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antiinflammatory drugs
chapter 25 antiinflammatory
66
Pharmacology
Undergraduate 4
04/10/2014

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Term
is an inflammation always an infection?
Definition
no
Term
is an there always inflammation in an infection?
Definition
yes
Term
what are the 5 cardinal signs of inflammation
Definition
heat, redness, edema, pain and loss of function
Term
what are some of the chemical mediators?
Definition
histamines, kinins and prostaglandins
Term
what is the first chemical mediator of inflammation?
Definition
histamine
Term
what are cyclo-oxygenase enzymes?
Definition
they convert arachidonic acid into prostaglandins
Term
what are the antiinflammatory drug groups?
Definition
nonsteroidal antiinflammatory drugs (NSAIDs), corticosteroids, disease-modifying antirheumatic drugs and antigout drugs
Term
What do NSAIDs do?
Definition
they Inhibit biosynthesis of prostaglandins
Analgesic effect
Antipyretic effect
Inhibit platelet aggregation
Mimic effects of corticosteroids
Term
what is NSAIDs action?
Definition
inhibit COX enzyme and inhibit prostaglandin synthesis
Term
what are NSAIDs used for?
Definition
they are used to reduce inflammation and pain.  they are not recommended for fever or headaches
Term
what are first-generation NSAIDs?
Definition
salicylates (aspirin), Parachlorobenzoic acid
Pyrazolone derivatives
Propionic acid derivatives
Fenamates
Oxicams
Phenylacetic acid derivatives
Term
what is the perferred drug for gout?
Definition
indomethacin (indocin) a para-cholorbenzoic acid
Term
what are second-generation  NSAIDs?
Definition
COX-2 inhibitors
Term
what is the action of aspirin and what group of first generation NSAIDs does it belong to?
Definition
it is aan acetylsalicylic acid (ASA) and its actions are antiinflammatory, antiplatelet and tipyretic effects
Term
what is the therapeutic serum salicylate leve.?
Definition
10-30 mg/gl
Term
what is a toxic serum salicylate level?
Definition
more than 30 mg/dl
Term
what is the first sign of ASA overdose
Definition
tinnitus
Term
what is the chemical name of ASA?
Definition
acetylsalicylic acid
Term
is there a risk of GI bleeding with ASA and NSAIDs
Definition
yes
Term
what levels do you check on PT and INR?
Definition
with coumadin
Term
what does PT stand for?
Definition
Protime
Term
what does INR stand for?
Definition
international ratio
Term
what are the drug interactions with salicylates?
Definition
Increase anticoagulation, hypoglycemia, increase gastric ulcer risk with glucocorticoids
Term
what are some lab results that you can look for with salicylates?
Definition
Increase PT, bleeding time, INR, uric acid
Decrease potassium, cholesterol, T3 and T4 levels
Term
what are some foods that contain salicylates?
Definition
prunes, raisings, licorice, and certain spices (paprika)
Term
what do pregnant woman usually take ASA for?
Definition
antiphopholipid disorder
Term
what are caustions with aspirin?
Definition
Do not take with other NSAIDs
Avoid during third trimester of pregnancy
Do not give to children with flu or virus symptoms (Reye’s sydrome)
Term
what are some side effects/adverse reactions with salicylates?
Definition
Tinnitus, peptic ulcer
Thrombocytopenia, leukopenia, agranulocytosis
Hepatotoxicity
Term
what is the ASA triade?
Definition

