Term
| Triglycerides and Cholesterol |
|
Definition
two primary forms of lipids in the blood
Water insoluble fats |
|
|
Term
|
Definition
| is the combination of triglyceride or cholesterol with apolipoprotein |
|
|
Term
| VLDL (very low density lipoprotein |
|
Definition
Produced by the liver
Transport endogenous lipids to the cell |
|
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Term
|
Definition
|
|
Term
| HDL high density lipoprotein |
|
Definition
resposible for recycling of cholesterol
also known as Good Cholesterol |
|
|
Term
| The risk of CHD in clients with cholesterol levels of 300 mg/dL is three to four times greater than |
|
Definition
| that in clients with levels less than 200 mg/dL |
|
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Term
|
Definition
| Male 45 yrs. or older HDL of 30 mg, history: DM |
|
|
Term
|
Definition
|
|
Term
| Positive Risk Factors High Blood Cholesterol |
|
Definition
Age
-Male 45 years or older
-Female 55 yrs or older, or women w/ premature menopause not on estrogen replacement therapy
Family history of CHD
Current cigarrete smoker
HTN 140/90 or higher or on HTN meds
Low HDL levels <35 mg/dL
DM |
|
|
Term
|
Definition
1. HMG-CoA reductase inhibitors (HMGs, or statins)
2. Bile acid sequestrants
3. Cholesterol absorption inhibitors
4. Niacin (nicotinic acid/Vit. B3)
5. Fibric acid derivatives |
|
|
Term
| HMG-CoA Reductase Inhibitors (HMGs, or “statins”) |
|
Definition
Most potent LDL reducers
Simvastatin (Zocor)
Atorvastatin (Lipitor)
Usually administer w/ evening meals or h.s.
*Lipitor may be doses any time of day |
|
|
Term
|
Definition
Less than 200 mg/dL Desirable level that puts you at lower risk for coronary heart disease. A cholesterol level of 200 mg/dL or higher raises your risk.
200 to 239 mg/dL Borderline high
240 mg/dL and above High blood cholesterol. A person with this level has more than twice the risk of coronary heart disease as someone whose cholesterol is below 200 mg/dL. |
|
|
Term
|
Definition
Less than 40 mg/dL
(for men)
Less than 50 mg/dL
(for women) Low HDL cholesterol. A major risk factor for heart disease.
60 mg/dL and above High HDL cholesterol. An HDL of 60 mg/dL and above is considered protective against heart disease. |
|
|
Term
|
Definition
Less than 100 mg/dL Optimal
100 to 129 mg/dL Near or above optimal
130 to 159 mg/dL Borderline high
160 to 189 mg/dL High
190 mg/dL and above Very high |
|
|
Term
|
Definition
Less than 100 mg/dL Optimal
Less than 150 mg/dL Normal
150–199 mg/dL Borderline high
200–499 mg/dL High
500 mg/dL and above Very high |
|
|
Term
|
Definition
| between 5 and 30 milligrams per decilite |
|
|
Term
|
Definition
Inhibit HMG-CoA reductase, which is used by the liver to produce cholesterol
Lower the rate of cholesterol production |
|
|
Term
|
Definition
First-line drug therapy for hypercholesterolemia
Treatment of types IIa and IIb hyperlipidemias
Reduce LDL levels by 30% to 40%*
Increase HDL levels by 2% to 15%
Reduce triglycerides by 10% to 30% |
|
|
Term
|
Definition
Mild, Transient GI disturbances
Rash
Headache
Myopathy ->rhabdomyolysis->myoglobinuria -> ARF
Teach client to monitor for muscle pain
Elevation in liver enzymes or liver disease
Monitor LFT's(baseline values & q3months for first year along with cholesterol) |
|
|
Term
|
Definition
Cholestyramine (QUESTRAN)
Colestipol Hydrochloride (Colestid)
Also called bile acid-binding resin and ion exchange resins |
|
|
Term
