unit 5 pharm

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NSAIDs and FEVER: *fever is the resuld of excess heat
*NSAIDS act on the hypothalmus to decrease its sensitvity to pyroges-> decrease in thermostat
INFLAMATION: *inflam is the bodies responce to tissue damage
Inflam symtoms localized: *red->vaso di
*Swelling(edema)-leakage of plasma into the extracellular spaces->ECF
*pain-prostaglandin irritation of nerve endings and pressure of edema
inclam symtons general: increase leukocytes, elecated erythocyte, sedimentation rate(ESR), fever, HA, loss of appetite, lethargy and weakness
Asprin: (ASA)
Asprin Dose: 325-600 mg q4-6 prn
arthritis 3.6-5.4 gm a day in divided dose
*toxic-->5-6gm
Asprin PK: *PO 80-100% absorbed
*pro bound 59-90%
*1/2t 2-3hr forlow doses and *2-20 hrs for high
*excreted in urin
Asprin PD: *PO onset 15-30min p1-2 duration4-6
Asprin Therapeutic effects: *Reduces pain, inflam, and fever, slow platet aggregation
Asprin Contrainications: *Hypersensitivity to saliclates, children that have been exposed t viruses or have a cold, third trimester of preg
*hepatic or renal failure
Asprin potential side effects of advers effects: A,N,V,D dixxiness, confusion, hearing loss, heartburn, rash, stomach pains, dowsiness, tinnitus, uticaria, ulceration, agranulocytosis, hemolytic anemia, brochospasm, anaphylaxis, thrombocytopenia, hepatotoxicity, leukopenia
Asprin porential interactions: increased risk of bleeding with anticoagulants, increased ulcergenic effect with gluccocorticoids
Asprin Considerations: *Normal therapeutic range 15-30 mg/dl
*Take with food to decrease gastric irritation.. enteric coating
Ibuprofen dose: (motrin)
*PO200-800mg tid qid to max of 3.2gm/day
Ibuprofen PK: *PO well abosrbed
*pro bound 98%
*1/2t 2-4 hr
*excreat primaily in the urin
Ibuprofen PD: PO onset .5hr p1-2hr duration 4-6 hr
Ibuprofen Theraputic effects: *Reduction of implammation and pain, antipyretic
Ibuprofen contraindications: Sever reanl or hepatic disease, asthma, pu, bleeding disorders, early preg, location, sle
Ibuprofen Potential s/e or adverse reactions: A,N,V,D, edema, rash, purpura, tinnitus, fatigue, dixxiness, lightheaded, anxiety, confusion, GIbleeding, blood dycrasias, cardiac dysrhythmias, nephrontoxicity, anaphylaxsis
Ibuprofen Potential interactions: *bleeding with oral anticoaggulants, increase the effect of phenytion, sulfonamides and warfarin
*increase sever effects with lithium
Narcotic Analgesics ADDICTION: * a patient of compulsive drugs use characterized by a continued craving for an opoid and the need to use the opioid for effect rather than pain mgt.
Narcotic Analgesics TOLERANCE: A larger dose of opoid analgesics is required to mantain the original efferd AND side effect.
Narcotic Analgesics PHYSICAL DEPENDANCE: When the abrupt discontinuation of an opoit produces with drawl symtoms.
-potential for addiction
Morphine Sulfate: (MS, Roxanol, MS contin)
PO, IM, IV, epidural
Used for sever pain
MS Contraindications: *vary addicting
*Athma with repiratory depression, INCREASE ICP, shock
MS Side effects: A,N,V constipation dorwsiness, dizzyness, sedation, confusion, urinary retention, rash, blurred vision, bradycardia, flushing, euphoria, puriits, hypotension, uticaria, seziures, respiratory depression, increased ICP
MS potential interactions: Increased effect with alcohol, sedatives, muscle relaxants.
Naloxone: (narcan) Narcotic antagonist
IV or IV
-use for overdose and post op
Naloxone PK: *crosses placental barrier
*metabolixed in the liver
*1/2t 60-90min
*excreated in the urin
*preg category B
Naloxone PD: IV onset 2min
duration 45min
naloxone Therapeutic effects: *Reversal of repiratory depressive effects of opoids*diagnosis of exclusion to rule out narcotic oversode
naloxone Side effects: N,V minimal toxicity, rapid loss of analgesia, sweating, increased b/p, tremors, hyperventilation, drowiness
naloxone Caution: *not effective wtih respiratory depression not caused by opioids
*naltrexone(depade, trexan) used for treatment of opoid additcions
Naloxone s/e: *monitor for opoid withdrawl, cns stim, dixxyness, confusion, thurst, fever, chills, drowsyness, HA siezures, N,V,D, rash, tachacardia, tachypenia, pulmonay, edema
naloxone interactions: reversal of analgesic effect of both narcotiv agonis oand agonist-antagonist
-block nocicepter
Sumatriptan: (imitrex)
po, sub Q, intranasal
sumatriptan PK: *po an sq well absorbed
*pro bound lwo 14-21%->80% metabolized in the liver
*1/2t
*Excreated primarily in the urin
Sumatriptan Therapeutic effects: antimigraine
sumatriptan Contraindications: pt taking erotamine, mao inhibior w/in last 14 days, uncontrolled HTN, caution with possible CAD, safty in prognancy not established
Sumatriptan S/E: Abdominal discomfort, dysphagia, fatige, dixxiness, vertigo, drowsiness, HA, anxiety, cardiac dysrhythmias, pressure for tightness in chest, fluching, discomfort in throat, ncasl cavity, sinus, mouth, jaw, or touge, alter vision, neck pain myalgia, muscle cramps disaphoresis, tingling, warm or hot sensation, burnintg strangeness, cold sensation
Sumatriptian interations: *Ergotamine-prolongs vaso effects-> do not use witin 24hr
*MAO inhibitor- increased effects of suatriptan-> do not use with in 14days
cancer pain: tumor, metastasis, complication, surgery, treatment, chemotherapy, radiation
Superficial pain: skin mucous memebranes
Viceral pain: smooth muscle and organs
Somatic pain: skelatal muscle, ligamints, and joints~

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