Pharm Final

• Aspirin indications

  reduce pain, inflammatory, platelet aggression, fever
• Adverse affects of aspirin

  thrombocytopenia, tinnitus, urticaria, ulceration
• do not give aspirin to

  children with flu like symptoms = reyes syndrome
• Indomethacin indications

  treat arthritis
• indomethacin concerns

  increases bp, sodium, water retention, highly protein bound
• voltaren (diclofenac sodium) indications

  decrease inflammation in RA, treat arthritis, ankylosing spoondylitis
• Voltaren ointment

  used for cardiovascular disease
• toradol (ketorolac acid)

  used for post surgical pain, 1st injectable NSAID
• Ibuprofen (Advil, Motrin) indications

  pain reliever, reduce fever, anti-inflammatory
• Ibuprofen side effects

  fluid retention with edema, GI bleeding, less ulcer formation
• Ibuprofen interactions

  anticoagulants = increased bleeding
• ibuprofen max dose

  3200 mg per day
• ibuprofen nursing considerations

  observe bleeding, avoid use with ASA or acetaminophen
• black box warning for ibuprofen

  increased risk of MI or stroke in existing cardiovascular disease
• Celebrex indications

  treat arthritis and relieve dysmenorrhea
• celebrex side effects and adverse

  flatulence and peripheral edema
• celebrex do not give

  concurrent use with diuretics or ACE inhibitors - increase INR
• celebrex black box

  increased risk of MI or stroke in existing cardiovascular disease
• infliximab (immunosuppressive) indications

  treat moderate to severe RA and crohn's disease
• infliximab side effects and adverse

  rash, alopecia, increase risk of HF
• infliximab interacts with

  vaccines = decreased effectiveness
• infliximab considerations

  worried about immunosuppression and infection. do not give live vaccine while taking this med
• allopurinol indications

  treat and prophylaxis for gout, hyperuricemia, and urate calculi, renal impairment
• allopurinol mode of action

  decreases uric acid
• allopurinol side effect and adverse

  metallic taste, cataracts
• allopurinol life threatening

  blood disorders
• colchicine indication

  treat gout symptoms. NOT for prevention
• colchicine side effects

  gi irritation - take with food
• colchicine do not give

  severe renal, cardiac, gi issues
• nursing considerations for antigout drugs

  monitor I&O's, take with food to avoid gi upset, monitor Cr and LFTs, increase fluid, avoid large doses of vitamin C, Avoid sardines, salmon, organ meat, gravy, legumes
• acetaminophen (tylenol) indications

  decrease pain and fever
• acetaminophen life threatening

  hepatotoxicity
• acetaminophen do not give

  severe renal or hepatic disease and alcoholism
• acetaminophen nursing considerations

  high doses = hepatotoxicity, adults do not take more than 10 days, children dont take more than 5 days, do not take more than 3250 mg per day
• antidote for acetaminophen

  acetylcysteine
• morphine sulfate indication

  relieve severe pain
• morphine sulfate side effects

  sedation, urinary retention, constipation, hypotension
• morphine sulfate life threatening

  respiratory depression, increased intracranial pressure
• morphine sulfate interactions

  anything that causes CNS depression have increased effect
• morphine sulfate do not use in

  asthma, increased intracranial pressure, shock, excreted in breast milk