W7 Exam NSAIDs, Osteo, Autoimmune/Inflamm DXs (kelliwilson1 PHARM muscuolskeletal), (Droopyhalo NSG 6005 WEEK 7 Pharmacology), (Shiphie_Philipose MU NURS 615: Advanced Pharm - Chapter 25 Study Guide) 2022

W7 Exam NSAIDs, Osteo, Autoimmune/Inflamm DXs (kelliwilson1 PHARM muscuolskeletal), (Droopyhalo NSG 6005 WEEK 7 Pharmacology), (Shiphie_Philipose MU NURS 615: Advanced Pharm - Chapter 25 Study Guide) 2022 Aspirin (exotrin) ASA What should you remember? - ANS-1. Most POTENT inhibitor of prostaglandin synthesis 2. Inhibit platelet aggregation 7-10 days (life span) 3. Reye's syndrome (children) chickenpox, influenza, & other viral disorders 4. hypersensitivity prevalent in those with asthma, nasal polyposis, chronic uritcaria 5. tinnitus and dizziness with elevated bl levels 6. caution liver and renal insufficiency 7. NO PREGNANCY cat D (used in infertility and toximia) 8. NO BFing 9. GI ulcer risk↑ 10. LOTS of interactions Acetaminophen (tylenol) APAP What should you remember? - ANS-1. MAX 3 g/day 2. reduce fever by direct act hypothalamus=(vaso dil, sweating) 3. ETOH limit ≤2 g/day, hepatotoxicity and hepatic failure reported even with therapeutic doses 4. minimal inhibition of protaglandidn synthesis=clinically insignificant antirheumatic or anti-inflammatory effects 5. NO platelet aggregation, NO affect on prothrombin response, No production of GI ulcer 6. PREG cat B 7. Poisoning= n/v, confusion, drowsiness, confusion, liver TTP, ↓ BP, cardiac arrythmias, jaundice, acute hepatic or renal failure, all occur in ≤ 24 hours 8. Death d/t liver necrosis and renal failure may occur 9. TX gastric lavage withing 4 hours Ibuprofen (motrin) What should you remember? - ANS-1. take with food, stay upright 15-30 min 2. block production prostaglandins (↓ BF kidney) 3. 3 or more doses/day, 5 x's/wk = rebound HA & pain 4. reversibly inhibit platelet aggregation, less and of shorter duration than aspirin 5. Preg Cat C...D ≥ 30 wk gestation 6. Do NOT combo with other NSAIDs 7. LABs: LFTs, Renal Fx, CBC 8. 2nd line TX arthritis Naproxen Sodium (aleve) What should you know? - ANS-1. may cause GI upset, bl, ulceration, perforation 2. take with food or milk to minimize GI upset 3. Max dose 1g/day 4. BLACK BOX: increased risk serious CV thrombotic event, MI, stroke, which can be fatal 5. Preg Cat C, enters Breastmilk 6. LABs: LFTs, Renal Fx, CBC Indomethacin (indocen) CLASS Indication BLACK BOX - ANS-NSAIDs Indication: acute gouty arthritis, acute bursitis/tendonitis/ severe/mod osteoarthritis, rheumatoid arthritis ≡IV form is used as alternative to surgery for closure of patent ductus arteriosus in neonates ≡manage preterm labor BLACK BOX: increased risk serious CV thrombotic event, MI, stroke, which can be fatal may increase risk of GI irritation, inflammation, ulceration, bl and perforation Preg Cat C Indomethacin (indocen) Routes AE Monitor - ANS-Routes: IV and oral and PR AE: HA, diziness, depression, fatigue, malaise, somnolence, vertigo, dyspepsia, epigastric pain, heartburn, indigestion, n/v/c/d, abd pain/cramps/distress, rectal irritation (suppository), tenesmus (suppository) Monitor: BP and opthalmic eval COX 1&2 Celecoxib (celebrex) CLASS Indication BLACK BOX - ANS-NSAID Indication: OA, ankylosing spondylitis, JIA, RA, acute pain, TX primary dysmenorrhea BLACK BOX: increased risk serious CV thrombotic event, MI, stroke, which can be fatal may increase risk of GI irritation, inflammation, ulceration, bl and perforation Contraindicated for TX perioperative pain in the setting of coronary artery bypass graft surgery (GABG) Preg Cat C Celecoxib (celebrex) Routes AE Monitor - ANS-Routes: CONTINUES...