Pharm

Inflammation, reaction to tissue injury, caused by release of chemical mediators, leads to vascular response, fluid and WBCs migrate to injured site

Histamines, kinins, prostaglandins

First mediator in inflammatory process and cause dilation of arterioles and increase capillary perm.

Increase cap. Perm. And increase pain

Increase cap. Perm.; increase vasodilation; increase pain and fever; used for: histamine effects, platelet aggregation and fever

Redness, swelling, heat, pain, loss of function

Converts arachidonic acid into prostaglandins; has two enzmyes forms: cox1 and cox2

Nonstereiodaa anti-inflammatory drugs (NSAIDS), corticosteriods, disease-modifying antirhumatic drugs, antigout drugs,

Inhibit biosyn. Of prostaglandins, analegisic antipyretic (against fever) effect, inhibit platelet aggregation, mimic effects of corticosteriods

Inhibit COX enzyme, inhibit prostaglandins synthesis

Reduce inflammation and pain, not recommended for fever or headaches, except asprin, ibuprofen

Salicylates (asprin), parachorobenzoic acid, pyrazolone derivatives, fenamates, oxicwns, pheyllacteic acid derivatives

Cox-2 inhibitors

Aspirin (acetylsalicylic acid) (ASA)

Anti-inflammatory, anti-,platelet, antipyretic effects

10-30 mg/dl

Greater than 30 mg/dl

Increase anticoagulants, hypoglycemia, increase gastric ulcer risk with glucocoticoids

Increase PT, bleeding time, INTO, and uric acid; decreases K+, cholesterol, T3 and T4 levels

Prunes, raisins, licorice, certain spices

Do not take with other NSAIDS; avoid during third trimester of pregnancy; dont give to children with flu or virus symptoms (reye's syndrome)

Tinnitus, peptic ulcer, thrombocytopenia, leukopenia, agranulocytes, hepatotoxcity (they will affect liver)

Tinnitus, dizziness, broncospasm

Tinnitus, dizziness, HA, confusion, sweating, drowsy, thirst, N&V, diarrhea

Convulsions, cardiovascular collapsex coma

Ibuprofens andnon selective COX inhibitors

Ibuprofen (motrin, advil)

Increase effects of warfarin and phenytoin

Gastric distress .( to be taken with food)

Celecoxib (celebrex); rofecoxib ( vioxx); meloxicam (Monic;)

Stomach bleeding and ulcers may occur;

GASTRIC Irritation

Selctively inhibits COX 2 ENZYME without inhibition of a COX 1

Decrease inflammation and pain

Mild: HA, dizziness, nausea, diarrhea, sinusitis, peripheral edema

Greater incidence of GO distress and ulcerationm; reduce dose to decrease SE

Assessing renal and GI status

Cause a decrease in in function due to presence of pain or disformity

Gold drug therapy ( chrysotherapy), immunosupressive agents, immunomodulstors, antimslsrisls, aursnofin

Decrease leukocyte migration, suppresses prostglandin activity, stops progression of joint degeneration

Rheumatoid arthritis

Stomatitis, photosynthesis, metallic taste, severe rash, corneal goldbdeposits, bradycardia, profound hypotension, hematuria, proteinuria, nephrotoxicity, agranulocytes, thrombocytopenia

Severe female or hepatic disease; pregnancy, blood dyscrasias, colitis; systemic lupus erythromatosus

Tumor necrosis factor blockers; entanercept (enbrel), inflixlmab (remicade)

HA, dizziness,chills, hot flashes, depression, N/V, diarrhea, urinary frequency

Disrupt inflammatory process, neutralize TNF, delay disease progression, used for Rhematoid arthritis

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

Colchicine; urix acid inhibitors; uricosurics

Inhibit migration of leukocytes to inflamed site, very potent

N, V, D, abdominal pain; take with food ti avoid GO distress

Severe renamed, cardiac, or GI problems

Allopurinol (zyloprim)

Decrease uric acid levels; prophylactic to prevent gout attacks

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

Probenecid (benemid)

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

Last for the duration of tissue injury

Pressure or blockage to tissue or cells

Persistent, lasts longer than 6 weeks

Bones, skeletal muscles and joints

Skin or mucous membranes

Body organ pain

Onset of temporal pattern, location, quality, intensity, modulating factors, previous treatment (did it work previously), impact

Application of heat and cold, massage, exercise, acupuncture, relaxation, imagery, peer group support, neurolytic nerve block, and radiation therapy

Not an opium derivative, non-narcotic, a lot of times it isOTC

Inhibits prostaglandin synthesis

Relieves pain, discomfort, fever; max dose is 4 g/day

Rash, low incidence of GI distress; toxic effects/overdose; hepatotoxicity, thrombocytopenia

Paraaminophenol derivative

Constitutes 25% of all OTC drugs sold, safe effective analegesic and antipyretic, can be hepatotoxic, used to be frequently to I'D

Mucomyst

Acetaminophen

Prescription only, controlled substances, nurses must sign for them, count them daily & account for the number of narcotics in cabinet

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)

Morphine and codeine

Meperidine (demerol) and hydromorphone (dilaudid)

Pain relief; antitussives (except meperidine)

Acts on the CNS to suppress pain impulses, cough centers and depresses respirations

1/15 to 1/20 we potent as morphine sulfate

Antitussive

Levo and dextro; Levo causes physical dependence

Hypotension, sedation, confusion, blurred vision, constipation, urinary retention; ithing, respiratory depression (must be 12 or narcotics cannot be administered), tolerance and dependence, withdrawal symptoms

Known drug allergy, head injuries, increased intracranial pressure; severe asthma or other respiratory disorders; shock or hypotension and pregnancy

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

Coma, respiratory depression, pinpoint pupils

Ventilator support, opioids antagonist,nalmefene (,revex)

Nalbuphine HCL (nubain)-most commonal used

Binds with opiate receptor and increases pain threshold

Decreases risk of narcotis abuse; safest to use during labor

Confusion, restlessiness, abdominal cramps, urinary urgency, depression; respiratory depression

Renal or hepatic dysfunction; head injuries, increased, intracranial pressure, impaired respiration; history of drug abuse or emotional instability

Antidote for opiate overdose; reverse effects of opiates, including respiratory depression, sedation, hypotension; respiratory distress

Naloxone (narcan)

Tremors, sweating, hypertension, tachy, excitement, N/V, reversal of analgesic, dysrhytmia, elevated PTT

Monitor vital signs and bleeding continuously

Weaning program, maintenance program, and hot life longer ( given once a day)