Anti-inflammatory Meds

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Anti-inflammatory Meds

• Megan Rohm, BSN, RN

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Inflammatory Response

• Protects the body from injury and pathogens
• Uses chemical mediators to produce the reaction
  that helps destroy pathogens and promote healing

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Anti-inflammatory Agents

• Block or alter the chemical reactions associated
  with the inflammatory response

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Types of Anti-inflammatory Agents

• Corticosteroids used systemically to block the
  inflammatory and immune systems
• Antihistamines block the release of histamine in
  the initiation of the inflammatory response
• NSAIDS

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Salicylates- NSAID

• Can block the inflammatory response
• Have antipyretic (fever-blocking) properties
• Have analgesic (pain-blocking) properties

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NSAIDs

• Provide strong anti-inflammatory and analgesic
  effects
• Sold over the counter, which may lead to abuse

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Common Salicylates

• Aspirin (Bayer,etc.) treats inflammatory
  conditions
• Balsalazide (Colazal) new drug that treats
  ulcerative colitis
• Choline magnesium trisalicylate (Trilisate)
  treats mild pain and fevers as well as arthritis
• Choline salicylate (Arthropan) treats mild pain
  and fevers as well as arthritis
• Mesalamine (Pentasa, etc.) treats inflammation
  of the large intestine
• Olsalazine (Dipentum) converted to mesalamine in
  the colon has the same direct anti-inflammatory
  effects
• Salsalate (Argesic, etc.) treats pain, fever,
  and inflammation
• Sodium thiosalicylate (Rexolate) treats episodes
  of acute gout and muscular pain as well as
  rheumatic fever

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Salicylates

• Action/indication
• Inhibit synthesis of prostaglandin used to treat
  mild to moderate pain and fever
• Pharmacokinetics
• Absorbed from the stomach, peak in 5 to 30 min.,
  metabolized in the liver, and excreted in the
  urine
• Contraindications
• Known allergy, bleeding abnormalities, and
  impaired renal function
• Drug-to-drug interactions
• Interact with other drugs by interfering with
  absorption

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SalicylatesAdverse Effects

• GI irritation
• Nausea, dyspepsia, and heartburn
• Clotting system
• Blood loss and bleeding abnormalities
• Eighth cranial nerve stimulation
• Salicylism
• Ringing in the ears
• Acidosis
• Nausea, vomiting, and diarrhea
• Mental confusion and lassitude

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Types of NSAIDs

• Propionic acids
• Fenoprofen
• Ibuprofen
• Acetic acids
• Diclofenac
• Etodolac
• Fenamates
• Mefenamic acid
• Cyclooxygenase-2 inhibitors
• Celecoxib

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NSAIDs Indications

• Relief of the signs and symptoms of rheumatoid
  arthritis and osteoarthritis
• Relief of mild to moderate pain
• Treatment of primary dysmenorrhea
• Fever reduction

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Contraindications to NSAIDs

• Presence of allergy to any NSAID or salicylate
• Cardiovascular dysfunction or hypertension
• Peptic ulcer or known GI bleeding
• Pregnancy and lactation
• Caution with renal or hepatic dysfunction

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Acetaminophen indications

• Action/indications
• Acts directly on the thermoregulatory cells of
  the hypothalamus
• Mechanism of action related to analgesic effects
  is not certain
• Used to treat pain and fever
• Treatment of pain and fever associated with a
  variety of conditions, including influenza
• Prophylaxis of children receiving
  diphtheriapertussistetanus (DPT) immunizations
• Relief of musculoskeletal pain associated with
  arthritis

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Acetaminophen

• Pharmacokinetics
• Absorbed from the GI tract
• Peaks in ½ to 2 hours
• Metabolized in the liver
• Excreted in the urine

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Acetaminophen

• Contraindications
• Known allergy
• Use with caution in pregnancy and lactation
• Adverse Effects
• Headache, hemolytic anemia, renal dysfunction,
  skin rash, fever, and hepatotoxicity
• Drug-to-drug interactions
• Oral anticoagulants increase bleeding

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Mnemonics

• NSAIDSNo alcoholSide effects (teach them to
  report any dark tarry stools, coffee-ground or
  bloody emesis, GI distress, tinnitus) ASA
  sensitivity - do not giveIbuprofen, indocin are
  a few examplesDo take with foodStop 5-7 days
  before surgery

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Mnemonics

• Empty stomach
• Penicillin Sulfa drugs Tetracycline

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Mnemonics

• Antacids-? FaCT
• Fluoroquinolone a Cephalosporins Tetracyclines

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Mnemonics- photosensitivity

• Terrible Fucking Sunburn
• Tetracycline Fluroquinolines Sulfonamides

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Mnemonics- ototoxicity /peak and trough

• Audio Visual
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Mnemonics and study aids

• http//www.studystack.com/gsearch.jsp?cxpartner-p
  ub-49096761131516543Ayhlp7k-59l2cofFORID3A9ie
  UTF-8qnursingantibioticsaSearchsiteurlwww
  .studystack.com2FNursing987
• http//www.scribd.com/doc/22593365/Nursing-Mnemoni
  cs-09
• http//jeopardylabs.com/play/anti-infectives