| Bile Acid Sequestrant: Mechanism of action |
|
Definition
Prevent resorption of bile acids from small Intestine
Bile acids are neccesary for absorption of cholesterol |
|
|
Term
| Bile Acid Sequestrant: Indications |
|
Definition
Type II hyperlipoproteinemia
Relief pruritus associated with partial biliary obstruction (cholestyramine) |
|
|
Term
| Bile Acid Sequestrant: Side effects |
|
Definition
Constipation
Heartburn, nause, belching, bloating (dissapear over time) |
|
|
Term
| Cholesterol Absorption Inhibitor ezetemibe (Zetia) |
|
Definition
First-line drug therapy for hypercholesterolemia
Treatment of types IIa and IIb hyperlipidemias
Reduce LDL levels by 30% to 40%*
Increase HDL levels by 2% to 15%
Reduce triglycerides by 10% to 30% |
|
|
Term
| Cholesterol Abosption Ezetemibe |
|
Definition
Vytorin=simvastatin (Zocor) + ezetemibe (Zetia) COMBINATION DRUG (NEW MEDICATION)
AVAILABLE AS 10/20 mg OR 10/40 mg (Zetia/Zocor) |
|
|
Term
|
Definition
Vitamin B3
Lipid lowering higher dose->vitamin
Efecctive, inexpensive, combine |
|
|
Term
| Niacin: mechanism of action |
|
Definition
Thought to increase activity of lipase, which breaks down lipids
Reduces the metabolism or catabolism of cholesterol and triglycerides |
|
|
Term
|
Definition
Effective in lowering triglyceride, total serum cholesterol, and LDL levels
Increases HDL levels
Effective in the treatment of types IIa, IIb, III, IV, and V hyperlipidemias |
|
|
Term
|
Definition
Flushing (due to histamine release)
Pruritus
GI distress
- Nicortinc Acids can cause pruritus, and cutaneous flushing as an adverse effect.
- To minimize these undesirable effects the nurse should advise the pt. to à take a small dose of aspirin 30 minutes before taking the nicotinic acid. |
|
|
Term
|
Definition
clofibrate
gemfibrozil (Lopid)
fenofibrate (Tricor) |
|
|
Term
| Fibric Acids: M of Action |
|
Definition
Activating lipase
Supress release of free fatty acids from the adipose tissue, and increase the secretion of Cholesterol in the bile |
|
|
Term
| Fibric Acid Derivatives: Indications |
|
Definition
Treatment of types IV and V hyperlipemias
Treatment of types III, IV and V hyperlipidemias |
|
|
Term
| Fibric Acid Derivatives: Side Effects |
|
Definition
Addominal discomfort
Diarreah
Prolonged prothrombin time |
|
|
Term
|
Definition
clofibrate
gemfibrozil (Lopid)
fenofibrate (Tricor) |
|
|
Term
| Nursing Implications with antilipemics |
|
Definition
health and medication history
Assess dietary patterns, exercise levels, w & h, VS, tabacco and alcohol use, family history
Contraindications (liver dysfunctions), drug interactions
Obtain baseline liver function studies
Clients on longer therapy need fat soluble vitamins A, D, K
Take with meals decrease Gi upset
Avoid grapefruit juice: drug interaction
Diet and nutrition counseled
POWDER FORMS MUST BE TAKEN WITH A LIQUID, MIXED BUT NOT STIRRED, AND NEVER TAKEN DRY
Other medication should be taken 1 hour before or 4 to 6 hours after meals to avoid interference with absorption |
|
|
Term
| Nursing Implication with antilipemic agents |
|
Definition
Clofibrate often causes cosntipations, low doses and gradually increase it, take with meals
Several weaks to show effectiveness
Report persistant Gi upset, constipation, abnormal or unusual bleeding, and yellow discoloration of the skin |
|
|
Term
| Coagulation Modifier Agents |
|
Definition
1. Anticoagulants
• Inhibit the action or formation of clotting factors
