1. What is the pathophysiology of anti-inflammatory drugs
    Inflammation, reaction to tissue injury, caused by release of chemical mediators, leads to vascular response, fluid and WBCs migrate to injured site
  2. What are the chemical mediators
    Histamines, kinins, prostaglandins
  3. What are the effects of histamines
    First mediator in inflammatory process and cause dilation of arterioles and increase capillary perm.
  4. What are the effects of kinin (bradykinin)
    Increase cap. Perm. And increase pain
  5. What are the effects of prostaglandins
    Increase cap. Perm.; increase vasodilation; increase pain and fever; used for: histamine effects, platelet aggregation and fever
  6. What are the cardinal signs of inflammation
    Redness, swelling, heat, pain, loss of function
  7. Cyclo-oxgenase (cox) enzyme
    Converts arachidonic acid into prostaglandins; has two enzmyes forms: cox1 and cox2
  8. What are theanti-inflammatory drug groups
    Nonstereiodaa anti-inflammatory drugs (NSAIDS), corticosteriods, disease-modifying antirhumatic drugs, antigout drugs,
  9. What are the effects of NSAIDS
    Inhibit biosyn. Of prostaglandins, analegisic antipyretic (against fever) effect, inhibit platelet aggregation, mimic effects of corticosteriods
  10. What is the action of NSAIDS
    Inhibit COX enzyme, inhibit prostaglandins synthesis
  11. What are the uses of NSAIDS
    Reduce inflammation and pain, not recommended for fever or headaches, except asprin, ibuprofen
  12. What are the first generation NSAIDS
    Salicylates (asprin), parachorobenzoic acid, pyrazolone derivatives, fenamates, oxicwns, pheyllacteic acid derivatives
  13. What are the 2nd gen. NSAIDS
    Cox-2 inhibitors
  14. What are salicylates
    Aspirin (acetylsalicylic acid) (ASA)
  15. What are the actions of salicylates
    Anti-inflammatory, anti-,platelet, antipyretic effects
  16. What is the therpetic serum level for salicylates
    10-30 mg/dl
  17. What is the toxic serum level salicylate level
    Greater than 30 mg/dl
  18. What are the drug interaction of salicylates
    Increase anticoagulants, hypoglycemia, increase gastric ulcer risk with glucocoticoids
  19. What are the lab interactions of salicylates
    Increase PT, bleeding time, INTO, and uric acid; decreases K+, cholesterol, T3 and T4 levels
  20. What are the foods containing salicylates
    Prunes, raisins, licorice, certain spices
  21. What are the cautions of aspirin (salicylates)
    Do not take with other NSAIDS; avoid during third trimester of pregnancy; dont give to children with flu or virus symptoms (reye's syndrome)
  22. What are the SE of aspirin
    Tinnitus, peptic ulcer, thrombocytopenia, leukopenia, agranulocytes, hepatotoxcity (they will affect liver)
  23. Hypersensitivity of aspirin
    Tinnitus, dizziness, broncospasm
  24. Saalicylism (,mild)
    Tinnitus, dizziness, HA, confusion, sweating, drowsy, thirst, N&V, diarrhea
  25. Severe salicylate poisoning
    Convulsions, cardiovascular collapsex coma
  26. What are the peopionic acid derivatives
    Ibuprofens andnon selective COX inhibitors
  27. What is the brand name for propionoc acid derivitives
    Ibuprofen (motrin, advil)
  28. What are the drug interactions for propionic acid derivatives
    Increase effects of warfarin and phenytoin
  29. What are the SE of ibuprofen
    Gastric distress .( to be taken with food)
  30. What are the cox 2 inhibitors
    Celecoxib (celebrex); rofecoxib ( vioxx); meloxicam (Monic;)
  31. What is to be remembered when INHIBITING COX 1
    Stomach bleeding and ulcers may occur;
  32. What is the most common SeE of aspirin and NSAIDS
    GASTRIC Irritation
  33. What tether actions of ibuprofen (advil)
    Selctively inhibits COX 2 ENZYME without inhibition of a COX 1
  34. What are the uses for advil
    Decrease inflammation and pain
  35. What are the SE of advil
    Mild: HA, dizziness, nausea, diarrhea, sinusitis, peripheral edema
