NURS 6015 LATEST QUESTIONS AND ANSWERS.
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Corticosteroids
Used to suppress inflammation (plus mediators), treat respiratory distress syndrome in
pre-term infants, and adrenocortical insufficiency
Side effects: High blood sugar, fluid retention, crushings syndrome (if dose is too high),
"moon face," osteoporosis, growth stunt in children, myopathy, peptic ulcer disease
(inhibition of prostaglandins in stomach), rarely pituitary carcinoma
Special: patient is immunocompromised, watch for signs of adrenal insufficiency, may
need more insulin, wean off gradually, don't use with drugs that waste K+, don't use in
pregnant women (breast feeding is OK in low doses)
Aspirin
Cox-1 Inhibitor (suppresses synthesis or prostaglandins), 1st Gen NSAID; ALSO
INHIBITS COX-2; Used to suppress inflammation and platelet aggregation, relieve pain,
reduce fever, and protect against MI, colorectal cancer, and stroke
Irreversible inhibitor if cyclooxygenase; bound to albumin
Side effects: gastric ulceration (all gastric distress, heartburn, nausea), bleeding, renal
impairment, salicylism with toxicity, ED
Special: monitor for toxicity (tinnitus, weating, headache, dizziness), don't use in
children (Reye's syndrome) or pregnant women (Cat D), watch for hypersensitivity, DO
NOT USE WITH other anticoagulants, glucocorticoids (gastric ulceration), alcohol, other
NSAIDS, ACE inhibitors, ARBS (renal function), vaccines (less response)
Ibuprofen
Cox-1 Inhibitor (AND COX-2); Non-aspirin 1st Gen NSAID; used for RA, osteoarthritis,
fever, bursitis, tendinitis; mild to moderate pain, and dysmenorrhea (superior)
Reversible inhibitor if cyclooxygenase; NOT indicated for MI and stroke (INCREASED
risk via vascoconstriction); no suppression of platelet aggregation; LESS gastric
irritation than aspirin
Side effects: GI disturbance, Reye's syndrome in children, low risk of causing Stevens-
Johnson syndrome (via hypersensitivity)
Special: Do not give to patients that are pregnant or children, safer to use with other
anticoagulants
Celecoxib
Cox-2 Inhibitor (selective); 2nd Gen NSAID; Indicated for osteoarthritis, rheumatoid
arthritis, ankylosing spondylitis, juvenile idiopathic arthritis, acute pain, dysmenorrhea,
, and off-label for familial adenomatous polyposis (lower risk of colorectal cancer)
NOT for long-term use; could increase risk for CV events
Side effects: renal impairment, could still cause GI issues (even without Cox-1 effects)
Special: Do not use with patients that are hypertensive, have edema, HF, have kidney
disease, avoid with patients allergic to sulfa, are pregnant
**May increase anticoagulant effects of WARFARIN
Diphenhydramine
1st Generation Antihistamine; Histamine 1 Antagonist (selectively); Can also block
muscarinic receptors (causing sympathetic response); Used for mild allergy, motion
sickness, insomnia, common cold
Side effects: HIGHLY SEDATING, but can cause CNS stimulation with higher doses
and children, dizziness, incoordination, confusional states, and fatigue
Special: Take with food to reduce feelings of neursea, vomiting, loss of appetite,
diarrhea or constipation, sympathetic response may occur due to blocking muscarinic
receptors (assist with dry mouth, etc.), don't take with other CNS depressants, alcohol
Use with caution with pregnancy (weigh risk/benefit) and don't use if breast feeding
p. 847
Fexofenadine
2nd Generation Antihistamine; Histamine 1 Antagonist; Used for seasonal allergic
rhinitis and chronic idiopathic urticaria
***Best combo of efficacy and safety in 2nd gen
NONSEDATING (cross BBB poorly and low affinity for H1 receptors in the CNS) and do
not cause anticholinergic effects
Special: Doseage should be reduced for patients with renal impairment, fruit juices can
reduce absorption (within 4 hours before dosing or 1-2 hours after)
p. 847
Allopurinol
For Hyperuricemia (secondary to chemo)/Gout; Reduces uric acid levels by inhibiting
uric acid formation as a Xanthine Oxidase Inhibitor (and causes regression of already
formed tophi); For chronic tophaceous gout
Long-term use; Lack antiinflammatory and analgesic actions
Side effects: rare toxicity (hypersensitivity syndrome), acute gouty attach with initial
Buy Quality Materials!
