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Pharm - Chapter 16 Pain, Fever, and Inflammation
Terms in this set (14)
What do the first generation "Non-selective" NSAIDs inhibit?
COX-1 and COX-2 enzymes
What do second generation "Selective" NSAIDs inhibit?
What drugs are first generation/non-selective?
- propionic acid
- oxicam derivatives
- acetic acid derivates
What drug is second generation/selective?
- decrease gastric acid secretion
- increase mucus production
- maintenances of GI mucosal perfusion
- increase capillary permeability
- Activation of WBCs to release inflammatory cytokines
What is the role of prostaglandins in pain, fever, and inflammation?
Prostaglandins are made at the site of tissue damage or infection, where they cause inflammation, pain, and fever as part of the healing process. They constrict and dilate the blood vessels
What is an important prostaglandin?
PGA2 (thromboxane A2) -- located in the kidneys, macrophages, platelets, vascular smooth muscle
Effects of PGA2 on blood vessels:
- increased platelet aggregation
- regulated by the hypothalamus
- occurs when Pyrogens - raise in body temperature
- endogenous (from inside the body -- like cytokines such as interleukins)
- exogenous (from outside the body -- like bacteria)
What are the two types of inflammation?
Bradykinin - pain lasts longer; an inflammatory mediator; a peptide that causes blood vessels to dilate
Histamine - vasodilation; a compound that is released by cells in response to injury and in allergic and inflammatory reactions causing contraction of the smooth muscle and dilation of capillaries
Pathophysiology of Osteoarthritis
- cartilage and synovial fluid (cushions that degrade over time)
- wears down over time
- causes inflammation and pain
- commonly affected areas
- worst pain upon waking and decreases with movement
Salicylates/Aspirin: Signs of Bleeding and Signs of Acute Toxicity
Signs of bleeding:
- petechiae, bruising
- black or tarry stool (GI bleed)
Signs of Salicylism (chronic use of high dosages):
- tinnitus, dizziness, difficulty hearing, confusion
Signs of Acute Toxicity:
- respiratory alkalosis
- respiratory failure
- metabolic acidosis
- pulmonary edema
How to deal with poison?
activated charcoal - add water, it will absorb the drug before it gets into the system
Pathophysiology of Gout
"disease of kings"
- increased uric acid (6.8 mg/dL)
- leads to hyperuricemia
3 stages of Gout
- stage 1: normal sw
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