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Pharm
Meds for pain and inflammation
| Question | Answer |
|---|---|
| Action of NSAIDs is inhibition of ____, decreases inflammation, pain, fever | COX-2 |
| Action of NSAIDs in the inhibition of COX-1, decreases _____ _____ | platelet accumulation |
| Therapeutic Action of NSAIDs | Suppress inflammation, Analgesia for mild-moderate pain, Reduce fever, Low level suppression of platelet accumulation |
| Side/Adverse Effects of NSAIDs | GI discomfort, Renal dysfunction, increase BUN and creatinine levels, Salicylism, tinnitus, sweating, respiratory alkalosis, Reye's syndrome |
| Aspirin is contraindicated in | PUD, Bleeding disorders, Pregnancy (Category D), Children who have virus (chicken pox) |
| Med/Food Interactions of NSAIDs | Coumadin (risk for increased bleeding), Glucocorticoids (risk for gastric bleeding), Alcohol, Ibuprofen (decrease anti-platelet effects) |
| Interventions for NSAIDs | Take with food, milk, or full glass of water; pts unable to take aspirin due to GI ulcers should take 2nd generation NSAIDS |
| 1st Generation NSAIDS (COX-1 and COX-2 inhibitor) ____, ____, ____, ____, ____ | aspirin, motrin, advil, naproxen, Toradol |
| 2nd Generation NSAIDS (selective COX-2 inhibitor) ____, ____ | Celebrex, Bextra |
| Class: Acetaminophen Drug: ______ | Tylenol |
| Action of Acetaminophen (Tylenol) - slows production of ___ in CNS | prostaglandins |
| Therapeutic Action of Acetaminophen (Tylenol) | Analgesic effect, Antipyretic effects (main function) |
| Side/Adverse Effects of Acetaminophen (Tylenol) | Constipation |
| Contraindications/precautions of Acetaminophen (Tylenol) | Caution in patient taking Coumadin |
| Med/Food Interactions of Acetaminophen (Tylenol) | Coumadin, Alcohol (increase risk of liver damage) |
| Interventions of Acetaminophen (Tylenol) | Do not exceed 4g/day |
| Antidote of Acetaminophen (Tylenol) | Acetylcysteine (Mucomyst) |
| Class: Opioid Agonists, Drugs (6) | Morphine Sulfate, fentanyl, Demerol, methadone, codeine, oxycodone |
| Action of Opioid Agonists Drugs | Acts on mu receptors and to a lesser degree kappa receptors |
| action of Mu receptors | produce analgesia, respiratory depression, euphoria, sedation |
| action of Kappa Receptors | produce analgesia, sedation, decrease GI motility |
| Therapeutic Action of Opioid Agonists Drugs | Relieve moderate-severe pain, Sedation, Reduce BM, Codeine: cough suppression |
| Side/Adverse Effects of Opioid Agonists Drugs | Respiratory Depression, Constipation (admin stimulant laxative), Sedation, Biliary colic, Emesis, Opioid Overdose Triad |
| What is the Opioid Overdose Triad and what would you do | coma, respiratory depression, pinpoint pupils – admin opioid antagonist |
| If patient is suffering from respiratory depression while on opioid agonists, stop if patient respirations are less than ___/min | 12 |
| therapuetic action for pts on opioid agonists with Sx of emesis and biliary colic | admin antiemetic |
| Contraindications/precautions for Opioid Agonists Drugs | premature infants and biliary tract surgery |
| Repeated use of Demerol can lead to ____ and ____; Do not admin more than ____mg/24hr; limit use to less than ____hr | seizures, neurotoxicity, 600, 48 |
| Med/Food Interactions of Opioid Agonists Drugs | CNS depressants, Anticholinergic agents, MAOIs (avoid Demerol), Antihypertensives (further lowers BP) |
| Interventions for Opioid Agonists Drugs | Pts respiratory rate less than 12/min hold med, Admin IV slowly over a period of 4-5min |
| Class: Antagonists Opioids, Drugs (3) | Narcan, naltrexone, nalmefene |
| Action of Antagonists Opioids (Narcan) | Interfere with action of opioids by competing with opioid receptor sites. Have no effect in absence of opioids. |
| Therapeutic Action of Antagonists Opioids (Narcan) | Treatment of opioid overdose, Reversal of effects of opioids (i.e. respiratory depression), Reversing respiratory depression in infants |
| Side/Adverse Effects of Antagonists Opioids (Narcan) | Tachycardia and tachypnea, Abstinence syndrome (occurs in pt that are physically dependent on opioids) |
| Contraindications/precautions for Antagonists Opioids (Narcan) | Pregnancy Category B, Opioid Dependency |
| Interventions for Antagonists Opioids (Narcan) | Rapid first-pass, Narcan should not be admin PO |
| Class: Adjuvant Meds for Pain (6) | Antihistamines, Glucocorticoids, Bisphophonate, Anticonvulsants, CNS stimulants, Tricylic antidepressants |
