1. HS140: Pharmacology Week 6: Analgesics/Antipyretics Musculoskeletal System and Disorders

2. Overview of Unit 6 Reading:  Chapter 16: Analgesics and Antipyretics  Chapter 24: Musculoskeletal System Disorders  Chapter 8: Converting Between Measurement Systems, p. 146-150. Discussion Board Seminar Assignment Quiz

3. Analgesics and Pain Evaluation of pain is based on:  Location  Duration  Intensity (1-10 scale)  Precipitating factors Pain may be Acute or Chronic:  Acute-short duration, responds to analgesics  Chronic-over time, less responsive to analgesics, tolerance

4. Progressive Levels of Pain Relief and Treatments 4 Three levels of pain: Mild Pain- acetaminophen, aspirin, or other NSAIDS. Moderate Pain- add mild opioid (codeine or hydrocodone). Severe Pain- strong opioid (demerol or morphine) only; the nonopioid should be continued.

5. Opiate and Opioid Analgesic Agents (Narcotics) 5 Used clinically to manage pain; strongest pain relievers known. An opiate is a drug derived from opium. An opioid is a synthetic agent with similar actions, not derived from opium. Tolerance and potential for dependence are important concerns. Let’s name some drug examples and discuss uses (turn to p. 293 in textbook).

6. Salicylate Analgesics (aspirin) Oldest of nonopioid analgesics; not for children. Four distinct therapeutic actions of aspirin:  Analgesic – inhibits prostaglandin release from damaged tissues  Anti-inflammatory—reducing prostaglandin synthesis (contributes to pain)  Anti-pyretic—reduces fever  Anti-coagulant - decrease blood clot formation Turn to p. 297 of the textbook. What are some examples? What are some drug interactions?

7. Acetaminophen Non-opioid. Has analgesic and antipyretic actions; No anti-inflammatory action. Turn to p. 297 of the textbook. What are some examples? What are some drug interactions?

8. Nonsteroidal Anti-inflammatory (NSAIDs) Non-opioid. Inhibits cyclooxygenase (COX) which results in decreased formation of prostaglandin precursors. Turn to p. 297 of the textbook. What are some examples? What are some drug interactions?

9. Class Exercise 1: Working in a Medical Office Virtual Consultation: http://www.youtube.com/watch?v=JhvKr V0Hjnw&feature=related http://www.youtube.com/watch?v=JhvKr V0Hjnw&feature=related Turn to p. 303 in the textbook. As a class, let’s discuss the critical thinking scenario.

10. Musculoskeletal System Two different systems working closely together. Muscular System made up of muscles and connective tissue (ligaments, tendons). Skeletal System made up of bones and joints.

11. Osteoporosis and Therapy Osteoporosis = Bone Resorption (Bone loss) Common causes:  Decreasing Estrogen (women)  Low/insufficient Calcium intake Turn to p. 479 of the textbook. What are some medications used to treat osteoporosis? What are the dosages?

12. Joint Diseases and Therapy Osteoarthritis – most common, generative noninflammatory, caused by ‘wear-and-tear’. Rheumatoid arthritis – autoimmune, pain/swelling/limits movement. Let’s discuss some of the medications used to treat joint diseases. Turn to p. 483-485 of your textbook.

13. Gout Hyperuricemia (excess uric acid accumulation). Symptoms: acute pain, swelling, redness, tenderness. Patients on anti-gout medications should avoid food high in purines. Medications:  Acute attack – colchicine  Prophylaxis – allopurinol, probenecid

14. Class Exercise 2: Working in a Medical Office Turn to p. 143 on the workbook. Let’s discuss scenario 2.

15. Systems of Measurement – Household System Commonly used to measure medications at home. Abbreviations and Equivalencies* Household measureAbbreviationMetric measure 1 fluid ouncefl oz1 fl oz = 30 mL 1 cupc1 c = 240 mL 1 pintpt1 pt = 480 mL 1 tablespoonT (tbs)1 T = 15 mL 1 teaspoont (tsp)1 t = 5 mL dropgtt1 gtt = 0.06 mL poundlb2.2 lb = 1 kg * Tables 8-2 and 8-3

16.  Thank you for your attention and participation today’s seminar!  Any questions?  I look forward to the rest of Unit 6. Please contact me with any questions throughout the week.