NURS 220: Anti-inflammatory RX Review

Flashcards generated to help review key concepts, drug classifications, mechanisms of action, adverse effects, and nursing implications related to anti-inflammatory medications (NSAIDs and Aspirin) from the NURS 220 lecture notes.

What is the primary purpose of inflammation?

To destroy, dilute, or wall off (sequester) both the injurious agent and the injured tissue.

Name some endogenous compounds involved in inflammation.

Proteins of the complement system, histamine, serotonin, bradykinin, leukotrienes, and prostaglandins.

What are the two primary pathways through which arachidonic acid mediates inflammatory reactions?

Leukotriene pathway and Prostaglandin pathway (Cyclooxygenase).

What are the functions of COX-1 in the Arachidonic Acid Pathway?

Platelet aggregation and vasoconstriction, contributing to inflammation.

What are the functions of COX-2 in the Arachidonic Acid Pathway?

Vasodilation, platelet inhibition, leading to inflammation, pain, and fever.

How do NSAIDs generally exert their mechanisms of action?

By inhibiting the leukotriene pathway, prostaglandin pathway, or both, and by blocking the chemical activity of COX enzymes.

What are the four main therapeutic effects of NSAIDs?

Analgesic, anti-inflammatory, antipyretic, and platelet inhibition.

What is the role of COX-1.

It plays a role in maintaining the gastrointestinal (GI) mucosa Housekeeping” prostaglandins (stomach, kidneys, platelets)

How does COX-1 inhibition by NSAIDs lead to peptic ulcers and GI bleeding?

By decreasing gastric protection, mucus secretion, bicarbonate, and mucosal blood flow.

How can NSAIDs lead to sodium and water retention, and potentially hypertension or kidney injury?

By inhibiting COX, they affect the afferent arteriolar vasodilation (GFR) and sodium/water excretion in the kidneys.

What is the cardiovascular risk associated with COX-2 inhibition by NSAIDs?

It can lead to an increased risk of stroke and myocardial infarction by affecting vascular vasodilation (PGI2) and platelet vasoconstriction (TXA2).

Which NSAID chemical category includes Aspirin?

Salicylates.

What is the primary action of Aspirin (ASA) related to pain and fever?

It inhibits the synthesis of prostaglandin, which reduces pain and fever.

What is the antithrombotic action of Aspirin?

It inhibits COX-1 receptors within platelets, which inhibits platelet aggregation.

Why should Aspirin be avoided in children and teenagers?

Due to the high risk of Reye's Syndrome if they have a viral illness.

What are common symptoms of salicylate toxicity (salicism)?

Increased heart rate, tinnitus, hearing loss, dimness of vision, headache, dizziness, mental confusion, drowsiness, nausea, vomiting, diarrhea, sweating, thirst, hyperventilation, and hypo- or hyperglycemia.

For what duration is Ketorolac (Toradol) typically prescribed?

Short-term use, up to 5 days, to manage moderate to severe acute pain due to concerns about severe renal and gastrointestinal effects.

What is the primary indication for Celecoxib (Celebrex)?

Osteoarthritis, rheumatoid arthritis, acute pain symptoms, ankylosing spondylitis, and primary dysmenorrhea.

What is a key contraindication for Celecoxib (Celebrex) related to allergies?

It should not be used in patients with a known sulfa allergy.

Which propionic acid derivative is the most commonly used NSAID?

Ibuprofen (Motrin, Advil).

What is the black box warning associated with all NSAIDs (except aspirin)?

An increased risk of adverse cardiovascular thrombotic events, including fatal MI and stroke.

What substance can be given with NSAIDs to reduce the risk of dangerous GI side effects like stomach ulcers?

Misoprostol (Cytotec), a synthetic prostaglandin.

What is a critical warning regarding Misoprostol (Cytotec) use during pregnancy?

It should not be taken during pregnancy as it may cause abortion, premature birth, or birth defects.

What are important nursing implications for administering NSAIDs regarding GI distress?

They are often better tolerated if taken with food, milk, or an antacid to avoid irritation.

What kind of bleeding should patients on NSAIDs be advised to watch for?

Any unusual bleeding, such as blood in the stool.

In an 82-year-old taking ibuprofen for arthritis, what is the most important assessment for the nurse to monitor?

Renal function studies, due to the NSAID's potential for renal impairment, especially in older adults.

How do Norco and Vicodin differ in their composition and acetaminophen content?

Norco (e.g., 10mg/325mg APAP) has a higher proportion of hydrocodone to acetaminophen compared to Vicodin (e.g., 5mg/500mg APAP).

Does acetaminophen reduce inflammation or affect platelets?

No, acetaminophen does not reduce inflammation and has no effect on platelets; it is primarily an analgesic.

A patient with salicylate toxicity exhibits which manifestation?

Altered hearing (tinnitus/hearing loss).

What is Reye’s syndrome?

A rare, life-threatening condition in children/teens, linked to aspirin use during viral illness. Causes liver damage (fatty changes) and brain swelling (encephalopathy) → symptoms include vomiting, confusion, seizures, coma.