Pharm II - Exam #2

s/s of inflammation

redness, swelling, heat, pain, loss of function

COX 1 & 2

COX-1: GOOD, protects stomach lining, regulates normal blood platelets

COX-2: BAD (NSAIDs inhibit COX enzyme needed for PG biosynthesis)

aspirin class & use

NSAID, salicylates

mild-to-mod pain, fever, prevent MI, arthritis

aspirin moa

inhibit biosynthesis of prostaglandins (cox 1& 2)

anti-inflam, anti-platelet, anti-pyretic

aspirin se

GI distress, ulceration, bruising, BLEEDING, REYE’S SYNDROME

Reye’s Syndrome

swelling of brain and liver damage

don’t take w other NSAIDs, no pregnancy, do not give to children w flu or virus symptoms

s/s changes in consciousness, seizures, lethargy

aspirin nsg con

bleeding precautions, assess s/s of bleeding

s/s of Reye’s Syndrome

overdose can cause metabolic acidosis (get sodium bicarbonate)

mon LFTs

stop taking 1 wk to surgery unless taken for cardiac reasons (talk to cardiologist)

enteric coats = no chewing

ibuprofen class & use

NSAID

pain, osteothritis, rheumatoid arthritis

ibuprofen moa

inhibits PG synthesis

ibuprofen se

GI distres, bleeding, tinnitus

ibuprofen nsg con

s/s bleeding (bleeding gums, petechiae, ecchymosis, black tarry stools)

report if pt has GI discomfort

may take several weeks to work, but if not at 3+ wks means change meds

no anticoag, no alcohol

read over labels well

infliximab class & use

immunomodulator, DMARD

rheumatoid arthritis, psoriatic arthritis, psoriasis, spondylitis ulcerative colitis, Crohn’s disease

infliximab moa

neutralize TNF, disrupt inflam process, delay disease progression

infliximab se

neutropenia, infection, malignancy, leukemia, immunosuppression!

infliximab nsg con

neutropenic precautions

mon CBC frequently

mon fever, chills, hives up to 2 hrs after infusion

mon for opportunistic infections like TB

mon skin for rashes

pain is a ——

fifth vital sign.

it should be assessed before, during, and after pain med is given

acetaminiphen class & use

nonopioid analgesic

muscular aches and pain fever

acetaminiphen moa

inhibits PG synthesis

acetaminiphen se

insomnia, headache, fatigue, constipation

hepatotoxicity, renal failure, blood dyscrasias, hearing loss

acetaminiphen nsg con

max dose 4g/day bc of liver toxicity risk

check LFTs

no alcohol!!!

w anticoag = bleeding risk

antidote: acetylcysteine

morphine class & use

opioid analgesic

mod-to-severe pain, acute pain, acute MI

morphine moa

act on CNS by suppressing pain impulses, respiration, and coughing

morphine se

n/v, constipation, urinary retention, generalized itching (by itself isn’t an allergy)

orthostatic hypotension, resp dep!

morphine nsg con

full vital before & after (30 min) given

first-timers need closer monitoring & lower dosing

MONITOR RESPIRATORY! cont pulse ox

have narcan near

give w zofran to lower n/v

no alcohol & no other CNS depressants

assess bowel function for constipation (esp in geriatrics). inc fluids & fibers

mon dependence & abuse & withdrawl

full pain assessment

OLDCART: onset, location, duration, characteristics, aggravating factors, relieving factors, timing

OPQRST: onset, palliation, quality, region, severity, timing

Peds: FLACC Scale (face, legs, activity, cry, consolability), Wong Baker Face Scale

Adults use 0-10 pain scale: Severe 8-10, mod 4-7, mild 1-3, none 0

sumatriptan class & use

selective serotonin 1 receptor agonist

tx acute migraine & cluster headaches

sumatriptan moa

coronary vasoconstriction

sumatriptan se

coronary vasospasms, EKG changes

changes in vision, tingling/warm sensation, dizziness

sumatriptan nsg con

assess freq, duration, and scale of migraine

assess migraine triggers and avoid them (diary)

contraindicated w hx of heart disease

TAKE AT FIRST SIGN not a preventative

non-pharm tx

rule out MI

non-pharm tx of migraines

dark quiet place

caffeine and aspirin = lack of caffiene can trigger headaches

newly diagnosed migraines = keep track of triggers in diary to see patterns

isoniazid class & use

isoniazid moa

isoniazid se

isoniazid nsg con

nystatin class & use

isoniazid moa

isoniazid se

isoniazid nsg con

nystatin class & use

nystatin moa

nystatin se

nystatin nsg con

acyclovir class & use

acyclovir moa

acyclovir se

acyclovir nsg con

hydroxychloroquine class & use

antimalarial

refractory rheumatoid arthritis

hydroxychloroquine moa

hydroxychloroquine se

hydroxychloroquine nsg con

ivermectin class & use

ivermectin moa

ivermectin se

ivermectin nsg con

metronidazole class & use

metronidazole moa

metronidazole se

metronidazole nsg con