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NSG 533 Advanced Pharmacology Exam 2 Questions With All Correct Answers 2024/2025
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NSG 533 Advanced Pharmacology Exam 2 Questions With All Correct Answers 2024/2025
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NSG 533 Advanced Pharmacology Exam 2Pain
the maximum common symptom prompting patients to visit number one care providers. More
than 80% of patients who go to physicians report ache. Often remains under treated.
Nociceptive pain
ache from a regular process that effects in noxious stimuli being perceived as painful. Explained
via ongoing tissue damage.
Thermal, mechanical and chemical nociceptors that interact "withdrawal" reflex observed with
the aid of inflammatory response to defend injured tissue
functional pain
ache sensitivity because of an ordinary processing or function of the principal fearful device in
response to everyday stimuli
neruopathic pain
Pain resulting from lesions or other harm to the frightened gadget.
Diabetic peripheral neuropathy
modern deterioration of nerve function that outcomes in loss of sensory perception
acute ache
is pain that occurs due to damage or surgery, under 3 months. Poorly dealt with acute ache can
purpose psychological stress and compromise the immune gadget. Somatic acute pain is an
damage to pores and skin, bone, joint, muscle and connective tissue. Visceral ache entails
damage to nerves on inner organs. Treat aggressively. Examples: reduce hand, menstrual
cramps.
Chronic pain
can be intermittent or chronic, greater than 3 months. Main influences include a) results on
bodily feature b) mental modifications c) social effects and d) societal effects. Usually
concerning existence threatening illnesses along with cancers, aids, revolutionary neurological
sicknesses, end level organ failure, dementia. Management must be multimodal with cognitive
,interventions, physical manipulations, pharmacological marketers, surgical interventions, and
regional or spinal anesthesia.
Chronic malignant ache
Painn is related to a progressive existence-threatening disorder like most cancers, aids,
neurologic diseases, stop degree organ failure, and dementia. Goal is pain remedy and
prevention. Dependence or addiction isn't a challenge. Pain no longer related to existence
threatening ailment and lasting greater than 6 months past the healing period is called "chronic
nonmalignant pain."
What are a few non-pharmacological strategies to ache?
Imagery, distraction, rest, psychotherapy, biofeedback, cognitive behavioral therapy, help
corporations, and religious counseling. Physical therapy, warmth, cold, water, ultrasound, TENS,
rub down and healing workout.
WHO three step analgesic ladder
* 1- nonopioid
* 2 - opioid for mild to mild ache
* 3 - opioid for moderate to severe pain
WHO first step pain ladder
slight ache/nonopioid analgesics inclusive of NSAIDS or acetaminophen w/ or w/out adjuvants
(which include pregablin) .. "discomfort." Med examples: apap 1000mg q 6hrs, ibu600mg q6 hrs
NSAIDs
Non-steroidal anti inflammatory capsules. Related to numerous clinically substantial
contraindications and drug interactions. NSAIDS are similarly effective in analgesia, antipyretic
and anti-inflammatory effects. Choice have to include STEPS (simplicity, tolerability, proof, rate,
protection). If affected person fails therapy with an agent from one class of NSAIDs, use of an
agent from some other class is cheap.
COX2 inhibitors
Celecoxib (Celebrex) selective dealers (celecoxib) have best indication in patients with high risk
for GI bleed, excessive intolerance of non-selective NSAIDS, or remedy failure with
non-selective retailers. NSAIDs are of minimal value in neuropathic pain. NSAIDs produce a flat
dose reaction curve (celling impact) with higher doses presenting no extra efficacy than slight
doses.
, Acetaminophen
Tylenol. Blocks PG synthesis in CNS, inhibits peripheral pain impulses. APAP does no longer
intrude with COX 1 or COX2 and thus has no anti inflammatory advantages.
WHO pain ladder step 2
mild pain: weak opioids (hydrocodone, codeine, tramadol) w/ or w/out nonopioid analgesics w/
or w/out adjuvants "on every occasion I do something, it hurts" med examples: apa325mg + cod
60mg this fall hrs
WHO ache ladder step 3
severe and continual pain, amazing opioids (morphine, tapentadol, oxycodone, hydromorphone,
fentanyl, w/ or w/out non-opioid analgesics and without or with adjuvants "regardless of what I
do it hurts, theres a bone protruding of my pores and skin!" Examples; morphine 10mg q4 hrs,
hydromorphone 4mg q4 hr
What is the mechanism of NSAIDs and precautions to apply?
NSAIDS are either nonselective (inhibit cox 1 and cox 2) or selective (inhibit cox 2). Cox 2
inhibition is responsible for anti-inflammatory consequences. - Cox 1 contributes to elevated GI
and renal toxicity assoc with nonselective NSAIDS. Use with caution in patients with dyspepsia,
peptic ulcers, bleeding, and patients taking corticosteroids. Nephrotoxicity can arise inside the
aged. A boxed caution is now required for prescription nonselective NSAIDs and Celecoxib due
to the growth hazard of cardiovascular events and GI bleeding. Generally pts prescribed
NSAIDS will need PPI's.
Managment for NSAID risks
Pts extra pre-disposed to GI toxicity if pre-present ulcer or dyspepsia, H Pylori contamination,
older age, and some concurrent medicines increase hazard. Management alternatives for GI
aspect results include taking with food or milk, Switch to distinct NSAID with better protection
profile, COX2 selective agent (celecoxib) and/or gastroprotection (H2RA, PPI, misoprostol
Celecoxib
is recommended for patients at multiplied threat of gastrointestinal bleeding / ulcer who require
a NSAID -Side results can also encompass htn, and irritating bronchial asthma signs and
symptoms.
Tordol (Ketorolac)
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