• Prevent clot formation
2. Antiplatelet drugs
• Inhibit platelet aggregation
• Prevent platelet plugs
3. Anti-fibrolinic agents : Hemostatic agents
• Promote blood coagulation
4. Thrombolytic drugs
• Lyse (break down) existing clots |
|
|
Term
|
Definition
THe process that halts bleeding after injury
substances that promote clot formation and inhibit coagulation or dissolve a formed clot |
|
|
Term
|
Definition
Have no direct effect on a blood clot that is already formed. used prophylactically to prevent:
Clot formation (thrombus)
An Embolus (dislodged clot) |
|
|
Term
|
Definition
| Cascade, each factor activates the next reaction, result is fibrin, intrinsic and extrinsic pathway |
|
|
Term
Anticoagulant:
Mechanism of action |
|
Definition
vary depending on agent
Work on different points of the clotting cascade
Do not lyse existing clots
HEPARIN -> Turns off coagulation pathway and prevents clot formation
WARFARIN (coumadin) |
|
|
Term
| Low molecular weight heparins |
|
Definition
|
|
Term
|
Definition
| Works by inhibiting synthesis of vitamin K by bacteria in the GI tract production of clotting factors (II, VII, IX, and X) are inhibited |
|
|
Term
| USed to prevent clot formation |
|
Definition
MI
Unstable Angine
Atrial Fib
Indwelling devices
Major orthopedic surgeries |
|
|
Term
| Antocoagulants: Side/Adverse Effects HEPARIN |
|
Definition
Monitored by activated APTT's times
Parenteral only
Short life (1-2 hours)
Effects reversed by protamine sulfate |
|
|
Term
| Anticoagulant side/adverse effects |
|
Definition
Bleeding
Nausea, vomiting, abdominal cramps, thrombocytopenia, others |
|
|
Term
Anticoagulants
Low molecular weight lovenox |
|
Definition
& dalteparin (fragmin)
More predictable
Do not require anticoagulant
Given subcutaneously |
|
|
Term
Anticoagulants Warfarin Sodium
Coumadin |
|
Definition
Given orally only
Monitored by PT or INR
Vitamin K can given if toxicity occurs |
|
|
Term
|
Definition
Prevent platelet adhesion
-Aspirin, dipyridamole (persantine)
Inhibit cyclooxygenase pathway
- Pentoxifyline
-Clopidogrel (Plavix) and ticlopidine
New class, ADP inhibitors |
|
|
Term
|
Definition
Antithrombotic effects
- Reduced risk of fatal and nonfatal strokes
Side effects vary |
|
|
Term
|
Definition
Prevents the lysis of fibrir
Promote clot formation
Used for prevention and treatment of excessive bleeding resulting from hyperfibrinolusis or surgical complications
Aminocaproic Acid (AMICAR)
Demopressin (DDAVP) Similar to ADH, in DI |
|
|
Term
| Antifibrinolytic Agents Side effects/adverse effects |
|
Definition
Uncommon and mid
Rare report of thrombotic events
Other: dysrhythmias, orthostatic hypotension, bradycardia, headache, etc |
|
|
Term
|
Definition
agents that break down, or lyse, preformed clots
-Older agents: streptokinase and urokinase
-Newer agents
Tissue plasminogen activator
APSAC |
|
|
Term
| Thrombolytic agents: mechanism of action |
|
Definition
Activete the fibrinolytic sistem to break down the clot in the blood vessel quickly
Activate plasminogen and convert it to plasmin, which can digest fibron
Reestablishes blood flow to the heart muscle via coronary arteries preventing tissue destruction |
|
|
Term
| Thrombolytic agents: indications |
|
Definition
ACUTE MI
Arterial thrombolysis
DVT
Occlusion of shunts or catheters
Pulmonary embolus |
|
|
Term
| Thrombolytic agent: Side and Adverse Effects |
|
Definition
Bleeding, Internal, intracranial, and superficial
