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61 Cards in this Set
- Front
- Back
- 3rd side (hint)
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CNS drugs
work on treat they are.. |
brain and spinal cord.
treat mental illness, seizures, pain and for anesthesia- all are analgesics |
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Prostaglandins
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bad-start pain receptors and increase inflammation- Cox1 and 2 help in this formation but Cox 1 prostag.work in the stomach where they promote the development of the mucous lining- a very good thing, whereas Cox 2 prost.cause pain/inflammation-
want to stop this- lipid cmpd |
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Most OTC pain relievers
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inhibit Cox enzymes which are necessary for prostaglandin formation.
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Cox enzymes 1 & 2
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responsible for the desired (Cox1-forms prostaglandins that promote mucus lining of stomach)and adverse effects (Cox2 is responsible for inflammation/pain of arthritis) of the drug:
for the formation of and inhibition of prostaglandins- ASA & AIM NSAIDs & selective NSAID (Celebrex) inhibit COX - relieves inflammation and pain- - main inhibitors are NSAIDS they inhibit all COX (AIM, Aleve/ibuprofen/Motrin)but may cause PUD and dyspepsia -new class of COX 2 inhibitors selectively block 2 only but may cause atherothrombosis (Celebrex, Vioxx) |
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Cox 1
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"good" Cox - does good things, Peripheral action: gastric protection, maintains renal blood flow, causes platelet aggregation(clotting), promotes uterine contractions
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Cox 1 - when blocked
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the inhibition causes: gastric ulceration, acute renal failure, bleeding tendencies, relaxes uterine muscles so the new selective COX 2 inhibitors would be good but have many side effects, only one on market is Celebrex
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Cox 2
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Peripheral action: causes inflammation- responsible w/Cox1 for the formation of prosgtagladins which cause pain, swelling, inflammation
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Cox 2 con't
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central action: causes pain and fever
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Cox 2 con't 2
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when blocked: inhibition causes: reduced inflammation,reduced fever, reduced pain
blocked by NSAIDS and new NSAIDs that selectively block (Celebrex) |
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Cox 1 and Cox 2
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only comes in combination
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Non-Narcotic Analgesics
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Salicylates
Para Aminophenol Derivatives NSAID Urinary tract analgesic (antiseptics) see hint |
PUNS
Paraaminophenol derivatives urinary tract antiseptics NSAIDs Salicylates |
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Salicylates
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Aspirin/acetylsalicylic acid
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Para Aminophenol Derivatives
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Tylenol/acetaminophen
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NSAID
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non-Steroidal Anti-Inflammatory Drug
Aleve/ibuprofen/motrin (AIM) |
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Urinary tract analgesic(antiseptics? Bactrim)
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Pyridium/phenazopyridine
(pyromanic sets fire, pee on him) |
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Salicylates
Aspirin/acetylsalicylic acid |
inhibits Cox 1 & 2
4 properties anti-platlet effects last for life of platelet (7-10 days)(do not take 2 wks b4 & after surgery) most common s.e.: GI, PUD, another s.e.: renal failure |
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4 properties of Salicylates
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analgesic (decreases pain)
anti-inflammatory anti-pyretic (decreases fever) anti-platelet |
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Aspirin toxicity
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mild dizziness
tinnitus(most alarming s.e.) N&V often caused when used to treat rheumatoid arthritis because of the high dosage required- check creatine levels for renal fx very acidic- to many cause Acidosis enteric coatings on ASA will help stop ulcers but since ASA inhibits Cox, it is a systemic result so will not help with stomach ulcers-prevention but not stop-so red flag pts with chronic inflammatory disease |
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Reye's syndrome
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if child under 18 has influenza or chickenpox, Aspirin can cause this and it can be fatal
kaopectate and Peptobismal both have aspirin |
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Para Aminophenol Derivatives
see hint |
works centrally
max dose: 4 gm/day mixed w.narcotic pain relievers lrg doses -hepatoxicity esp. with alcohol overdose antidote: mucomyst/acetylcysteine |
PAD-Pad the tylenol-add the minophen
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2 properties of PADs
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1.analgesic
2.anti-pyretic tylonal - pain and fever |
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Non-Steroidal Anti-Inflammatory Drugs
NSAIDS (non selective) |
non-selective Cox inhibitors
Aleve/ibuprofen/Motrin AIM Block 1 & 2 Cox 4 properties:analgesic, anti-inf.antiplat, anti-py. adverse: GI, PUD, Renal failure, slight bleeding tendencies (better for menstrual cramps) |
