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Chapters 18, 19, 20, 21, 22

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Question
Answer
Salicylates Action   Stops the production of prostaglandins, which affects the pain & inflammatory processes in the body.  
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Salicylates Action   Have analgesic, antipyretic, & anti-inflammatory effects.  
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Salicylates Uses   Treatment of mild to moderate pain, fever, inflammation.  
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Salicylates Uses   Used as an emergency anti-platelet drug in patients having an MI or stroke.  
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Salicylates Uses   Used to reduce risk of death or nonfatal MI in patients with previous MIs.  
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Salicylates Uses   First line therapy to treat arthritis.  
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Salicylates Adverse Reactions   GI distress, GI bleeding, tinnitus, visual changes,& hives.  
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Salicylates Drug Interactions   Alcohol increases the risk of GI bleeding. Increased effect of anticoagulants & sulfonamides if used with salicylates. Increased effects & toxicities if used with other NSAIDs.  
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Salicylates Common Drug Name   acetylsalicylic acid (aspirin, ASA)  
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Acetaminophen Action   Direct action on the hypothalamic heat-regulating center.  
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Acetaminophen Uses   Treatment of fever, & mild to moderate chronic pain. Initial drug of choice for treatment of osteoarthritis.  
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Acetaminophen Adverse Reactions   If used as directed, adverse reactions are rare. Skin eruptions, erythema, jaundice, & liver toxicity. Overdose may be fatal particularly in young children & older adults.  
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Acetaminophen Drug Interactions   Use with barbiturates, hydantoins, rifampin, & ETOH increase the risk of liver toxicity.  
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Acetaminophen Common Drug Name   acetaminophen (Tylenol)  
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NSAIDS Action   Exact mode of action is not known but it is believed that the analgesic & anti-inflammatory effects are largely the result of their ability to stop production of prostaglandins.  
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NSAIDS Uses   Acute or chronic musculoskeletal pain. Treatment of rheumatoid arthritis & osteoarthritis.  
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NSAIDS Adverse Reactions   Asthma, fluid retention, hypertension, dizziness, sleepiness, GI bleeding.  
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NSAIDS Drug Interactions   Various NSAIDs have different interactions. Consult with a drug handbook prior to administration.  
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NSAIDS Common Drug Names   ibuprofen (Advil)  
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Muscle Relaxants Action   Reduce muscle tone & involuntary movement without loss of voluntary motor function.  
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Muscle Relaxants Uses   Relief of pain in musculoskeletal & neurologic disorders involving peripheral injury & inflammation.  
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Muscle Relaxants Adverse Reactions   Flushing, hypotension, syncope, tachycardia, ataxia.  
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Muscle Relaxants Drug Interactions   Increases the effects of CNS depressants.  
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Muscle Relaxants Patient Education   Avoid driving. Avoid use of other CNS depressants. Take at bedtime to help with sleep.  
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Muscle Relaxants Nursing Implications   Should not be given to patients with history of alcohol abuse. Monitor for hepatotoxicity, nephrotoxity, and abnormal blood cells. Taper dose when discontinuing. A  
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Anti-Arthritis Uses   Methotrexate is used in cases of severe rheumatoid arthritis that is unresponsive to other treatment.  
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Anti-Arthritis Adverse Reactions   Stomatitis, esophagitis, oral ulceration, GI distress.  
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Anti-Arthritis Drug Interactions   Methotrexate interacts with many drugs. Consult drug handbook prior to administration.  
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Anti-Arthritis Common Drug Names   methotrexate  
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Anti-Gout Action   Reduces the inflammatory response, decreases uric acid production, & increases uric acid clearance.  
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Anti-Gout Uses   Oral colchicine is the first-line agent for systemic treatment of acute attacks. It does not decrease the uric acid levels, however.  
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Anti-Gout Uses   Allopurinol lowers the uric acid level & is used for long-term treatment because it does not have analgesic properties.  
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Anti-Gout Adverse Reactions   Dizziness, pruritus, GI distress, skin rash.  
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Anti-Gout Drug Interactions   Salicylates interfere with the action of these drugs.  
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Anti-Gout Common Drug Names   prednisone, colchicine, allopurinol  
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Antacids, H2 Receptor Antagonists, Proton Pump Inhibitors Action   Neutralize hydrochloric acid & increase gastric pH. Promote healing of ulcers.  
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Antacids, H2 Receptor Antagonists, Proton Pump Inhibitors: Uses   Treat peptic ulcer disease, gastritis, gastric ulcer, peptic esophagitis, hiatal hernia, gastric hyperacidity & esophageal reflux. Proton pump inhibitor, Protonix, is drug of choice for ulcers.  
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Antacids, H2 Receptor Antagonists, Proton Pump Inhibitors: Drug Interactions   There are many drug interactions. Consult a drug handbook.  
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Antacids: Adverse Reactions   Weakness, anorexia, frequent burping, & thirst.  
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Histamine H2 Receptor Antagonists: Adverse Reactions   Dizziness, headaches, rash, muscle pain.  
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Proton Pump Inhibitor: Adverse Reactions   Headache, diarrhea, abdominal pain, nausea.  
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Antacids, H2 Receptor Antagonists, Proton Pump Inhibitors: Common Drug Name   Protonix  
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Antacids, H2-Receptor antagonists, Proton Pump Inhibitors: Nursing Implications   Increase fluid intake and monitor for constipation. H2-Receptor Antagonists should be given with food at bedtime.  