Nausea, vomiting, hypotension, dysrhythmias |
|
|
Term
| When administering heparin subq |
|
Definition
| Usea a 25 to 28 gauge needle |
|
|
Term
| Nursing Implications Heparin |
|
Definition
Double checked with another nurse
Ensure SC site, fat subcutaneous areas
Rotate, do not give SC doses within 2 inches of umbilicus, abdominal incisions, or unhealed wounds ( may cause hematoma)
DO NOT Massage injection site
Given by bolus or IV infusions (different tubing)
LABS are done daily APTT
PROTAMINE SULFATE antidote |
|
|
Term
|
Definition
Given subcutaneously in the abdomen
Rotate injection sites |
|
|
Term
|
Definition
May be started while the patient is still on heparin until prothrombin times indicate adequate anticoagulation
Full therapeutic effect takes several days
Monitor PT and PT-INR regularly
Antidote is vitamin K (IM, IV, or PO) |
|
|
Term
| Patient education: anticoagulants |
|
Definition
Education should include:
Importance of regular lab testing
Signs of abnormal bleeding
Measures to prevent bruising, bleeding, or tissue injury
Wearing a medical alert bracelet
Avoiding foods high in vitamin K (tomatoes, dark leafy green veg, bananas, fish)
Consulting physician before taking other meds or OTC products, including herbals |
|
|
Term
|
Definition
Concerns and teaching tips same as for anticoagulants
dipyridamole should be taken on an empty stomach
Nicotine causes vasoconstriction, which alters the effectiveness of antiplatelet agents
Drug-drug interactions
Adverse reactions to report
Monitoring for abnormal bleeding |
|
|
Term
|
Definition
Follow strict manufacturer’s guidelines for preparation and administration
Monitor IV sites for bleeding, redness, pain
Monitor for bleeding from gums, mucous membranes, nose
Observe for signs of internal bleeding (decreased BP, restlessness, increased pulse) |
|
|
Term
| Coagulation Modifier Agents |
|
Definition
Monitor for therapeutic effects
Monitor for signs of excessive bleeding
Bleeding of gums while brushing teeth, unexplained nosebleeds, heavier menstrual bleeding, bloody or tarry stools, bloody urine or sputum, abdominal pain, vomiting blood
Monitor for adverse effects
Increased BP, headache, hematoma formation, hemorrhage, shortness of breath, chills, fever |
|
|
Term
|
Definition
COPD
A. Asthma à pediatrics
B. Emphysema à smoker
C. Chronic bronchitis
Commonality
– Obstruction of air flow |
|
|
Term
|
Definition
COPD
A. Asthma à pediatrics
B. Emphysema à smoker
C. Chronic bronchitis
Commonality
– Obstruction of air flow |
|
|
Term
|
Definition
Narrowed airways due to:
1. Bronchospasm
2. Inflammation of the bronchial mucosa
3. Edema of the bronchial mucosa
4. Production of viscid mucus
5. Wheezing
6. Difficulty Breathing |
|
|
Term
|
Definition
à not reversible, a chronic condition
Destruction of alveolar walls
S/S: respiratory acidosis, clubbing fingers, etc… |
|
|
Term
|
Definition
Continuous inflammation of the bronchi and bronchioles
Primary: smoker or past smoker
Secondary: second hand smoke |
|
|
Term
| Treatment of Diseases of the Lower Respiratory Tract |
|
Definition
Bronchodilators
– Beta Adrenergic Agonists à Epi, Isoprotenol, albuterol
– Anticholinergics à atrovent (prevention, not treatment)
– Xanthine Derivatives à aminophylline (911), theophylline (increase cAMP)
Non-bronchodilating Drugs
– Antileukotrienes à Singular
– Corticosteroids à used to reduce inflammation, along with a bronchodilator in patients with chronic asthma.