  36. What is seen with NSAIDS in older adults
    Greater incidence of GO distress and ulcerationm; reduce dose to decrease SE
  37. Whatbarethe NI for NSAIDS
    Assessing renal and GI status
  38. Rhematoid arthritis and NSAIDS
    Cause a decrease in in function due to presence of pain or disformity
  39. What are the disease modifying antirhematic drugs
    Gold drug therapy ( chrysotherapy), immunosupressive agents, immunomodulstors, antimslsrisls, aursnofin
  40. What are the actions of disease modifying antirheumtic drugs
    Decrease leukocyte migration, suppresses prostglandin activity, stops progression of joint degeneration
  41. What is the use for disease modifying antirheumatic drugs
    Rheumatoid arthritis
  42. What are the SE/adverse effects reactions
    Stomatitis, photosynthesis, metallic taste, severe rash, corneal goldbdeposits, bradycardia, profound hypotension, hematuria, proteinuria, nephrotoxicity, agranulocytes, thrombocytopenia
  43. What are the contraindications of antirheumatic drugs
    Severe female or hepatic disease; pregnancy, blood dyscrasias, colitis; systemic lupus erythromatosus
  44. What are the immunomodulstors
    Tumor necrosis factor blockers; entanercept (enbrel), inflixlmab (remicade)
  45. What are the SE of immunomodulstors
    HA, dizziness,chills, hot flashes, depression, N/V, diarrhea, urinary frequency
  46. What is the action of abalimumab (humira)
    Disrupt inflammatory process, neutralize TNF, delay disease progression, used for Rhematoid arthritis
  47. Gout pathophysiology
    Inflammatory disease of joints, tendons; usually occurs in great toe, defect in purine metabolism leads to uric acid accumulation in the joints; purine -containing foods: salmon, liver, sardines
  48. What are the antigout drugs
    Colchicine; urix acid inhibitors; uricosurics
  49. What colchicine used for
    Inhibit migration of leukocytes to inflamed site, very potent
  50. What are the SE of colchicine
    N, V, D, abdominal pain; take with food ti avoid GO distress
  51. What are the contraindications of.colchicine
    Severe renamed, cardiac, or GI problems
  52. What is the drug used for uric acid inhibitors
    Allopurinol (zyloprim)
  53. What is the action of allopurinol
    Decrease uric acid levels; prophylactic to prevent gout attacks
  54. What are the NI of allopurinol
    Monitor CBC, liver enzymes, renal function; yearly eye exams for visual changes; client to avoid alcohol, caffeine, and thiazide diuretics that increase fluid intake to increase uric acid excretion
  55. What are the uricosurics
    Probenecid (benemid)
  56. What is pain
    Unpleasant sensosory and emotional experience associated with tissue damage; pt pain is conerstone of pain assessment; pain is personal and individual experience; pain iswhatever the pt says it is! Don't be iudgemental and stingy with pain less
  57. What is acute pain
    Last for the duration of tissue injury
  58. What is cancer pain
    Pressure or blockage to tissue or cells
  59. What is chronic pain
    Persistent, lasts longer than 6 weeks
  60. What is somatic pain
    Bones, skeletal muscles and joints
  61. What is superficial pain
    Skin or mucous membranes
  62. What is visceral pain
    Body organ pain
  63. What are the assement parameters of pain
    Onset of temporal pattern, location, quality, intensity, modulating factors, previous treatment (did it work previously), impact
  64. What are the non-drug therapy assessments of pain
    Application of heat and cold, massage, exercise, acupuncture, relaxation, imagery, peer group support, neurolytic nerve block, and radiation therapy
  65. What are the non-opiods
    Not an opium derivative, non-narcotic, a lot of times it isOTC
  66. What is the action of acetaminophen
    Inhibits prostaglandin synthesis
  67. What are theuses of acetaminophen
    Relieves pain, discomfort, fever; max dose is 4 g/day
