NURS 2750 - Health and Healing Quiz 2 Pharm Questions
With Complete Solutions
St. John's wort
A patient with ulcerative colitis is taking cyclosporine. The
patient has started to take several herbal preparation. Which of
the follow preparations poses a possible problem for the patient?
non-opiod drugs
-NSAIDS, acetaminophen, antidepressants
NSAIDS
- Works for fever as well as pain, could be expected to reduce
pain by 1-3 points/10
- MOA
- Block the COX I enzyme with results in less chemicals that
promote gastric mucosal healing, vasoconstriction and platelet
clumping
- Also block COX II enzyme which results in less chemicals that
cause vasodilation, inflammation, pain and reduce platelet
clumping
- ADR
- Common:
- Diarrhea
- GI upset (take with food if possible)
- Serious:
- Renal failure or dysfunction
- GI bleeding
,- Contraindications:
- Use contraindicated in hemorrhage, heart failure, recent MI,
liver failure, renal failure or GI ulceration/bleeding
- IV ketorolac have the highest rate of GI bleeding and should
not be used >72h
- Agents that are more COX-II selective seem to have less GI
bleeding by more cardiovascular risk
- Drug interactions
- Increased lithium levels, antagonize/ block effects of
ACEIs/ARBs, as well as ASA for prevention of heart
attack/stroke
- NSAIDS have synergistic side effect with other drugs that
cause GI bleeding
- Anticoagulants
- High dose steroids
- Antiplatelets
- Nursing implications
- If NSAIDS are needed with the drugs putting patients on
stomach/gastric protection is commonly required
- Selective and non-selective
- ASA
NSAIDS
Works for fever as well as pain, could be expected to reduce
pain by 1-3 points/10
NSAIDS MOA
- Block the COX I enzyme with results in less chemicals that
promote gastric mucosal healing, vasoconstriction and platelet
, clumping
- Also block COX II enzyme which results in less chemicals that
cause vasodilation, inflammation, pain and reduce platelet
clumping
NSAIDS ARD
- Common:
- Diarrhea
- GI upset (take with food if possible)
- Serious:
- Renal failure or dysfunction
- GI bleeding
NSAIDS contraindications
- Use contraindicated in hemorrhage, heart failure, recent MI,
liver failure, renal failure or GI ulceration/bleeding
- IV ketorolac have the highest rate of GI bleeding and should
not be used >72h
- Agents that are more COX-II selective seem to have less GI
bleeding by more cardiovascular risk
NSAIDS drug interactions
- Increased lithium levels, antagonize/ block effects of
ACEIs/ARBs, as well as ASA for prevention of heart
attack/stroke
- NSAIDS have synergistic side effect with other drugs that
cause GI bleeding
- Anticoagulants
With Complete Solutions
St. John's wort
A patient with ulcerative colitis is taking cyclosporine. The
patient has started to take several herbal preparation. Which of
the follow preparations poses a possible problem for the patient?
non-opiod drugs
-NSAIDS, acetaminophen, antidepressants
NSAIDS
- Works for fever as well as pain, could be expected to reduce
pain by 1-3 points/10
- MOA
- Block the COX I enzyme with results in less chemicals that
promote gastric mucosal healing, vasoconstriction and platelet
clumping
- Also block COX II enzyme which results in less chemicals that
cause vasodilation, inflammation, pain and reduce platelet
clumping
- ADR
- Common:
- Diarrhea
- GI upset (take with food if possible)
- Serious:
- Renal failure or dysfunction
- GI bleeding
,- Contraindications:
- Use contraindicated in hemorrhage, heart failure, recent MI,
liver failure, renal failure or GI ulceration/bleeding
- IV ketorolac have the highest rate of GI bleeding and should
not be used >72h
- Agents that are more COX-II selective seem to have less GI
bleeding by more cardiovascular risk
- Drug interactions
- Increased lithium levels, antagonize/ block effects of
ACEIs/ARBs, as well as ASA for prevention of heart
attack/stroke
- NSAIDS have synergistic side effect with other drugs that
cause GI bleeding
- Anticoagulants
- High dose steroids
- Antiplatelets
- Nursing implications
- If NSAIDS are needed with the drugs putting patients on
stomach/gastric protection is commonly required
- Selective and non-selective
- ASA
NSAIDS
Works for fever as well as pain, could be expected to reduce
pain by 1-3 points/10
NSAIDS MOA
- Block the COX I enzyme with results in less chemicals that
promote gastric mucosal healing, vasoconstriction and platelet
, clumping
- Also block COX II enzyme which results in less chemicals that
cause vasodilation, inflammation, pain and reduce platelet
clumping
NSAIDS ARD
- Common:
- Diarrhea
- GI upset (take with food if possible)
- Serious:
- Renal failure or dysfunction
- GI bleeding
NSAIDS contraindications
- Use contraindicated in hemorrhage, heart failure, recent MI,
liver failure, renal failure or GI ulceration/bleeding
- IV ketorolac have the highest rate of GI bleeding and should
not be used >72h
- Agents that are more COX-II selective seem to have less GI
bleeding by more cardiovascular risk
NSAIDS drug interactions
- Increased lithium levels, antagonize/ block effects of
ACEIs/ARBs, as well as ASA for prevention of heart
attack/stroke
- NSAIDS have synergistic side effect with other drugs that
cause GI bleeding
- Anticoagulants