Mast cell Inhibitors
– Prevents the release of histamine and leukotrienes
Beta Adrenergic Agonists Bronchodilator
MOA: stimulate beta2 receptors
– Activation of beta2 receptors à bronchodilation
– Activates cAMP,
– Relaxes smooth muscles |
|
|
Term
|
Definition
1. Nonselective adrenergic
Stimulate alpha-, beta1- and beta2- receptors à Ex: epinephrine
2. Nonselective beta-adrenergic
Stimulate beta1- and beta2-receptors à Ex: isoproterenol (Isuprel)
3. Selective beta2 drugs
Stimulate only beta2-receptors. à Ex: albuterol |
|
|
Term
|
Definition
relief bronchospasm
treatment and prophylaxis of acute attacks |
|
|
Term
| Beta Agonist: Side Effects |
|
Definition
Alpha-Beta (epinephrine)
restlessness
anorexia
vascular headache
Hyperglycemia à A diabetic patient with asthma attack, must monitor blood sugar
tremor
cardiac stimulation |
|
|
Term
| Beta Agonist Side effects |
|
Definition
Beta 1 and Beta 2 (Isoproterenol)
cardiac stimulation
tremor
vascular headaches
Hypotension à due to dilation
Anginal pain à due to a Hypoxic state, treatment O2 and Nitro |
|
|
Term
|
Definition
– Expensive
– longer onset, shorter duration
– less active ingredient
– slower therapeutic response
w/ =90 |
|
|
Term
| Beta 2 side Effects Albuterol |
|
Definition
Hypotension (vascular dilation) or HTN
vascular headaches
tremor. Used for most acute asthma attacks
Must assess pulses before administering
albuterol to attain a baseline
w/=120 |
|
|
Term
|
Definition
aminophylline à IV
dyphilline
oxtriphylline
theophylline (Bronkodyl, Slo-bid, Theo-Dur, Uniphyl) à IV, PO
metabolizes caffeine |
|
|
Term
|
Definition
o Increase levels of energy-producing cAMP*( cyclic adenosine monophosphate)
o Inhibits phosphodiesterase (PDE), which breaks down cAMP (result: increase cAMP)
o Result: smooth muscle relaxation, bronchodilation, and increased airflow
o Also cause CNS stimulation |
|
|
Term
|
Definition
dilation of airways in asthmas, chronic bronchitis and emphysema
MIld to moderate cases of acute astma. AMINOPHYLLINE CAN BE USED AS AN IV DRIP FOR STATUS ASTHMATICUS, if pat has not responded to beta 2 meds
adjunt agent int he management of COPD |
|
|
Term
|
Definition
o Nausea, vomiting, anorexia
o Gastro esophageal reflux during sleep
o Sinus tachycardia, extra systole, palpitations, ventricular dysrhythmias
o Transient increased urination
o CNS stimulation |
|
|
Term
| must know with bronchodilators |
|
Definition
High incidence of Drug-Drug and Drug-Food interactions
Teach pts to avoid all caffeine products à CNS stimulation
- Monitor Theophylline levels (10-20 mcg/ dL)
Ex: a trough of: 5mcg à sub-therapeutic, continue drip and call doctor
40 mcg àtoxic levels, discontinue drip and call doctor |
|
|
Term
|
Definition
Epinephrine
2. Albuterol
3. Xopenex |
|
|
Term
|
Definition
avoid caffeine
avoid OTC
Monitor HR |
|
|
Term
|
Definition
Leukotriene receptor antagonists (LRTAs)
Currently available agents
montelukast (Singulair)
zafirlukast (Accolate)
zileuton (Zyflo) |
|
|
Term
| Antileukotrienes: Mechanism of Action |
|
Definition
released in response to a trigger
Cause
o Inflammation
o Bronchoconstriction
o Mucus production
Result: coughing, wheezing, shortness of breath
agents prevent leukotrienes from attacking to receptors |
|
|
Term
|
Definition
Prevent smooth muscle contraction
Decrease mucus secretion
Prevent vascular permeability
Decrease neutrophil and leukocyte infiltration
Preventing inflammation |
|
|
Term
| Antileukotrienes: Indications |
|
Definition
Prophylaxis and chronic treatment of asthma
NOT meant for management of acute asthmatic attacks
Montelukast approved for use in children ages 2 and olderà Singulair |
|
|
Term
| Antileukotrienes: Nursing Implications |
|
Definition
| asses liver functionavoid tylenol and alcohol use |
|
|
Term
|
Definition
Anti-inflammatory
Used for chronic asthma
Do not relieve symptoms of acute asthmatic attacks
Oral or inhaled forms
Inhaled forms reduce systemic effects
May take several weeks before full effects are seen |
|
|
Term
| Corticosteroids: Mechanism of Action |
|
Definition
Stabilize membranes of cells that release harmful bronchoconstricting substances
Increase responsiveness of bronchial smooth muscle to beta-adrenergic stimulation |
|
|
Term
| Corticosteroids indications |
|
Definition
Treatment of bronchospastic disorders not controlled by conventional bronchodilators
NOT considered first-line agents for management of acute asthmatic attacks or status asthmaticus |
|
|
Term
| nursing implications with corticosteroids |
|
Definition
Contraindicated in clients with psychosis, fungal infections, AIDS, TB à immunocompromised
Cautious use in clients with diabetes (monitor blood sugar for hyperglycemia), glaucoma, osteoporosis, PUD, renal disease, HF, edema
Teaching
– Gargle and rinse mouth with water afterward
DO NOT STOP ABRUPTLY
– Wean for 1 to 2 weeks, if stopping recommended by physician
– Report any weight gain, or occurrence of chest pain |
|
|
Term
|
Definition
long term maintenance
cromolyn
stabilize membrane of mast cells
dry mouth
Need good oral hygiene and good nutrition |
|
|
Term
|
Definition
| Spacers creates a better seal with the mouth |
|
|
Term
|
Definition
TB
Mycobacterium tuberculosis
treat all form of mycobacterium
gain entry into the body by inhalation
Tubercle bacilli spread to other organs via blood and lymphatic system, may become dormant or walled off by calcified or fibrous tissue |
|
|
Term
|
Definition
If the 1st doesn’t work, they will add a 2nd line agent.