  68. What are the SE of acetaminophen
    Rash, low incidence of GI distress; toxic effects/overdose; hepatotoxicity, thrombocytopenia
  69. What are analgesic used for
    Paraaminophenol derivative
  70. What is the other information about acetaminophen
    Constitutes 25% of all OTC drugs sold, safe effective analegesic and antipyretic, can be hepatotoxic, used to be frequently to I'D
  71. What is the antidote for acetaminophen
  72. What is an exaaple of non-opiods
  73. What are opoid analgesic
    Prescription only, controlled substances, nurses must sign for them, count them daily & account for the number of narcotics in cabinet
  74. What are the opoid analgesicsused for
    For moderate to severe pain, acute MI, cancer, dyspena from pulmonary edema, preop med for balanced anesthesia, cough center depressant, treatment of diarrhea, antidote is narcotic anatagonists naxolone (narcan) and naltrexone (revia)
  75. What are the opoid drugs
    Morphine and codeine
  76. What are.the synthetic opioids
    Meperidine (demerol) and hydromorphone (dilaudid)
  77. What are the uses of opioids
    Pain relief; antitussives (except meperidine)
  78. What is the actions of opioids
    Acts on the CNS to suppress pain impulses, cough centers and depresses respirations
  79. Codenine
    1/15 to 1/20 we potent as morphine sulfate
  80. What do most opioids with exception of demerol have the effect of
  81. What are the two isomers of opioids
    Levo and dextro; Levo causes physical dependence
  82. What are the SE/ adverse effects of opioids
    Hypotension, sedation, confusion, blurred vision, constipation, urinary retention; ithing, respiratory depression (must be 12 or narcotics cannot be administered), tolerance and dependence, withdrawal symptoms
  83. What are.the contraindications for opioids
    Known drug allergy, head injuries, increased intracranial pressure; severe asthma or other respiratory disorders; shock or hypotension and pregnancy
  84. What are the.NI for opioids
    Obtain allergies history, obtain baseline vital signs and I & O, perform a through pain assessment, be sure to medicate pt before the pain becomes severe as to provide adequate analgesia and pain control, ensure saefty measures (side rails up and call light within reach, bed in lowest position)drugs can cause othostatic hypotension, sedation so we need to give them a safe environment
  85. What are the classic triads of opioids OD
    Coma, respiratory depression, pinpoint pupils
  86. What is.the treatment for opioid OD
    Ventilator support, opioids antagonist,nalmefene (,revex)
  87. What is the drug used for opioid agonist-antagonist
    Nalbuphine HCL (nubain)-most commonal used
  88. What is the action of nalbuphine HCL (nubain)
    Binds with opiate receptor and increases pain threshold
  89. What is the advantages of nalbuphine (nubain)
    Decreases risk of narcotis abuse; safest to use during labor
  90. What are the SE/adverse effects of nalbuphine (nubain)
    Confusion, restlessiness, abdominal cramps, urinary urgency, depression; respiratory depression
  91. What are the contraindications of nalbuphine (nubain)
    Renal or hepatic dysfunction; head injuries, increased, intracranial pressure, impaired respiration; history of drug abuse or emotional instability
  92. What is the use for opioid antagonists
    Antidote for opiate overdose; reverse effects of opiates, including respiratory depression, sedation, hypotension; respiratory distress
  93. What is the drug used for opioid antagonist
    Naloxone (narcan)
  94. What are the SE of naloxone(narcan)
    Tremors, sweating, hypertension, tachy, excitement, N/V, reversal of analgesic, dysrhytmia, elevated PTT
  95. What are the NI for opioid antagonist
    Monitor vital signs and bleeding continuously
  96. What is the methadone treatment program
    Weaning program, maintenance program, and hot life longer ( given once a day)
Card Set
Pharmacology Test 3