an acute attack -urinary excretion of uric acid -N/V, diarrhea, abdominal pain |
| Antigout drugs | allopurinol (Zyloprin) -decreases production of uric acid levels, but does not prevent inflammation -probenecid (Benemid) -increases excretion of uric acid |
| allopurinol (Zyloprin) & probenecid (Benemid)Avoid what? Take when? Monitor what? Increase what? | -during an acute attack -w/food if GI irritation occurs -kidney stones -fluids |
| What should be taken for pain instead of aspirin? Why? | Acetaminophen, to promote uric acid retention |
| Avoid foods rich in purines Examples… Why? | wine, alcohol/coffee/caffeine, organ meats (liver), sardines, salmon, grave. -Bc they increase the formation of uric acid salts. |
Created by:
jessinms
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