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39 Cards in this Set
- Front
- Back
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Inflammation |
A normal defense mechanism in the body intended to localize and remove the injurious agent |
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Histamine |
Causes immediate vasodilation and increased capillary permeability to form exudate Responsible for throat swelling, watering eyes, and running nose associated with allergies |
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Kinins |
Causes vasodilation and increased capillary permeability, pain, and chemotaxis Associated with redness and heat |
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Prostaglandins |
Causes vasodilation, increased capillary permeability, pain, fever, potentiates histamine effect |
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Leukotriene |
Promotes bronchospasm and increased vascular permeability with resultant edema |
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5 Cardinal signs of inflammation |
Redness Heat Swelling or edema Pain Loss of function |
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5 groups of nsaid agents |
Salicylates Acetic Acid Derivatives Selective COX-2 Inhibitors Enolic Acid Derivatives Propionic Acid Derivatives |
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What is an example of a salicylate? |
ASA |
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What are 2 examples of acetic acid derivatives? |
Voltaren Toradol |
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What is an example of a selective COX-2 inhibitor? |
Celebrex |
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What are 2 examples of enolic acid derivatives? |
Relafen Mobic |
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What are 2 examples of propionic acid derivatives? |
Motrin Advil |
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What is the oldest anti-inflammatory agent used today? |
Aspirin |
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ASA 81-325mg |
Prophylactic therapy for adults who have strong risk factors for developing coronary artery disease or cardiovascular accident Effective after MI Both strengths appear to be equally beneficial for the prevention thrombotic events |
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Aspirin uses |
Headache Neuralgia Myalgia Arthralgia Pain resulting from inflammation Antipyretic effect Systemic lupus erythematosus Not typically given for inflammation anymore |
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What causes Reyes Syndrome to occur? |
The administration of aspirin to a child whose body is fighting a viral infection |
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Reyes Syndrome |
Causes neuro-deficits that can lead to coma and death If survived, permanent neurological damage is possible |
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Salicylates |
Salicylic acid (aspirin) is the most common type |
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Salicism |
Occurs before salicylate toxicity Leads to: - increased heart rate - tinnitus, then hearing loss - dimness of vision - headache - dizziness - mental confusion - drowsiness - N/V/D - sweating, thirst - HTN - abnormal blood glucose |
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Salicylate Toxicity |
Affects cardiovascular, central nervous, GI, and metabolic systems Same symptoms as salicism |
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Celebrex |
The only COX-2 Inhibitor Black box warning regarding cardiac risks Used for arthritic pain and dysmenorrhea |
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Adverse effects of celebrex |
Headache Sinus problems Dizziness Lower extremity edema HTN |
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Contraindications for celebrex |
Heart disease Sulfa allergy |
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Ibuprofen |
Most commonly used NSAID Used for arthritic pain, dental pain, musculoskeletal pain, and as an antipyretic |
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Naproxen |
Similar to ibuprofen, but has better adverse effect profile |
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Indomethacin |
Analgesic, anti-inflammatory, antirheumatic, and antipyretic Used for: RA, OA, acute tendinitis, ankylosing spondylitis, acute gouty arthritis, PDA, and preterm labor |
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Ketorolac |
Some antiinflammatory activity Short term use only (up to 5 days) Good for post-op pain Comparable effect to morphine without a sedative effect |
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Adverse effects of ketorolac |
Renal impairment, edema, GI pain, nausea, dyspepsia |
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PDA |
Patent ductus arteriosus A hole in the fetal heart that allows blood to bypass the lungs |
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NSAID Mode of Action |
Work through inhibition of the leukotriene pathway, prostaglandin pathway, or both. Relieve pain, headache, and inflammation by blocking the chemical activity of the enzyme cyclooxygenase (COX) |
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What are the main effects of NSAIDs? |
Analgesic Anti-inflammatory Antipyretic |
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How should NSAIDs be taken? |
With a full 8oz glass of water |
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Which NSAIDs inhibit platelet aggregation? How? |
Only aspirin It is an irreversible inhibitor of COX-1 receptors within platelets themselves |
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General side effects/adverse reactions to NSAIDs |
Gastric irritation (heart burn, GI bleeding) Sodium and water retention Purpura/petechiae Dizziness |
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What are contraindications for NSAIDs? |
- Known allergy - Risk for bleeding - Vitamin K deficiency - Liver failure - Renal failure - Third trimester pregnancy |
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Why is vitamin K deficiency a contraindication for NSAIDs? |
Vitamin K is necessary for blood clotting |
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How can the nurse monitor liver and renal functioning? |
Blood BUN and creatinine levels |
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Pre and post administration assessments for NSAIDs? |
Pre: Determine drug allergies, history of hepatic or renal disease, GI upset, or peripheral edema
Post: assess for GI upset, peripheral edema, signs of bleeding. Monitor VS |
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Patient teaching points for NSAIDs? |
- Do not take with ASA or Tylenol - Avoid alcohol - May take several weeks to see effect - Take with food - Watch for the following side effects: Nausea/vomiting Edema Bleeding GI upset Dizziness |
