exam 2 pharm pain and inflammation, herbal

ibuprofen

NSAID

naproxen

NSAID

indomethacin

NSAID

ketorolac

NSAID

meloxicam

NSAID

celecoxib

NSAID

NSAID administration Oral

take with food

ketorolac administration

IV push

NSAID side effects

Gi lining irritation, bleeding, fluid retention, elevated BP

organ of concern with NSAID

kidney

GI, cardiac, lungs

NSAID considerations

contain high amount of sodium

not during pregnancy

aspirin administration

give with food or water to decrease GI irritation

aspirin administration for acute MI

chew immediate release aspirin when ordered

aspirin side effects

GI irritation/bleeding

easy bruising/prolonged

tinnitus

aspirin considerations

irreversibly inhibits platelets for 7-10 days

assess for bleeding, ulcers, kidney disease, and aspirin/NSAID allergy

aspirin children consideration

avoid with viral illness= Reye syndrome (swelling of liver)

aspirin patient education

report black stools, bloody emesis, unusual bleeding, tinnitus

avoid taking additional NSAID/aspirin

acetaminophen

non opioid/ antipyretic (pain/fever)

short half-life (q4hr)

acetaminophen organ of concern

liver

acetaminophen max dose

4g/day = 4000 mg/day

morphine

opioid

hydromorphone

opioid

fentanyl

opioid

transdermal 72 hours

oxycodone

opioid

codeine

opioid

PCA

educate on patient should be pushing button

opioid administration

slow IVP

opioid side effects

respiratory depression

constipation

urinary retention

sedation

pupil constriction

pinpoint pupils with opioids=

toxicity

don’t administer opioids if respiratory rate is less than

12

antidote for opioid

naloxone

sumatriptan (-triptan)

migraine acute/absorptive: STOP the migraine

take at first sign of migraine

-triptans cause

vasoconstriction

serotonin syndrome alert

ergotamine, dihydroergotamine

ergot alkaloids/ migraine meds

vasoconstriction

other meds that help with migraines

beta blockers, antiseizure meds, antidepressants, opioids, non opioids, antiemetics

colchicine

antigout (form of inflammatory arthritis caused by excess uric acid leading to crystal deposits in joints)

allopurinol

anti gout prevention

probenecid

anti gout prevention

antigout side effects

watch for rash (steven johnson syndrome)

organ of concern with antigout

kidney

avoid what foods when taking antigout

high purine (liver, red meat, beer)

infliximab

DMARDs

methotrexate

DMARDs

DMARD (Disease‑Modifying Antirheumatic Drugs)

used to slow autoimmune diseases including rheumatoid arthritis

DMARD considerations

thrombocytopenia (low platelet count)

Tb test and CXR before treatment

Can you get vaccine while on DMARDs

no live vaccines

can get flu and pneumonia

alendronate, risedronate, ibandronate (-dronate)

bisphosphonates

bisphosphonates

help prevent loss of bone density

osteoporosis other bone weakening diseases

what is garlic used for as a herbal remedy

high cholesterol, HTN, heart health

what drug should you be cautious with when taking garlic, ginger, gingko biloba

anticoagulants, increases bleeding risk

ginger herbal used for

nausea, motion sickness, digestion

gingko biloba used for

memory support, dementia

st johns wort drug interactions

oral contraceptives, warfarin, antidepressants, immunosuppressants

SSRI, SNRI serotonin syndrome

kava drug interactions

no alcohol or other CNS

kava used for

anxiety and sleep

licorice root

gi issues, ulcers, increases BP

interacts with diuretics and corticosteroids

valerian root

use for sleep aid, anxiety

CNS depressant