mini quiz D- nonopioids

Sensation of pain:

Means by which body is made urgently aware of the presence of tissue damage

Pain

Protective reflex for self-preservation

Variables For pain:

pt's age, gender, race, ethnic group, fatigue, fear

Pain threshold

Pt. awareness of lowest intensity of painful stimulation

Reaction to pain varies

From person to person

Physiology Of pain

uniform through nerves (signal from site of pain to CNS)

________ activate and sensitize peripheral pain receptors, producing pain response

Prostaglandins

When body tissue is injured, the damaged cells release ________

bradykinin

bradykinin

one of the strongest pain-producing substances

___________ unleashes an avalanche of inflammatory and pain-provoking substances, such as prostaglandins

Bradykinin

NSAIDs Stands for

NonSteroidal Anti-inflammatory Drugs

NSAIDs Include:

aspirin and ibuprofen and others

NOT acetaminophen

Nonopioids act primarily on

peripheral nerve endings

Nonopioids generally work by inhibiting

prostaglandin synthesis

AlL NSAIDs work by blocking

cyclo-oxygenase

cyclo-oxygenase

a pair of enzymes dubbed COX-1 and COX-2 that have different jobs around the body

COX-1:

prostaglandins that:

• protect against stomach acids

• stimulate platelets (makes blood "sticky")

• helps protect kidneys (renal protection)

COX-2:

• prostaglandins that turn on in response to inflammation (produces inflammation)

• helps protect arteries

• helps keep platelets from clumping.

COX-1 blockers:

• removes stomach's protection agst acids

• prevents platelets from clumping

COX-2 blockers:

• eases pain and inflammation

• contributes to platelet clumping

• constricts blood vessels, has artery clogging effects.

The arachidonic acid (AA) pathway plays a key role in

• cardiovascular biology

• carcinogenesis

• inflammatory diseases, such as asthma, arthritis, etc

most common form of Salicylate

Aspirin

aspirin inhibits both COX I AND COX II, but is more potent against

COX I

Salicylates (Aspirin) Is absorbed by

stomach and small intestine.

Aspirin/Salicylates is an

Antiplatelet aggregator

Salicylates (Aspirin) Inhibits COX-1 and woks by

protecting against heart attacks and strokes by making platelets less sticky.

BUT, removes stomach's protection against acids.

Buffered aspirin to aid absorption in -_______.

small intestine

Aspirin NOT an obtundent, which means

Does not dulls sensation or lessens pain

ingredients in aspirin:

Excedrin PM® (diphenhydramine)

Anacin®-- (caffeine) potentiates effects of aspirin

antacids, acetaminophen sometimes added

Kaopectate®, Pepto-Bismol®, Alka-Seltzer®

bismuth subsalicylate is a ________, the same class of drugs as aspirin

salicylate

Salicylates (Aspirin) Pharmacologic effects

• Analgesia - Mild-mod. pain; more effective before onset of pain. More effective against. throbbing pain vs. stabbing

  pain

  
  

• Antipyretic - Reduces fever; acts on hypothalmic heat regulatory center; Induces peripheral vasodilation and swelling

  
  

• Anti inflammatory - Reduces inflammation; good for throbbing pain

  
  

• Antiplatelet - Anti-platelet aggregator

  Irreversible inhibitor of platelet function (lasts 4-7 days)

  COX-1 inhibitor

• Salicylates (Aspirin) Therapeutic uses:

• Pain control

• Fever, inflammation in adults

• Prevent blood clots in pts. with previous MIs or stroke

Emergency drug (MI (Myocardial Infarction); chewable form for quicker absorption)

Adult dose for pain?

Two 325 mg tablets or 650 mg

CV disease; TIA (transient ischemic attack), dose :

81mg/day