Drugs for treating inflammation

Medication either has ___________ or ___________ effect on inflammation

Direct or Indirect

NSAIDS have secondary effects such as

While aspirin has a _____________ secondary effect

Analgesic - pain redux

Antipyretics - fever redux

Anticoagulant

NSAIDs mechanism is to decreased ______________ production by inhibiting __________

Prostaglandin

COX 1 or 2

COX 2 activity is in response to -

COX 1 inhibition is linked to -

pain or inflammation

GI effects

How do AT's go about selecting the BEST NSAID?

Trial & Error, there are no guidelines for which NSAID is the best

How does selection of NSAID's go?

Experience of physician

Patient preference

Age of patient

Cost

Duration of treatment

Adverse effects

T/F: in the 2016 Rio Olympics, dosages were typically 30-50% higher than recommended for NSAID use

True

T/F: Avoid taking NSAIDs with food

False - take with food or milk

Why must we take NSAID's with food?

Prevent adverse effects of GI symptoms of the 1-2% chance for a peptic ulcer to develop

Aspirin

Dosage =

Use =

Adverse effects =

325mg is regular

500mg is extra strength

Anti-inflam, Anti-pyretic, analgesic, anticoagulant

N&V, Stomach pain, heartburn, hives/rash, Reye's syndrome

Ibuprofen

Dosage =

Use =

Adverse effects =

200-400mg every 4-6 hours

Anti-inflam, anti-pyretic, analgesic, peak is w/in 15-30mins

Constipation, diarrhea, gas, dizziness, tinnitus

Naproxen Sodium

Dosage =

Use =

Adverse effects =

220mg every 8-12hrs

Anti-inflam, anti-pyretic, analgesic

Constipation, gas, diarrhea, thirst, HA, Drowsinesspe

T/F: Taking NSAIDs with other NSAIDs increases the effectiveness of each

False - they hinder each other, do not take with each other

With indomethacin, it was ________________ developed

It has a ton of _________ __________

one of the first

Side effects

T/F: Nabumetone only needs to be taken twice a day

false - once a day

Why might people not take Celecoxib?

It is a COX-2 drug, it has improved but still has MI problems

along with kidney and liver

what makes Ketorolac (toradol) a unique NSAID?

Only IM/IV/Oral NSAID

Equally effective as opioids w/no withdrawal symptoms

What is the purpose of inejectable NSAIDs?

Used for RTP

Helps with pain management at the active site

What are some uses of corticosteroids?

Rheumatoid arthritis

Lupus

IBS

Tendinopathy's

Allergic reactions

T/F: Tapering is common with corticosteroids?

True

What are the adverse effects with corticosteroids?

Flare up of withdrawal symptoms

Increased susceptibility of infection from immunosuppression

Stunt in growth in children

Common medication of corticosteriods?

Dexamethasone

Cortisone

Hydrocortisone

Prednisone

Dexamethasone

Dosage =

Polarity =

38-40mg

(-) polarity

Lidocaine

Dosage =

Polarity =

20mg

(+) polarity

Acetic acid

Dosage =

Polarity =

50mg

(-) polarity

Indications for use of iontophoresis?

Inflammation

Pain management

Calcific tendons

Heterotopic ossificans

Hyperhidrosis

Reduce scar tissue formation

Contraindications for iontophoresis?

Skin allergy

PAD

Open wound

Diabetes

Skin irritation

New scars/tissues

Over new implants (wire, screw, staples)

Active injuries

What is the parameters for the needles?

Needle Gauge

Needle length

23-25 gauge

5/8 inch needle

Indications for using injections?

Vaccinations

T1 diabetics

Aspiration of over swollen areas

Unable to take oral administrations

IV Saline drip bags

Contraindications of using needles?

Known bleeding disorders

Erythema at injection site

Contraindication of the meds

Fear of needles