| Action of Adjuvant Meds for Pain | Enhances effects of opioids |
| Therapeutic Action of Adjuvant Meds for Pain | Used in combination with opioids (not substitute), used in cancer-related conditions – increased ICP |
| Side/Adverse Effects of Antihistamines | Sedation |
| Side/Adverse Effects of Glucocorticoids | Osteoporosis (VitD sup), Hypokalemia (potassium sup), Glucose intolerance, PUD (with meals), Prophylactic use of H2 antagonist, Adrenal insufficiency with prolonged use |
| Side/Adverse Effects of Bisphophonate | Flu-like symptoms, Venous irritation at injection site |
| Bisphophonate used for relief of ____-_____ _____ pain | cancer-induced bone |
| Anticonvulsants are used to relieve what type of pain? | neuropathic |
| side effect of anticonvulsants | Bone marrow suppression |
| Side/Adverse Effects of CNS stimulants | Weight loss, Insomnia |
| Side/Adverse Effects of Tricylic antidepressants | Orthostatic hypotension, Sedation, Anticholinergic Effects (dry mouth, urinary retention, constipation) |
| Administer stimulant ____ to counteract decreased BM and stool softener to prevent ____ | laxative, constipation |
| Tricylic antidepressants are used to relieve what type of pain? | neuropathic |
| Interventions for Adjuvant Meds for Pain | pain management program |
| Tricyclic Antidepressants for pain (1) | Elavil |
| Anticonvulsants for pain (3) | Tegretol, gabapentin, Dilantin |
| CNS Stimulant for pain (2) | Ritalin, Dexedrine |
| Antihistamine for pain (1) | Vistaril |
| Glucocorticoid for pain (2) | dexamethasone, prednisone |
| Bisphosphonates for pain (2) | Didronel, Aredia |
| Class: Antigout (4) | Colchine, Indocin, Allopurinol, Probenecid |
| Action of Colchine and Indocin | decrease inflammation by preventing infiltration of WBC |
| Action of Allopurinol | inhibits uric acid production |
| Action of Probenecid | inhibits uric acid reabsorption by renal tubules |
| Therapeutic Action of Colchine and Indocin | treat acute attacks of gout or if given early enough can abort attack |
| Therapeutic action of Allopurinol and Probenecid | hyperuricemia |
| Therapeutic Action of Probenecid | prolongs penicillins and cephalosporins by delaying elimination |
| Side/Adverse Effects of antigout meds | Colchicine-GI toxicity (take with food; provide antidiarrheal); Probenecid -Renal Injury (encourage fluids) |
| Contraindications/precautions of antigout meds | Avoid use during pregnancy |
| Med Interactions of antigout meds | Coumadin and Salicylates – lessens effectiveness of probenecid |
| Interventions for Antigout meds | Avoid foods high in purine (red meat, scallops, liver, organ foods) |
| Other Medications for antigout | Colchicine, indocin, zyloprim |
| Class: Migraine Meds, Types (6): | Imitrex, Inderal, Divalproex, Elavil, Verapamil, Ergot alkaloids |
| Action of Migraine Meds | Prevent inflammation and dilation of intracranial blood vessels |
| Therapeutic Action of Migraine Meds | prevention/ceasing migraines |
| Side/Adverse Effects of Imitrex | Chest symptoms (heavy arms or chest pressure), Coronary vasospasm/angina – don’t give to pt with CAD |
| Imitrex is a serotonin receptor ____ | antagonist |
| Side/Adverse Effects of Inderal | Extreme fatigue |
| Inderal is a ____-blocker | beta |
| Side/Adverse Effects of Divalproex | Neural tube defects – avoid during pregnancy |
| Action of Divalproex | anticonvulsant |
| Side/Adverse Effects of Elavil | Anticholinergic effects (dry mouth, constipation, urinary retention)-Increase fluids and physical activity |
| Action of Elavil is | tricyclic antidepressants |
| Side/Adverse Effects of Verapamil | Orthostatic hypotension, Constipation |
| Verapamil is a ____ channel blocker | Calcium |
| Side/Adverse Effects of Ergot alkaloids | GI discomfort (admin Reglan), Ergotism (muscle pain, paresthesias in fingers, toes) – stop med, physical dependence, abortion |
| Contraindications/precautions for migraine meds | Ergotamine – avoid in pts with renal/liver dysfunction, sepsis, CAD; Triptans – avoid in pts with ischemic heart disease, hx of MI, uncontrolled BP, pregnancy |
| Med/Food Interactions migraine meds | Ergostat, Imitre, Triptans w/MAOIs |
| Interventions with migraine meds | Avoid triggers (alcohol, fatigue, tyramine-containg foods) |
| Migraine Meds | Ergostat, Imitrex, Inderal, divalproex, Elavil, Verapamil, Estrogens |
Created by:
BrandiLynn
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