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28 Cards in this Set
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Chapter 16
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Anti-inflammatory agents
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Salicylates
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Asprin (ASA)
Choline magnesium trisalicylate |
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Sites of action
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Inhibit the synthesis of prostaglandins
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Therapeutic actions
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Antipyretic effect by blocking pyrogen signals at the hypothalamus
Decreases platelet aggregation by inhibiting synthesis of thromboxane A2 |
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Indications
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Treatment of mild to moderate pain
Fever Inflammatory conditions incl rheumatoid arthritis and osteoarthritis Prevention of Transient eschemic attack Reduce risk of death by MI MI treatment |
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Pharmacokinetics
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Absorbed by the stomach
Peak 5-30 minutes Metabolized by the liver Excreted in the urine Cross placenta and breast milk |
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Contraindications
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Known allergy to salicylates
Bleeding abnormalities Impaired renal function |
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Adverse reactions
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GI irritation
Reduced clotting 8th cranial nerve stimulation-Ears Salicylism-tinnitus, acidosis, nausea, diarrhea, confusion |
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Drug-Drug interactions
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Interfers with absorption of other drugs
Effects on liver Extending of therapeutic effects of one or both |
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NSAIDS
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Ibuprofen-motrin, advil
Naproxen Celebrex-cox 2 inhibitor |
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Site of action
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COX-1 systemic blocking of prostiglandin producing enzymes
COX-2 local blocking of prostiglandin producing enzymes |
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Therapeutic actions
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Inhibit prostiglandin synthesis by blocking COX-1 and COX-2 enzyme
Anti-inflammatory, analgesic, and antipyretic effects |
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Indications
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OTC releif of signs and symptoms of arthritis, relief of mild to moderate pain, treatmetn of primary dysmenorrhea, fever reduction
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Pharmacokinetics
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Oral-GI absorption
Onset 30 min Peak 1-2 hr Liver metabolized Urine excretion Placenta and breast milk crossing |
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Contraindications
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Allergy to any NSAID or salicylate
CV disfunction or HPT Peptic ulcers or GI bleeding Pregnancy or lactation |
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Adverse reactions
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COX-1 Systemic
GI integrity, blood clotting, NA and H2O balance, CNS prostiglandin activity Headache, dizziness, somnolence, fatigue, rash, nausea, dyspepsia, bleeding, constipation |
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Drug-Drug interactions
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Beta Blockers-Decreases diuretic effects of loop blockers
Ibuprofen-lithium toxicity |
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Acetomenophen
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Tylenol
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Sites of action
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Acts directly on the thermoregulartory cells of the hypothalamus
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Therapeutic actions
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Release of heat and lowering of fever through sweating and vasodilation
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Indications
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Treatment of pain and fever associated with a variety of conditions including flu, and DPT immunization, musculoskeletal pain, arthritis.
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Pharmacokinetics
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Route oral GI
Onset varies Peak .5-2 hours Duration 3-6 hours Liver metabolized Urine excreted Placenta and breast milk crossing |
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Contraindications
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Toxic levels in patients with hepatic or renal impairments
pregnancy or lactation |
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Adverse reactions
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Rash, fever, chest pain, liver toxicity, bone marrow suppression
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Drug-Drug interactions
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Oral anticoagulants effect liver
Ethanol toxicity on liver Barbiturate hepatotoxicity |
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Salicylates
F>I>R>E> |
Fever
Inflamation Reduces TIA's Eliminates death c hx MI |
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N<S<A<I<D<S<
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No alcohol-liver toxic
See birth-crosses placenta Asprin sensitivity-allergy Inhibits prostaglandins Do take with food-GI upset Stop before surgery-bleeding |
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Antidote to Acetaminophen/Tylenol poisioning
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Acetylchysteine
mucomist An antagonist to the same hypothalamus receptors |