OR
Treat active TB with 2 agents for severe cases. |
|
|
Term
|
Definition
isoniazid INH severely hepatotoxic ***
ethambutol
pyrazinamide PZA
rifampin: not as toxic on the liver |
|
|
Term
|
Definition
Capreomycin
cycloserine
ethionamide
kanamycin
para-aminosalicyclic acid |
|
|
Term
|
Definition
1. Protein wall synthesis inhibitors (streptomycin, kanamycin, capreomycin, rifampin)
2. Cell wall synthesis inhibitors (cycloserine, ethionamide, isoniazid)
3. Other mechanisms of action |
|
|
Term
|
Definition
Drug of choice for TB
Resistant strains of Mycobacterium emerging
Metabolized in the liver through acetylation—watch for “slow acetylators”
Used alone or in combination with other agents
Indications: used for prophylaxis or treatment of TB
liver function test 1st baseline them repeat q3 months |
|
|
Term
| Antibercular therapy effectiveness dependsn on |
|
Definition
• Type of infection (where in the body)
• Adequate dosing
• Sufficient duration of treatment
• Drug compliance
• Selection of an effective drug combination (1st vs. 2nd) |
|
|
Term
|
Definition
• INH à Peripheral neuritis, hepatotoxicity
o Treatment à Vitamin B6, monitor liver function, assess for jaundice |
|
|
Term
|
Definition
Hepatitis, discoloration of urine, stools
o Teach patients about stool color (reddish/orange is normal)
o Not as hepatotoxic as INH |
|
|
Term
|
Definition
lenght of therapy 6 months to a year
pt become non contagious after 2-3 weeks of therapy
diabetic watch hyperglycemia
USE CONDOMS
Rifampin causes urine, stool, saliva, sputum, sweat, or tears may become reddish orange
Pyridoxine may decrease neurologic side effects associated with INH therapy à Treat w/ Vitamin B6 |
|
|
Term
| antihistamines paradoxical efffects |
|
Definition
| opposite effect of sedation:"hyperactivity in children and the elderly |
|
|
Term
|
Definition
o Relieve nonproductive or harmful cough
o A harmful cough in patients that are post-op retinal surgery or post- hernia repair. |
|
|
Term
Antitussives: mechanism of action
Opioids |
|
Definition
Act by suppressing cough reflex in the cough center in the medulla
Examples:
o codeine (Robitussin A-C, Dimetane-DC)
o hydrocodone = C
o Remember: opioids can cause constipation and sedation
Nonopioids |
|
|
Term
|
Definition
Numbing stretch receptors in the respiratory tract, prevents stimulation of cough center
o benzonatate (Tessalon Perles)
o dextromethorphan (Vicks Formula 44, Robitussin-DM) |
|
|
Term
|
Definition
o Definition à cough up and spit out
o guaifesin (Robitussin)
Action
o Decrease viscosity of respiratory secretions à liquefies mucous
MUCINEX |
|
|
Term
|
Definition
Large and chemically diverse group of drugs with the following properties:
Analgesic
Antiinflammatory
Antipyretic
Antirheumatic |
|
|
Term
|
Definition
—treatment of headaches, mild to moderate pain, and inflammation
Block the chemical activity of either or both COX enzymes (prostaglandin [PG] pathway) and lipoxygenase (LT pathway)
Result: limits the undesirable inflammatory effect of PGs |
|
|
Term
|
Definition
reduce fever
Inhibit prostaglandin E2 within the area of the brain (HYPOTHALAMUS) that controls temperature |
|
|
Term
|
Definition
| inhibit platelet aggregation |
|
|
Term
| Salicylates seven structurally related groups |
|
Definition
1. Acetic acids à INDOCIN,
2. Carboxylic acids (salicylates)
Acetylated à ASPRIN
Nonacetylated à TORADOL
3. Propionic acids à IBUPROFEN (MOTRIN, ADVIL, ETC…)
4. COX-2 inhibitors à CELEBREX
5. Fenamic acids
6. Napthylalkanones (nonacidic)
7. Oxicams |
|
|
Term
|
Definition
diclofenac sodium (Voltaren)
diclofenac potassium (Cataflam)
indomethacin (Indocin)
sulindac (Clinoril)
