Drugs for Inflammation and Fever

1. Drugs for Inflammation and Fever Chapter 33

2. Inflammatory Response Define the inflammatory response. Discuss the central purpose of the response. Identify triggering events. Verbalize the cardinal symptoms.

3. Inflammation Compare and contrast Acute and Chronic inflammation. Discuss the role of pharmacotherapy. Identify common inflammatory diseases.

4. Chemical Mediators Define mediator Identify chemical mediators Discuss the role of chemical mediators in the inflammatory response.

5. Histamine Key chemical mediator Primarily stored in mast cells When released Quickly initiates inflammatory response Stimulates pain receptors Differentiate between H1 and H2 receptors.

6. Inflammatory Response vs. Anaphylaxis Differentiate between the inflammatory response and anaphylaxis

7. Cyclooxygenase Discuss the physiologic function of cyclooxygenase. Differentiate between Cox-1 and Cox-2.

8. Nonsteroidal Antiinflammatory Drugs Analgesic, Antipyretic, Antiinflammatory Inhibit prostaglandins Prototype: ibuprophen, p. 475 Indications for use: Mild to moderate inflammation Fever Dysmenorrhea Pain

9. NSAIDs: Nursing Considerations Assess for: Bleeding disorders, PUD, HF, fluid retention, HTN, renal disease, diuretic use, lithium, anticoagulants, herbal supplements, alcohol and cigarettes Baseline RFTs, LFTs, CBC Monitor bleeding time in long term use Assess for: GI bleed, hepatitis, nephrotoxicity, hemolytic anemia, salicylate toxicity

10. NSAIDs: Nursing Considerations Be alert for signs of hypersensitivity Contraindication: Liver disease Liver disease ASA: Age < 18 yrs Use cautiously HF elderly

11. Glucocorticoids Discuss the role of glucocorticoid therapy in treatment of inflammation. Prototype: prednisone, p. 477 Compare and contrast the mechanism of action of NSAIDs and glucocorticoids. Compare and contrast the side effects of NSAIDs and glucocorticoids.

12. Glucocorticoids Identify the key teaching point and rationale regarding withdrawal of glucocorticoids.

13. Glucocorticoid Therapy: NCs Short term for severe inflammation Cautious: immunocomprimised, pregnant, lactating, mental instability Prior to therapy assess for: Current drug hx, PUD, renal disease, HTN, osteoporosis, varicella, DM, HF, mental instability Be alert for drug interactions Long term: alternate day dosing Contraindicated: systemic fungal infections

14. Glucocorticoid Therapy: Client Education Take with food or milk Same time each day Do not suddenly stop drug avoid exposure to infection No alcohol, cigarettes, caffeine, ASA Immediately report Difficulty breathing; heart burn; chest, abdominal or joint pain; nose bleed

15. Fever What is fever? Identify causes of fever. Describe the beneficial effects of fever.

16. Fever Identify the therapeutic drug class used to treat fever. Identify pharmacologic drug classifications. Discuss the goal of pharmacotherapy. Prototype: acetaminophen, p. 479

17. Antipyretic Therapy: NCs Prior to therapy assess VS Baseline RFTs, LFTs Acetaminophen contraindicated in liver disease NSAIDS may be contraindicated with warfarin Salicylates contraindicated < 18 yrs of age

18. Antipyretic Therapy: Client Teaching Liquid forms available in different concentrations < 1 yr of age: use infant drops Immediately report: Nausea, vomiting, abdominal pain Notify HCP if fever not gone within 3 days