Corticosteroids
Used to suppress inflammation (plus mediators), treat respiratory distress syndrome in
pre-term infants, and adrenocortical insufficiency
Side effects: High blood sugar, fluid retention, crushings syndrome (if dose is too high),
"moon face," osteoporosis, growth stunt in children, myopathy, peptic ulcer disease
(inhibition of prostaglandins in stomach), rarely pituitary carcinoma
Special: patient is immunocompromised, watch for signs of adrenal insufficiency, may
need more insulin, wean off gradually, don't use with drugs that waste K+, don't use in
pregnant women (breast feeding is OK in low doses)
Aspirin
Cox-1 Inhibitor (suppresses synthesis or prostaglandins), 1st Gen NSAID; ALSO
INHIBITS COX-2; Used to suppress inflammation and platelet aggregation, relieve pain,
reduce fever, and protect against MI, colorectal cancer, and stroke
Irreversible inhibitor if cyclooxygenase; bound to albumin
Side effects: gastric ulceration (all gastric distress, heartburn, nausea), bleeding, renal
impairment, salicylism with toxicity, ED
Special: monitor for toxicity (tinnitus, weating, headache, dizziness), don't use in
children (Reye's syndrome) or pregnant women (Cat D), watch for hypersensitivity, DO
NOT USE WITH other anticoagulants, glucocorticoids (gastric ulceration), alcohol, other
NSAIDS, ACE inhibitors, ARBS (renal function), vaccines (less response)
Ibuprofen
Cox-1 Inhibitor (AND COX-2); Non-aspirin 1st Gen NSAID; used for RA, osteoarthritis,
fever, bursitis, tendinitis; mild to moderate pain, and dysmenorrhea (superior)
Reversible inhibitor if cyclooxygenase; NOT indicated for MI and stroke (INCREASED
risk via vascoconstriction); no suppression of platelet aggregation; LESS gastric
irritation than aspirin
Side effects: GI disturbance, Reye's syndrome in children, low risk of causing Stevens-
Johnson syndrome (via hypersensitivity)
Special: Do not give to patients that are pregnant or children, safer to use with other
anticoagulants
Celecoxib
Cox-2 Inhibitor (selective); 2nd Gen NSAID; Indicated for osteoarthritis, rheumatoid
arthritis, ankylosing spondylitis, juvenile idiopathic arthritis, acute pain, dysmenorrhea,
, and off-label for familial adenomatous polyposis (lower risk of colorectal cancer)
NOT for long-term use; could increase risk for CV events
Side effects: renal impairment, could still cause GI issues (even without Cox-1 effects)
Special: Do not use with patients that are hypertensive, have edema, HF, have kidney
disease, avoid with patients allergic to sulfa, are pregnant
**May increase anticoagulant effects of WARFARIN
Diphenhydramine
1st Generation Antihistamine; Histamine 1 Antagonist (selectively); Can also block
muscarinic receptors (causing sympathetic response); Used for mild allergy, motion
sickness, insomnia, common cold
Side effects: HIGHLY SEDATING, but can cause CNS stimulation with higher doses
and children, dizziness, incoordination, confusional states, and fatigue
Special: Take with food to reduce feelings of neursea, vomiting, loss of appetite,
diarrhea or constipation, sympathetic response may occur due to blocking muscarinic
receptors (assist with dry mouth, etc.), don't take with other CNS depressants, alcohol
Use with caution with pregnancy (weigh risk/benefit) and don't use if breast feeding
p. 847
Fexofenadine
2nd Generation Antihistamine; Histamine 1 Antagonist; Used for seasonal allergic
rhinitis and chronic idiopathic urticaria
***Best combo of efficacy and safety in 2nd gen
NONSEDATING (cross BBB poorly and low affinity for H1 receptors in the CNS) and do
not cause anticholinergic effects
Special: Doseage should be reduced for patients with renal impairment, fruit juices can
reduce absorption (within 4 hours before dosing or 1-2 hours after)
p. 847
Allopurinol
For Hyperuricemia (secondary to chemo)/Gout; Reduces uric acid levels by inhibiting
uric acid formation as a Xanthine Oxidase Inhibitor (and causes regression of already
formed tophi); For chronic tophaceous gout
Long-term use; Lack antiinflammatory and analgesic actions
Side effects: rare toxicity (hypersensitivity syndrome), acute gouty attach with initial
