1050: Pain NEW (salicylate/NSAID/COX-2 IN/PARA-AMINO DERI) Exam 2

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xiongav
ID:
286824
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1050: Pain NEW (salicylate/NSAID/COX-2 IN/PARA-AMINO DERI) Exam 2
Updated:
2014-10-23 23:10:05
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NURS
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Description:
sal: aspirin; nsaid: ibuprofen; cox2: celecoxib; para: aceta
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  1. What is the purpose of the COX1 & COX2 enzymes?
    • 1: normal cell function.
    • 2: produce prostaglandins that cause inflammation, swelling, joint pain.
  2. aspirin 

    X=NOT FOR ADOL/CHILDREN

    Uses:
    Max dose:
    Action
    Pt teaching
    SFX/AFX
    Nurse interventions
    • Uses: mild-mod pain, prevent TIA/MI, reduce fever.
    • Max dose: 4 g/24 hrs
    • Action: inhibit COX1 & decrease prosta.
    • Pt teaching:
    • -Take with food/milk to reduce GI distress.
    • -DO NOT crush/chew sustained-release/enteric-coated
    • -Watch for bleeding gums, pink spots, GI bleeding
    • -Notify prescriber if taking other OTC drugs containing aspirin
    • -Pregnant women should avoid.
    • *Drug is leading cause of POISONING in CHILDREN.
    • SFX: confusion, headache, hypotension, N/V
    • AFX: anaphylaxis, GI bleeding, seizures, REYE'S SYNDROME in children w/ chickenpox.
    • Nurse interventions: 
    • -Better for long-term therapy.
    • -May be given as a suppository.
    • -May inhibit platelet aggregation, stop few days before surgery (blood thinner)
    • -
  3. celecoxib (ONLY COX2-inhibitor in US; inhibits prosta. synth)

    X = NOT FOR ADOL/CHILDREN

    Usesmild
    Max dose
    Action
    Pt teaching
    SFX/AFX
    Nurse interventions
    • Uses: mild-mod pain, similar to ibuprofen.
    • Max dose: N/A
    • Action: inhibits prosta. synth. 
    • Pt teaching: 
    • -Report allergies to NSAIDs.
    • -Report black, tarry, bloody stools, GI bleeding.
    • -If pregnant
    • -Can be taken w/ applesauce.
    • -Taking w/ other OTC NSAIDs may cause toxicity.
    • SFX: headache, hypertension, nausea.
    • AFX: Stevens-Johnson Syndrome, edema
  4. acetaminophen

    O=GOOD FOR CHILDREN

    Uses
    Max dose
    Action
    Pt teaching
    SFX/AFX
    Nurse Interventions
    • Uses: mild-mod pain, fever, Pts who are hypersensitive to aspirin or NSAIDs or receiving anti-coagulant therapy. 
    • Max dose: 4 g/24 hrs (same as aspirin)
    • Action: Inhibit prosta. synthesis
    • Pt teaching:
    • -Short-term use only (<5 days)
    • -Excessive alcohol use may increase liver damage.
    • SFX: headache, fatigue, N/V
    • AFX: skin reactions, Stevens-Johnson Syndrome
    • Nurse Interventions:
    • -In children, don't exceed 5 doses in 24 hrs.
  5. naloxone (Narcan)

    Uses
    Action
    Pt teaching
    SFX/AFX
    Nurse Interventions
    • Uses: reveres effect of morphine (resp. dep)
    • Action: BLOCKS ops receptors.
    • Pt teaching:
    • -will monitor Pt until opioid effects resolve.
    • -Instruct on use of autoinjector and if used, seek emergency care ASAP.
    • SFX: hypertension, N/V
    • AFX: tachycardia, vfib, seizures
    • Nurse Interventions:
    • -Monitor respiratory depth and rate. Provide oxygen, ventilation, and other resuscitation measures.

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