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NSG-533-H11 Advanced Pharmacology Exam Two Study Guide – Download For An A+

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Course
NSG 533

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Chamberlain College Of Nursing

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NSG-533-H11 Advanced Pharmacology Exam Two Study Guide –
Download For An A+
What are the various Pain types of pain and how do they differ.
Consider acute, chronic, nociceptive, neuropathic and malignant
pain
acute- sudden and usually subside when treated (ex: postop pain)
chronic- persistent or recurring , lasting 3 -6months or longer, difficult
to treat
nociceptive-pain results from the stimulation of sensory nerve fibers.
transmit pain signals from various body regions to the spinal cord and
brain which creates the sensation of pain
neuropathic- results from damage to peripheral or CNS nerve fibers by
disease or injury but may be idiopathic (unexplained)
malignant pain- associated with diminishing function due to disease
progression. Emphasize non-pharmacological treatments

What are some non-pharmacological approaches to pain
• acupuncture, art therapy, behavior therapy, biofeedback, comfort
measures, counseling, distraction, hypnosis, imagery, music/pet
therapy, therapeutic communication, baths, touch, yoga, hot/cold
packs

The World Health Organization (WHO) has recommended a three-
step ladder approach to pain management. What is this approach
and provide examples of proper therapy at each step
§ Also see figure 34-1, 34-2 and table 34-1
NSAIDs

,mechanism:
-inhibits the leukotriene pathway, the prostaglandin pathway or both.
- relieves pain, headache, and inflammation by blocking the chemical
activity called the cyclooxygenase (COX) enzyme
*ALL NSAIDs can be ulcerogenic and induce gastrointestinal bleeding
due to their activity against COX1

Aspirin
– inhibits platelet aggregation. Has the ability to be an irreversible
inhibitor of COX-1receptors within the platelets themselves. perfect for
treatment in MI and other thromboembolic disorders. Other NSAIDs
lack these antiplatelet effects.
Indication : analgesic, anti-inflammatory, and antipyretic effects, and
antiplatelet inhibition
Contraindication; known drug allergy, conditions that place the patient
at risk for bleeding, vitamin K deficiency and peptic ulcer disease.
• Category C ( in first and second trimester) Category D (not
recommended in 3 trimester)
rd

- stop taking NSAIDs 1 week before surgery
- not recommended for breastfeeding, secreted in breastmilk
Adverse effect: gastrointestinal bleeding, risk of heart attack, stroke,
death
***Ceiling effect- NSAIDs show ceiling effects that can limit their
effectiveness. any further increase in the dosage beyond a certain level
increases the risk of adverse effect without a corresponding increase in
the therapeutic effect

, Celebrex- CO-2 inhibitor (arthritis and dysmenorrhea)

A. Pain – 16% of exam
Acetaminophen
B. mechanism (works similar to salicylates)
- it blocks peripheral pain impulses by inhibition of prostaglandin
synthesis.
- lowers febrile body temperatures by acting on the hypothalamus
- lack anti-inflammatory effects, not associated with CV effects
(edema) or platelet effect (bleeding)
- analgesic and antipyretic

C.

1. Know the normal maximum daily dose of Acetaminophen
and the maximum daily dose of Acetaminophen in the
elderly. Understand Acetaminophen is also in
combination products.
Acetaminophen APAP: The maximum recommended dose for patients
with normal renal and hepatic function is 4000 mg/day.
FDA limited the APAP component of narcotic analgesic combination to
325 mg per dosing unit.
maximum dose should be reduced by 50% to 75% in patients with renal
dysfunction or hepatic disease and in those who engage in excessive
alcohol use.
b. Know which medications are Cyclooxygenase inhibitors.
COX 1: promotes the synthesis of prostaglandins that have beneficial
effects on various bodily functions (ex: maintains intact gastrointestinal
mucosa)

NSAIDs: nonselective (they inhibit COX-1 and COX-2)
Aspirin, ibuprofen, and naproxen

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