Ch. 16: Anti-Inflammatory, Antiarthritis, and Related Agents (Karch Focus on Nursing Pharmacology)

analgesic
compounds with pain-blocking properties, capable of producing analgesia

anti-inflammatory agents
drugs that block the effects of the inflammatory response

antipyretic
blocking fever, often by direct effects on the ther- moregulatory center in the hypothalamus or by blockade of prostaglandin mediators

chrysotherapy
treatment with gold salts; gold is taken up by macrophages, which then inhibit phagocytosis; it is reserved for use in patients who are unresponsive to conventional therapy, and can be very toxic

inflammatory response
the body’s nonspecific response to cell injury, resulting in pain, swelling, heat, and redness in the affected area

nonsteroidal anti-inflammatory drugs (NSAIDs)
drugs that block prostaglandin synthesis and act as anti-inflammatory, antipyretic, and analgesic agents

salicylates
salicylic acid compounds, used as anti-inflammatory, antipyretic, and analgesic agents; they block the prostaglandin system

salicylism
syndrome associated with high levels of salicylates—dizziness, ringing in the ears, difficulty hearing, nausea, vomiting, diarrhea, mental confusion, and lassitude

Prototype of Salicylates
Aspirin

Indications of Aspirin
(Prototype of Salicylates)
Treatment of mild to moderate pain,
fever, inflammatory conditions; reduction of risk of transient ischemic attack or stroke; reduction of risk of myocardial infarction.

Actions of Aspirin
(Prototype of Salicylates)
Inhibits the synthesis of prostaglandins; blocks the effects of pyrogens at the hypothalamus; inhibits platelet aggregation by blocking thromboxane A2.

Adverse Effects of Aspirin
(Prototype of Salicylates)
Nausea, vomiting, heartburn, epigastric discomfort, occult blood loss, dizziness, tinnitus, acidosis.

Nursing Considerations – Aspirin
Monitor for salicylate toxicity. In adults, a sensation of fullness in the ears, tinnitus, and decreased or muffled hearing are the most frequent symptoms associated with chronic salicylate overdosage.

Do not give aspirin to children or teenagers with symptoms of varicella (chickenpox) or influenza-like illnesses because of association of aspirin usage with Reye’s syndrome.

Use enteric-coated tablets, extended release tablets, buffered aspirin, or aspirin administered with an antacid to reduce GI disturbances.

Take aspirin 1-2 d before menses when prescribed for dysmenorrhea. When experiencing heavy menstrual blood loss, take another analgesic, such as acetaminophen, instead of aspirin.

Discontinue aspirin therapy about 1 wk before surgery to reduce risk of bleeding. Do not use aspirin-containing gum or gargles or chew aspirin products for at least 1 wk following oral surgery.

Observe and report signs of bleeding (e.g., petechiae, ecchymoses, bleeding gums, bloody or black stools, cloudy or bloody urine).

Prototype of NSAIDs
Ibuprofen

Indications of Ibuprofen
(Prototype of NSAIDs)
Relief of the signs and symptoms of rheumatoid arthritis and osteoarthritis; relief of mild to moderate pain; treatment of primary dysmenorrhea; fever reduction.

Actions of Ibuprofen
(Prototype of NSAIDs)
Inhibits prostaglandin synthesis by blocking cyclooxygenase-1 and -2 receptor sites, leading to an anti-inflammatory effect, analgesia, and antipyretic effects.

Adverse Effects of Ibuprofen
(Prototype of NSAIDs)
Headache, dizziness, somnolence, fatigue, rash, nausea, dyspepsia, bleeding, constipation.

Indications of Acetaminophen
Treatment of mild to moderate pain, fever, or signs and symptoms of the common cold or flu; musculoskeletal pain associated with arthritis and rheumatic disorders.

Actions of Acetaminophen
Acts directly on the hypothalamus to cause vasodilation and sweating, which will reduce fever; mechanism of action as an analgesic is not understood.

Adverse Effects of Acetaminophen
Rash, fever, chest pain, liver toxicity and failure, bone marrow suppression.

Prototype of Antiarthritis Agents
Auranofin

Indications of Auranofin
(Prototype of Antiarthritis Agents)
Treatment of selected cases of adult rheumatoid arthritis, who have insufficient response to or intolerance to NSAIDs

Actions of Auranofin
(Prototype of Antiarthritis Agents)
Taken up by macrophages, which inhibits phagocytosis and release of lysosomal enzymes that cause damage associated with inflammation.

Adverse Effects of Auranofin
(Prototype of Antiarthritis Agents)
Bone marrow suppression, renal toxicity, dermatitis, nausea, vomiting, stomatitis.

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NSAIDs action 1. NSAIDs inhibit prostaglandins 2. Cox-2 inhibitors block the enzyme responsible for inflammation without blocking the Cox-1 enzyme 3. ASA has anti-platelet activity NSAIDs indications 1. Pain, fever, arthritis, dysmenorrhea 2. ASA: transien ischemic attacks (TIAs), prophylaxis of …

The mechanisms actions of non-steroidal anti-inflammatory drugs (NSAIDs) To summarise, non-steroidal anti-inflammatory drugs are drugs which have anti-inflammatory, analgesic and antipyretic properties due to their mechanism and enzymes involved COX-1 and COX-2. However as well as being beneficial NSAIDs have …

Adverse Effects drugs effects that are not to the desired therapeutic affects; may be unpleasant or even dangerous Brand Name name given to a drug the pharmaceutical company that developed it; also called a trade name WE WILL WRITE A …

Adverse Effects The undesired, unpleasant, or even dangerous results some drugs produce. Brand Name The name given to a drug by the pharmaceutical company that developed it. WE WILL WRITE A CUSTOM ESSAY SAMPLE ON ANY TOPIC SPECIFICALLY FOR YOU …

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