A NTI - INFLAMMATORY M EDS Megan Rohm, BSN, RN

I NFLAMMATORY R ESPONSE Protects the body from injury and pathogens Uses chemical mediators to produce the reaction that helps destroy pathogens and promote healing

A NTI - INFLAMMATORY A GENTS Block or alter the chemical reactions associated with the inflammatory response

T YPES OF A NTI - INFLAMMATORY A GENTS Corticosteroids: used systemically to block the inflammatory and immune systems Antihistamines: block the release of histamine in the initiation of the inflammatory response NSAIDS

S ALICYLATES - NSAID Can block the inflammatory response Have antipyretic (fever-blocking) properties Have analgesic (pain-blocking) properties

NSAID S Provide strong anti-inflammatory and analgesic effects Sold over the counter, which may lead to abuse

C OMMON S ALICYLATES Aspirin (Bayer,etc.): treats inflammatory conditions Balsalazide (Colazal): new drug that treats ulcerative colitis Choline magnesium trisalicylate (Trilisate): treats mild pain and fevers as well as arthritis Choline salicylate (Arthropan): treats mild pain and fevers as well as arthritis Mesalamine (Pentasa, etc.): treats inflammation of the large intestine Olsalazine (Dipentum): converted to mesalamine in the colon; has the same direct anti-inflammatory effects Salsalate (Argesic, etc.): treats pain, fever, and inflammation Sodium thiosalicylate (Rexolate): treats episodes of acute gout and muscular pain as well as rheumatic fever

S ALICYLATES Action/indication Inhibit synthesis of prostaglandin; used to treat mild to moderate pain and fever Pharmacokinetics Absorbed from the stomach, peak in 5 to 30 min., metabolized in the liver, and excreted in the urine Contraindications Known allergy, bleeding abnormalities, and impaired renal function Drug-to-drug interactions Interact with other drugs by interfering with absorption

S ALICYLATES —A DVERSE E FFECTS GI irritation Nausea, dyspepsia, and heartburn Clotting system Blood loss and bleeding abnormalities Eighth cranial nerve stimulation Salicylism Ringing in the ears Acidosis Nausea, vomiting, and diarrhea Mental confusion and lassitude

T YPES OF NSAID S Propionic acids Fenoprofen Ibuprofen Acetic acids Diclofenac Etodolac Fenamates Mefenamic acid Cyclooxygenase-2 inhibitors Celecoxib

NSAID S I NDICATIONS Relief of the signs and symptoms of rheumatoid arthritis and osteoarthritis Relief of mild to moderate pain Treatment of primary dysmenorrhea Fever reduction

C ONTRAINDICATIONS TO NSAID S Presence of allergy to any NSAID or salicylate Cardiovascular dysfunction or hypertension Peptic ulcer or known GI bleeding Pregnancy and lactation Caution with renal or hepatic dysfunction

A CETAMINOPHEN INDICATIONS Action/indications Acts directly on the thermoregulatory cells of the hypothalamus Mechanism of action related to analgesic effects is not certain Used to treat pain and fever Treatment of pain and fever associated with a variety of conditions, including influenza Prophylaxis of children receiving diphtheria–pertussis– tetanus (DPT) immunizations Relief of musculoskeletal pain associated with arthritis

A CETAMINOPHEN Pharmacokinetics Absorbed from the GI tract Peaks in ½ to 2 hours Metabolized in the liver Excreted in the urine

A CETAMINOPHEN Contraindications Known allergy Use with caution in pregnancy and lactation Adverse Effects Headache, hemolytic anemia, renal dysfunction, skin rash, fever, and hepatotoxicityanemia Drug-to-drug interactions Oral anticoagulants increase bleeding

M NEMONICS NSAIDS N o alcohol S ide effects (teach them to report any dark tarry stools, coffee-ground or bloody emesis, GI distress, tinnitus) A SA sensitivity - do not give I buprofen, indocin are a few examples D o take with food S top 5-7 days before surgery

M NEMONICS Em p ty st omach P enicillin S ulfa drugs T etracycline

M NEMONICS Antacids-  FaCT F luoroquinolone a C ephalosporins T etracyclines

M NEMONICS - PHOTOSENSITIVITY T errible F ucking S unburn Tetracycline FluroquinolinesSulfonamides

M NEMONICS - OTOTOXICITY / PEAK AND TROUGH A udio V isual ma In nco gm ly yc ci on s I d e

M NEMONICS AND STUDY AIDS %3Ayhlp7k-59l2&cof=FORID%3A9&ie=UTF- 8&q=nursing+anti+biotic&sa=Search&siteurl= ursing#