Term
| What are the roles of Prostaglandins? |
|
Definition
GI Protection
Renal Protection
Uterine Contractions
Pain
Inflammation at Tissue Level |
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|
Term
|
Definition
| inhibits cyclooxygenase and blocks prostaglandins |
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Term
| Whats the difference between nonselective NSAIDS and COX2 inhibitors? |
|
Definition
| Nonselective NSAIDS are the first generation NSAIDS that inhibit BOTH COX 1 and COX 2 while COX2 inhibitors are the second generation NSAIDS that only inhibit COX2 |
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Term
| What are the effects of blocking COX 2? |
|
Definition
| prevention sensitization of pain receptors, Lower body temperature and prevention of inflammation |
|
|
Term
| What are the effects when you block COX 1? |
|
Definition
| Prevent platelet aggregation |
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|
Term
|
Definition
| Moderate pain, sunburn, fever, arthritis pain, menstrual cramping, headach, orthopedic injuries (fractures, sprains, tendonitis), dental pain, postpartum pain |
|
|
Term
| Aspirin (ASA) Mechanism of action |
|
Definition
Blocks formation of prostaglandins
--irreversible inhibition of COX
(other NSAIDS are not irreversible inhibitors) |
|
|
Term
|
Definition
| Relieve fever, pain, and inflammation |
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Term
| What is low dose Aspirin used for and what is the dosage? |
|
Definition
(less than 2g a day)
Used for pain, inflammation, and mild fever |
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|
Term
| What is the dosage and use for high dose Aspirin? |
|
Definition
(2-4 grams/day)
Used for Rheumatoid Arthritis |
|
|
Term
| What is the prophylactic Aspririn dosage and use? |
|
Definition
(80-235mg)
Used to prevent MI
--treatement of acute MI - 2 chewable aspirins |
|
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Term
| What is Salicyclism and what should the nurse assess? |
|
Definition
Aspirin is derived from salicyclic acid which can result in acid-base disorders in excess dose causes respiratory alkalosis. (salicyclism)
Nurse should asses for tinnitus and ototoxicity |
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|
Term
| What is the mechanism of action for TYLENOL (Acetaminophen) |
|
Definition
| Inhibits prostaglandin synthesis in the CNS |
|
|
Term
| What is TYLENOL used for? |
|
Definition
antipyretic and analgesic properties;
(1 gram dosage treats mor mild to moderate pain)
--drug of choice for mild pain and fever
--combined with opiods (codeine or hydrocodone) to provide analgesia
--CATEGORY B for pregnancy |
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|
Term
| How dose tylenol differ fron NSAIDs? |
|
Definition
Not linked to Reyes Syndrome (can give to as young as 3 months old)
weak antiiflammatory properties |
|
|
Term
| What increases risk for toxicity with Acetaminophen? |
|
Definition
combination products containing Tylenol plus Tylenol itself increases the risk of toxicity. Tylenol is used in more combination products than any other drug.
-Alcohol. |
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|
Term
| What does Acetaminophen toxicity look like? |
|
Definition
0-24 hours--Nausea/Vomitting
24-72 hours--RUQ pain
72 hours and beyond--Hepatic failure, bleeding, other organ failure
(Hepatic Necrosis in 72 hours) |
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|
Term
| What is the antidote for Acetominophen toxicity? |
|
Definition
| Mucomyst (acetylcysteine) PO or Acetadote IV |
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Term
| What are the Opiod receptors and what does each do when activated? |
|
Definition
(Mu and Kappa)
Mu activation leads to analgesia, sedation, decreased GI motility, euphoria, respiratory depression, physical dependence
Kappa activation leads to Analgesia, Sedation and Decreased GI motility, or constipation. |
|
|
Term
| Why are Mu receptors more dangerous to activate? |
|
Definition
| Cause CNS depression (Respiratory depression) |
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Term
| What is the most common full-agonist opiod and what is it used for? |
|
Definition
Morphine. Used for
-severe pain
(postop pain, chronic cancer pain, pain associated with MI, pain related to trauma.
-Most effective against dull constant pain( visceral pain) |
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|
Term
| What is the Mechanism of action of full agonist Opiods? |
|
Definition
| vasodilation-- decreases preload and afterload, decreases demand on the heart. |
|
|
Term
| What is a PCA pump and why is it used? |
|
Definition
Patient Controlled Analgesia
--used in hospitals for patients to receive quick and effective pain relief via IV and a button that is either controlled with a timer or by continuous infusion |
|
|
Term
| How fast can you push morphine and other opiods? |
|
Definition
slow push.
(4-5 minutes for 10 mg dose, anything under 10 mg is 2-3 minutes) |
|
|
Term
| Should patients with opiods addiction receive opiods? |
|
Definition
| Yes, if trauma trumps addiction. |
|
|
Term
| What are the CNS side effects of Opiods? |
|
Definition
| can cause CNS/Respiratory depression.. |
|
|
Term
| What are BP side effects of Opiods? |
|
Definition
| Hypotension due to increased vasodilation-- can lead to shock due to tachycardia. |
|
|
Term
| What are the GI side effects of Opiods? |
|
Definition
| constipation-- increased strain increases pain |
|
|
Term
| Why is itching a side effect of Opiods? |
|
Definition
Opiods are histamine-mediated.
The release of histamine causes itching. |
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|
Term
| Drug interactions with Opiods |
|
Definition
| SSRIs and MAOIs can cause serotonin syndrome. |
|
|
Term
| What is unique about meperidine? |
|
Definition
Demerol is a prodrug that is renally eliminated. It is a toxic metabolite that can stay in the body a a long time causing confusion, renal dysfxn, seizures, tremors, and irritability.
it is the drug of choice in healthcare workers that are opiod addicted and does not affect the pupils. |
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|
Term
| What is the opiod antidote? |
|
Definition
| Narcan (naloxone) which is a narcotic antagonist given IV push 0.4 mg. |
|
|
Term
| Why cant we use partial opiods in opiods-dependent patients? |
|
Definition
| If given to someone physically dependent to pure opiod agonist, can PRECIPITATE WITHDRAWAL |
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