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NSAIDS
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4 properties (same as ASA)
anti-inflammatory analgesic anti-pyretic better anti-infl, than ASA, better for sprained ankels, etc anti-platelet (only last as long as it is in bloodstream) |
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Selective Cox inhibitors
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Celebrex/celecoxib
block COX 2 2 properties: analgesic, anti-inflammatory rare side effects have cardiac issues |
Celebrex-
Cox 2, 2 prop., Cardiac issues |
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All NSAIDS are useful in treating
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Rheumatoid arthritis
Menstrual cramps post-op pain |
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Anti-inflammatory
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Selective COX 2 inhibitors (Celebrex/celecoxib) NSAIDS-(AIM)
Salicylates- Aspirin/acetylsalicylic acid |
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non-narcotic analgesic
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ASA
Tylenol/acetymenophen Motrin Aleve ibuprophen Celebrex |
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anti-pyretic
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ASA
Tylenol AIM (aleve,ibuprofen,motrin) |
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anti-platlet
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AIM
ASA |
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NSAIDs
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AIM
Celebrex |
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least effective treating pain from inflammation
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Tylenol
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Most appropriate to prevent heart attacks/strokes
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ASA
blood thinner |
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most effective in treating pain in a chronic inflammatory condition
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NSAIDs- more powerful than ASA & not acidic, less GI problems - if intigent then NSAIDs are expensive so give ASA
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choice to treat headache in alcoholic patient
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NSAIDs
if there is no hepatic problems then could take tylenol |
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choice for a pt with renal failure
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tylenol-affects liver not kidney
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Urinary Tract Analgesics
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Pyridium/phenAZOpyrindine - AZO standard drug ( take with food, drink, milk or after meals)
calms -lidocaine effect no anti-infective property often comb. w/urinary antiseptics like Bactrim (has some pryridium in it) turns urine orange-red, may be mistaken for blood |
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Narcotic Agonist Analgesics
or Opioids - Morphine & demorals |
Morphine/morphine sulfate
actions: relieves pain by binding to opiate receptor sites in the brain and spinal cord, blocks pain alters pain perception causes decreased GI motility (can cause fecal impaction), euphoria, sedation, pupil constriction, drowsiness, respiratory depression (danger below 12 so monitor pt) |
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Opioids-problems
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if on an opioid more than 2 days then pt will need a stool softner, will cause impacts,
watch for physical dependence give high fiber food Morphine one of most difficult drugs to rehab from |
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Give tylenol to child
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tylenol every 4 hrs
motrin every 6 hrs |
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Nursing implications of Opioids
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1.do not admin if resp.<12
2.may cause physical depend. 3.prevent constipation 4.give on fixed sch. or b4 pain is moderate/pca Pump 5.used to treat acute or cancer related pain(most used in patches or PCA pump) 6. overdose is treated w/opioid/narcotic antagonist- Narcan/naloxone |
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Narcan/naloxone
see hint |
1.competes w/Morphine at recepter sites
2.dose may be repeated every 2-3 min 3. contraindicated in persons chemically dependent-causes withdrawal |
Narc-stops Opioids
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Nursing assessments/interventions for Opioids
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1.respirations & vital signs
2.constipation 3.flatulence 4.pain scale 5 or below good |
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Mixed Agonist-Antagonist Opioids
see hint |
Stadol/butorphanol
1.decreases pain w/out respiratory depression and GI effects 2. is not as effective in treating moderate to severe pain as agonists 3. equal in effectiveness to Tylenol/NSAIDs |
Is "stad all?" just 2?-all mixed up
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Anti-anxiety- narcotic analgesic-Opioid
Valium & Dalmine hint |
Class:Benzodiazepine/Valium/
diazepam anti-anx & muscle relax Dalmane should not be used in elderly due to long half-life (pt will sleep long time) most common s.e: Sedation should be D/C slowly |
VD - Valium & Dalmine
Val Dal |
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Barbiturates- narcotic antianxiety - Opioid
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Luminal/pentobarbital
treats anxiety, seizures supresses REM sleep raises seizure threshold less safe than benzodiazepines (Valium)(antianxiety & muscle relaxant used with antidepresants and SSRI's |
barbituates a-luminate your mind
pento-barbit-al |
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Narcotic analgesics - Opioids
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Morphine-pain reliever
