NUR 2407 Pharmacology Study Guide Exam #2

NUR 2407 Pharmacology Exam #2 Study Guide Pharmacology Exam #2 [Unit 7: Pain and Inflammation Management Drugs]  Nonsteroidal Antiinflammatory Drugs (NSAIDS): o Aspirin (ASA)- (Salicylates)  used to reduce pain and inflammation symptoms, decreased fever, and inhibit platelet aggregation; for osteoarthritis and rheumatoid arthritis  Side Effects:  Dizziness  Drowsiness  loss of appetite (anorexia)  nausea and vomiting  diarrhea  heartburn  abdominal pain  rash  Adverse Reactions:  Tinnitus  hearing loss  G.I. ulceration and bleeding  Life Threatening:  hemolytic anemia  bronchospasm  anaphylaxis  hepatotoxicity  Drug Interaction:  increased risk of bleeding with anticoagulants and other NSAIDs  increased risk of hypoglycemia with oral hypoglycemic drugs  effects are decreased by corticosteroids  increased ulcerogenecid effect with glucocorticoids  Contraindications:  hypersensitivity to salicylates or NSAIDs  flu or virus symptoms in children  G.I. bleeding  Caution: renal or hepatic disorders, gout, alcoholism, anticoagulant therapy, G.I. bleeding, bone marrow suppression, head trauma, immunosuppression, pregnancy.  Anemia  Measles  Chicken Pox  Reye Syndrome  Decreased prothrombin levels (clotting factor)  Salicylate Poisoning:  tinnitus (ringing in ears)  elevated temperature  nausea and vomiting  dehydration/disorientation  hyperventilation  severe toxicity – o metabolic acidosis o seizures  severe toxicity occurs with 300 to 500 mg/kg acute ingestion of aspirin   Steroids: o reverse inflammation systemic in a profound way o They suppress the anti-inflammatory response of the body (Increased risk of infection) o NSAIDs reverse inflammation (and related pain) in a more limited way (not steroid) o steroids may treat diarrhea caused by ulcerative colitis o Take in the morning (AM) with food o What is the role for steroids in the treatment of anaphylaxis?  Dilate airways to assist with breathing and also decrease inflammation o Side Effects and Adverse Reactions-  Increased risk of Infection  Hyperglycemia (high blood sugar)  Hypertension (High BP)  Hypokalemia  sodium retention  Puffy face (moon face)  edema (slow weight gain not rapid-often fluid retention)  Increased bleeding risk  gastric erosion  poor wound healing  Addison’s disease:  Occurs when the adrenal glands do not produce enough cortisol and often insufficient levels of aldosterone. It can because by prolonged use of steroids  another common cause of secondary adrenal insufficiency occurs when people who take corticosteroids for treatment of chronic conditions, such as asthma or arthritis, abruptly stopped taking their corticosteroids o Drug Interactions-  Avoid caffeine  Do not take with NSAIDS  Increased risk of bleeding and gastric ulcers o Nursing Priorities-  Take with food  Take in morning (insomnia)  What does a fever indicate?  Infection (due to immunodepression)  Very sick take seriously  Gradually discontinue dose  Corticosteroids: o Use- treatment of adrenocortical deficiency, other endocrine disorders, allergic states, collagen diseases, dermatological diseases, G.I. disorders, hematological disorders, respiratory disease, rheumatoid disorders. o Side Effects and Adverse Reactions-  Seizures  edema due to sodium retention  hypertension  poor wound healing  moon face  hyperglycemia  G.I. perforation  pancreatitis o Contraindications-  live viral vaccines  immunosuppressive drugs  use can exacerbate fungal infections  PO use can induce peptic ulcers and should be given with meals/antacids  long-term use can result in osteoporosis, related fractures, tendon ruptures  use can increase blood pressure, water retention, potassium excretion o Drug Interactions-  use with aspirin, NSAIDs produces additive effects  antidiabetic drugs may require increase in dosage  use with toxoid/vaccines decreased their antibody formation o Prednisone/Hydrocortisone (Short-acting corticosteroids)  Use: used in a variety of chronic illnesses, including inflammatory, allergic, hematologic, neoplastic, and autoimmune diseases  Side Effects and Adverse Reactions:  Hypertension  hyperglycemia  fluid retention (long-term high dosages)  hypokalemia  peptic ulceration  anorexia  Cushingoid appearance (moon face, buffalo hump)  increased susceptibility for infection  weight gain (often fluid retention)  Contraindications:  active untreated infections  administration of live virus vaccines  May mask signs of potential infection  Nursing Priorities:  administer PO with food  avoid administration at bedtime (insomnia)  avoid exposure to infection  Sudden withdrawal can be deadly do not take with aspirin or other NSAIDs .....Continued...