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Antacids, H2-Receptor Antagonists: Patient Education   Proton pump inhibitors take 6-8 weeks to improve condition. Antacids should be taken one hour prior to taking enteric coated meds. Proton pump inhibitors should be taken one hour before meals.  
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Anti-gout medications: Nursing Implications   Monitor for improvement of inflammation, erythema, extreme tenderness and pain in affected joint.  
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Anti-gout medications: Patient Education   Dietary changes can prevent or control gout attacks. Colchicine should be taken with food. Drink at least 8 glasses of fluid every day.  
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Anti-arthritis medications: Nursing Implications   These drugs have significant adverse reactions. The benefits must be weighed against the risks. Typically given by the rheumatologist.  
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Anti-arthritis medications: Patient Education   Medications are potent and slow-acting. Notify healthcare provider if unusual symptoms develop. Work closely with healthcare provider, keep appointments, and have lab work done as ordered.  
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NSAIDS: Nursing Implications   Should not be given if pt has aspirin sensitivity. Evaluate after 3-4 weeks for improvement. Monitor older adult for peptic ulcers.  
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NSAIDS: Patient Education   Take with food or milk. Don't take aspirin with NSAIDS. May experience drowsiness and lightheadedness. NSAIDS should be taken on a schedule to maintain medication levels in blood.  
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Acetaminophen: Nursing Implications   Monitor for fever or pain control. Notify physician if severe pain or high fever occur. Drug of choice for reduction of fever. Monitor for symptoms of gastric distress, nausea or bleeding.  
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Acetaminophen: Patient Education   Avoid alcohol intake while taking to avoid liver damage. Do not exceed the recommended dosage and use caution with OTC meds containing acetaminophen.  
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Salicylates: Nursing Implications   Do not give to children under 12. Monitor closely in patients with history of gastric irritation, blood dyscrasias, decreased renal function, patients on anticoagulants. Should not be given to patients with liver disease  
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Salicylates: Patient Education   Aspirin should be discontinued prior to surgery. Take medication with food to reduce stomach upset. Contact physician if tinnitus, abnormal bleeding or bruising, or black tarry stools develop. Medication should be taken regularly to reduce inflammation.  
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Anticholinergics, Antispasmodics, and Antidiarrheals: Uses   Treat peptic ulcer, pylorospasm, biliary colic, hypermotility, hyperacidity, irritable colon, and acute pancreatitis. Nonspecific diarrhea or diarrhea caused by antibiotics.  
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Anticholinergics, Antispasmodics, and Antidiarrheals: Adverse Reactions   Anticholinergic-antispasmodic drugs may cause rapid, weak pulse, blurring of vision, dysphagia, difficulty talking, dilation of pupils. Antidiarrheals may cause tachycardia, dizziness, drowsiness, abdominal distention, and constipation.  
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Anticholinergics, Antispasmodics, and Antidiarrheals: Drug Interactions   Anticholinergics may decrease the effect of anticoagulants. Many other interactions exist-check drug handbook.  
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Anticholinergics, Antispasmodics, and Antidiarrheals: Nursing Implications   Patients with diarrhea should have clear liquid diet for 24 hours and gradually add back in food. Increase fluids. Anti-diarrheal meds relieve symptoms and prevent dehydration until underlying cause can be found.  
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Anticholinergics, Antispasmodics, and Antidiarrheals: Patient Education   Avoid becoming overheated. High environmental temperatures may make the patient feel unusually hot and fatigued. Diarrhea lasting longer than 48 hours should not be self-treated.  
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Laxatives: Uses   Relieve constipation, reduce straining. Saline laxatives used to cleanse the bowel prior to surgery and after procedures where barium contrast was used.  
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Laxatives: Adverse Reactions   Abdominal cramps, diarrhea, electrolyte imbalance, GI distress  
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Laxatives: Drug Interactions   Fecal softeners should not be given with mineral oil or other laxatives. Do not give bulk-forming laxatives within two hours of administering antibiotics, anticoagulants, digitalis preparations, and salicylates.  
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Laxatives: Nursing Implications   Bulk-forming agents may become dry, thick, and hardened in the throat or intestine if not taken with sufficient amounts of water. Overdosage or overuse of stimulant laxatives may cause excessive fluid loss and electrolyte imbalance.  
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Laxatives: Patient Education   Increase fluids and eat a diet high in bulk or fiber to prevent constipation. Daily exercise also helps maintain bowel regularity. Frequent laxative use will rob the bowel of the ability to function on its own.  
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Antiflatulents   Breaks up and prevents mucus-surrounded pockets of gas. Short-term use only. Often used after abdominal surgery. Should be encouraged to ambulate frequently.  
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Antiflatulents: Common Name   simethicone (Gas-X)  
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Disulfiram: Uses   Used for management of alcoholism. Produces severe nausea, vomiting, and diarrhea after alcohol consumption.  
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Disulfiram: Nursing Implications   Use with extreme caution in patient with diabetes, epilepsy, cerebral damage, hypothyroidism, coronary artery disease, and hypertension.  
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Disulfiram: Patient Education   Requires careful education of the patient and a responsible family member. Permission from the patient must be obtained prior to prescribing this drug. Avoid OTC products that may contain alcohol.  
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