tolmetin (Tolectin |
|
|
Term
|
Definition
|
|
Term
|
Definition
| toradol, very good pain reliever for pts with opiod drug addictions |
|
|
Term
|
Definition
fenoprofen (Nalfon)
flurbiprofen (Ansaid)
ibuprofen (Motrin, Advil, others) ***PROTOTYPE***
ketoprofen (Orudis)
naproxen (Naprosyn)
oxaprozin (Daypro |
|
|
Term
|
Definition
celecoxib (Celebrex)
Developed primarily to decrease GI adverse effects associated with NSAIDS
Population that would benefit from COV-2 inhibitor
Elderly
History of peptic ulcers
History of gastritis |
|
|
Term
|
Definition
Specifically inhibits the COX-2 enzyme involved in the inflammatory process
This greater enzyme specificity allows for the beneficial anti-inflammatory effects while reducing the prevalence of GI ulceration associated with traditional /nonspecific NASIDs |
|
|
Term
|
Definition
| Osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, and primary dysmenorrhea |
|
|
Term
|
Definition
| should not be used in clients with known sulfa allergy |
|
|
Term
| NSAIDS salicylates aspirin |
|
Definition
| More potent effect on platelet aggregation and thermal regulatory center in the brain ***FEVER AND ANTI-COAGULATION*** |
|
|
Term
|
Definition
Patients must discontinue use of aspirin 7-10 days prior to surgery
To prevent gastric mucosal injury while taking NSAIDS for long periods, it should be paired with CYTOTEC- an anti-ulcer agent. ** |
|
|
Term
|
Definition
1. Underexcretion of uric acid
2. Overproduction of uric acid
• Uric acid crystals are deposited in tissues and joints, resulting in pain |
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Term
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Definition
allopurinol (Zyloprim)
Used to reduce production of uric acid
Reduces inflammatory response to the deposits of urate crystals |
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Term
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Definition
colchicine (Colcrys)
Indication
Acute attacks of gouty arthritis
Recommended for short-term use only
Take on empty stomach – 1hr before or 2hrs after meal |
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Term
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Definition
Monitor for:
1. Leukopenia
2. Bleeding in the GI or GU tract – drug should be stopped should such appear & physician notified
Contraindicated for client with
Known hypersensitivity to this drug
Blood dyscrasias, severe renal, GI, CV, or hepatic disorders |
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Term
| cytoprotective/antiulcer agent |
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Definition
misoprostol (Cytotec)
Synthetic prostaglandin E-1 analogue
Mechanism of Action – unclear
Believe to inhibit gastric acid secretion thus preventing gastric mucosal injury in clients taking NSAIDs |
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Term
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Definition
Renal
Reductions in creatinine clearance
Acute tubular necrosis with renal failure
Gastrointestinal
Dyspepsia, heartburn, epigastric distress, nausea
– GI bleeding*
– Mucosal lesions* (erosions or ulcerations)
*misoprostol (Cytotec) can be used to reduce these dangerous effects
Cardiovascular
Noncardiogenic pulmonary edema |
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Term
| NSAIDS salicylate toxicity |
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Definition
Adults: tinnitus and hearing loss
Children: hyperventilation and CNS effects
Effects arise when serum levels exceed 300 mcg/mL
Metabolic acidosis and respiratory alkalosis may be present |
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