Stadal-pain reliever Valium-Benzodiazepine-Dalmine -anti-anxiety Luminal- barbituate Dexadrine-amphetamine |
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Analgesics-Opioids
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main use: pain relief
bind opioid recepters all addictive |
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Amphetamines-narcotic analgesic-opioid
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nervous system stimulant
acts: increases prod. of neuroreceptors (norepinephrine, dopamine, serotonin_ actions: causes euphoria, mental alertness, decreases fatigue, sympathetic NS stimulation causes in adults: hyperactivity, restlessness, agitation, diff. concentrating used to treat: narcolepsy, ADHD, obesity overdose may cause convulsions, increase HR causes in children: sedation Used for ADHD |
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Do not use amphetamines with:
see hint |
MAO inhibitors - blocks the blocker, causes hypertensive crisis, doubles the epinephrine, stimulates sympethetic response which MAO inhibitors break down epinephrine, synergenic response
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Amp cannot play with Maoi, cause Maoi keeps blocking amp, makes him have a adrenaline rush, makes him have a hypertensive crisis, but makes him sympathetic
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Nursing implications of amphetamines
see hint |
1. caffeine is similar w/out extreme
s.e. potentiates (enhances) amphetamines 2.contraindicated if have heart disease, HTN, glaucoma due to its adreneric(mimics norepinephrine-bronchiodilators- nasal decongestants) effects produce tolerance and dependance |
HTN is hypertension
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Contraindicated (amphetamines) with
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MAO inhibitors
decongestants heart failure pts coffee glaucoma pts |
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Psychotropic agents:
Antidepressants |
in general:
1.used to treat depressed mood, feelings of sadness, emotional upset & chronic pain 2. exact cause and cure is unknown 3.depression is attributed to decreased amts of the neurotransmitters norepinephrine and serotonin in the brain and neurotransmitter receptor function (increase) 4. 3 classes -all take 2 wks or more to become theraputic |
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Antidepressants
hint |
Tricyclic agents: Elavil/amitriptyline
SSRIs- Prozac/fluozetine MAO inhibitors St. Johns Wort |
Msst
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Tricyclic agent
see hint |
Elevil/amitriptyline
typical-andrenic uptake inhibitor more side eff. than new agents -used to treat chronic pain s.e.: sedation, orthostatic hypotension, major wgt gain(leds to non-compliance) anticholinergic effects: most serious s.e.: cardiac toxicity/cardiac arrythmias:do EKG b4 admin. lethal overdose w/ 5-10 day supply-do not give many to pt use cautiously w/: sympathomimetics, MAO inhibitors and anticholinergics (antimuscarinic and antinicotinic agents) all synergestic-all cause sympathetic response |
will Elevate you tri-ways
to hang yourself,to have heart problems,to gain wgt--- how typical -reuptake with Eleval and you will have plenty side effects |
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SSRI- Selective Serotonin Reuptake Inhibitors
antidepressant see hint |
Prozac/fluozetine-reuptakes from the synopsys cavity btw the neursotransmitters and receptors to allow serotonin to linger in the synopse cavity longer
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Pro zac dates Sera tonin
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Prozac/fluozetine
antidepressant |
less serious side effects than tricyclics
very effective in treating major depression s.e.: sexual dysfuntions 70%(no1 reason for non-compliance), wgt gain/loss, nausea, headaches, insomnia do not mix w/MAOI |
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Prozac/fluozetine problems
see hint |
Serotonin Syndrome:
usually begins w/first few days of therapy usually caused by drug interactions with other serotonergics/MAOI S&S- ALTERED MENTAL STATUS, INCOORDINATION, FEVER |
Poor(pro) zac he is having problems with Sara Tonin(seretonin)after just a few dates, she is interacting w/Maoi and she altered her state, and became incoordinated
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MAO inhibitors-antidepressant
see hint |
*last ditch effort drug
as effective as other antidepressants but more dangerous often used in atypical depression adverse & main s.e.: CNS stimulation, hypotension (this does not subside), wgt gain, sexual dysfunction do not eat foods containing tyramine will cause hypertensive crisis & watch for OTC drug interactions with decongestants that decrease blood pressure |
Maoi, is depressed and dangerous. his "last ditch effort"caused CNS stimulation, hypotension, & sexual problems, he gained wgt so had to quit eating old foods "with tyramine", that made his bl pressure go hygh.
maybe he will get a cold, the decongestant will make his blood pressure fall. |
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Atypical depression: treated by MAO inhibitors
see hint |
bulimia, panic attacks, obsessive-compulsive disorders
may be given with anti-anxiety |
Maoi can mix with antianna- val and dal
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Tyramine foods not to eat when taking MAO inhibitors
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aged cheeses, red wine, beer, sausages like bologna, pepperoni, salami and aged fish or meat
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St. John's Wort
is an SSRI antidepressant see hint |
adverse eff: photosensitivity, increases the metabolism of many drugs (warfarin/Coumadin, oral contraceptives, antiepilemics) synergenic effects with MAOIs SSRIs, TCAs
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ssri poor old st. john he's depressed
he got a bad sunburn,went to war with coumadin, took birth control pills by mistke, and had an anti-epilemic seizure |