ASA sensitivity

polyps in the nose and asthma

Term
what is an example of propionic acid derivatives?
Definition
ibuprofen
Term
what is ibuprofens?
Definition
it is a nonselective COX inhibitor
Term
what are some of the drug interactions of iburprofen?
Definition
increases effects of warfarin and phenytoin
Term
what are side effects of ibuprofens?
Definition
GI diestress (take with food)
Term
what is another example of a propionic acid?
Definition
naproxen (naprosyn)
Term
what is the action of COS-2 inhibitors?
Definition
 selectively inhibits COX-2 enzyme without inhibition of COX-1
Term
what are COX-2 uses?
Definition
decreases inflammation and pain
Term
what drug should be avoided with liver pain?
Definition
ibuprofen
Term
what drug should be avoided with liver problems?
Definition
tylenol
Term
what are some drug agents of COX-2 inhibitors?
Definition
celecoxib (celebrex), nabumetone (relafen) and meloxicam (mobic)
Term
what is celebrex used for?
Definition
rheumatoid arthritis and for people who can't use ibuprofen
Term
what are some side effects of COX-2 inhibitorss?
Definition
Mild: headache, dizziness, nausea, diarrhea, sinusitis, peripheral edema
Assess renal function and GI status
Term
what are DMA drugs used for?
Definition
immunosuppresive agents
Term
what types of DMAs are there?
Definition
Gold drug therapy (chrysotherapy)
Immunosuppressive agents
Immunomodulators
Antimalarials
Term
what are is a gold drug therapy?
Definition
auranofin (ridaura)
Term
what is the action of gold drug therapy?
Definition
Decreases leukocytes migration
Suppresses prostaglandin activity
Stops progression of joint degeneration
Term
what is gold drug therpay used for?
Definition
rheumatoid arthritis
Term
what are side effects/adverse reactions with gold drug therapy?
Definition
tomatitis, photosensitivity, metallic taste, severe rash
Corneal gold deposits, bradycardia, profound hypotension
Hematuria, proteinuria
Nephrotoxicity, agranulocytosis, thrombocytopenia
Term
what are some contraindications with gold drug therapy?
Definition
Severe renal or hepatic disease
Pregnancy, blood dyscrasias, colitis
Systemic lupus erythematosus
Term
when do you use immunomodulators?
Definition
when DMAs don't work
Term
what are immunomodulators?
Definition
Tumor necrosis factor (TNF) blockers
Term
what are some examples of immunomodulators
Definition
Entanercept (Enbrel)
Infliximab (Remicade)
Adalimumab (Humira)
Term
what are the actions of immunomodulators?
Definition
Neutralize TNF
Disrupt inflammatory process
Delay disease progression
Used for rheumatoid arthritis
Term
what are side effects/adverse reactions with the immunomodulators infliximab (remicade)?
Definition
Headache, dizziness, chills, hot flashes, depression, nausea, vomiting, diarrhea, urinary frequency
Hypotension, hypertension, altered liver enzymes, severe infections
Term
what are condraindicaitons with immunomodulators?
Definition
Renal or hepatic disease
Immunosuppression, infection
Term
what are the different types of gout?
Definition
uric acid crystals gout  and psuedo gout
Term
what is gout?
Definition
Inflammatory disease of joints, tendons
Usually occurs in great toe
Defect in purine metabolism leads to uric acid accumulation
Purine-containing foods: salmon, liver, sardines
Term
what are some antigout drugs?
Definition
Colchicine
Uric acid inhibitors
Uricosurics
Term
what does colchine (antigout drug) do?
Definition
inhibits migration of leukocytes to inflammed site
Term
what are the side effects of antigout drugs?
Definition
N, v, d, abdominal pain
Term
should antigout be taken with food or without food?
Definition
with food to avoid GI distress
Term
what are some contraindications with colchicine?
Definition
Severe renal, cardiac, or GI problem
Term
what does allopurinol (zyloprim) do?
Definition
Decreases uric acid levels
Prophylactic to prevent gout attacks
Term
what are nursing interventions with allopurinol (zyloprim)?
Definition
Monitor CBC, liver enzymes, renal function
Yearly eye exams for visual changes
Client to avoid alcohol, caffeine, and thiazide diuretics that increase uric acid level
Increase fluid intake to increase uric acid excretion
Term
what is the action of probenecid (benemid)?
Definition
Blocks reabsorption of uric acid and increases uric acid excretion
Term
what are the side effects of probenecid (benemid)?
Definition
Gastric irritation; take with food
Term
what are nursing interventions for probenecid (benemid)?
Definition
Not to be given with other highly protein-bound drugs
Increase fluid intake to increase uric acid excretion
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