Ch 24 Drugs Treating Mild To Moderate Pain, Fever, INFLammation, And Migrane

The correct answer is "all of the above." Patient teaching for acetaminophen therapy should include taking only the recommended dose, reading the labels of all over-the-counter medications to avoid overdose, and seeking medical care immediately in case of overdose. It is important for patients to understand the proper dosage and potential risks associated with acetaminophen use to ensure their safety and well-being.

The most appropriate statement is "We will monitor your lithium level closely and make any adjustments necessary." This response acknowledges the patient's concern about taking other drugs with lithium and reassures them that their lithium levels will be closely monitored. It also suggests that any necessary adjustments to the medication regimen will be made based on these monitoring results. This response demonstrates a proactive approach to the patient's care and addresses their concerns effectively.

The correct answer is "You have three predisposing factors for an increased risk to develop an ulcer with aspirin therapy. Let's start with trying to quit smoking." This statement acknowledges the patient's risk factors (arthritis, smoking, and alcohol consumption) and addresses the most important factor, which is smoking. Quitting smoking can significantly reduce the risk of developing an ulcer with aspirin therapy. It shows a proactive approach to addressing the patient's lifestyle choices and promoting their overall health.

Aspirin is contraindicated in patients with peptic ulcer disease. This is because aspirin is a nonsteroidal anti-inflammatory drug (NSAID) that can irritate the lining of the stomach and increase the risk of developing ulcers or worsening existing ulcers. Therefore, Constance, who has peptic ulcer disease, should avoid taking aspirin to prevent further damage to her stomach lining.

The most common adverse effects to most NSAIDs are gastrointestinal (GI) in nature. NSAIDs can irritate the lining of the stomach and intestines, leading to symptoms such as stomach pain, indigestion, nausea, vomiting, and even ulcers or bleeding in severe cases. These GI side effects occur because NSAIDs inhibit the production of certain chemicals in the body that help protect the stomach lining. It is important to take NSAIDs with food or use stomach-protective medications to minimize these GI effects.

Hepatoxicity is a well-known adverse effect associated with acetaminophen therapy. Acetaminophen is primarily metabolized in the liver, and excessive or prolonged use can lead to liver damage or toxicity. This can occur due to the formation of a toxic metabolite called N-acetyl-p-benzoquinone imine (NAPQI), which depletes glutathione and causes oxidative stress in the liver. Hepatoxicity can manifest as elevated liver enzymes, jaundice, liver failure, or even death in severe cases. It is important to use acetaminophen within the recommended dose range and avoid concomitant use with alcohol to minimize the risk of hepatoxicity.

The correct answer is "It may take up to 2 weeks to feel the benefit of this medication." This response acknowledges the patient's concern and provides an explanation for why they may not be feeling better yet. It is important to educate the patient about the expected timeline for improvement with ibuprofen and reassure them that it may take some time for the medication to take effect. This response also indicates that the current treatment plan should be continued for now.

Sumatriptan should not be given to patients with pre-existing cardiovascular disorders because it can cause vasoconstriction, which may lead to an increase in blood pressure and potentially worsen the condition. It is important to consider the patient's medical history and assess the risks and benefits before prescribing any medication, especially for patients with underlying cardiovascular issues.

The most frequently occurring adverse effects of sumatriptan commonly affect the cardiovascular system. This means that the drug is more likely to cause negative effects on the heart and blood vessels. It is important to monitor patients taking sumatriptan for any cardiovascular symptoms or complications.

Celecoxib is a prescription medication because it is a COX-2 inhibitor that is specifically designed to target inflammation and pain associated with osteoarthritis. Unlike aspirin and ibuprofen, which are available over the counter, celecoxib has a lower risk of causing gastrointestinal (GI) upset. This is particularly important for the patient with a history of a gastric ulcer, as COX-2 inhibitors are known to have a reduced risk of causing GI complications compared to non-selective NSAIDs like aspirin and ibuprofen. Therefore, prescribing celecoxib ensures better pain relief with a lower risk of GI side effects for the patient.

Aspirin is known for its analgesic (pain-relieving), anti-inflammatory, and antipyretic (fever-reducing) properties. However, aspirin is not an antihistamine. Antihistamines are medications commonly used to treat allergies and allergic reactions by blocking the effects of histamine, a chemical released by the immune system during an allergic response. Aspirin does not have this specific action and is not typically used for allergy relief.

Acetaminophen is a medication commonly used for pain relief and reducing fever. It has analgesic properties, meaning it can relieve pain, and antipyretic properties, meaning it can reduce fever. Therefore, the correct answer is "analgesic and antipyretic."

Salicyclism is a condition that occurs due to mild aspirin toxicity. The symptoms of salicyclism include headache, tinnitus (ringing in the ears), and gastrointestinal (GI) distress. Headache is a common symptom experienced by individuals with salicyclism. Tinnitus is another symptom characterized by a ringing or buzzing sound in the ears. GI distress refers to discomfort or pain in the gastrointestinal system, which can include symptoms such as nausea, vomiting, and stomach pain. Therefore, the answer choice "headache, tinnitus, and GI distress" accurately describes the symptoms associated with salicyclism.

The question "Are you taking the drug at the first sign of the headache?" would be appropriate in response to the patient's statement because it addresses the timing of when the patient takes the medication. Sumatriptan is most effective when taken at the earliest sign of a migraine attack, so if the patient is not taking it at the first sign, it may explain why their headaches are not going away for a long time. This question helps to assess if the patient is using the medication correctly and may provide insight into potential reasons for the lack of response to the medication.

Sumatriptan works by vasoconstriction and inhibiting the release of proinflammatory neuropeptides. Vasoconstriction refers to the narrowing of blood vessels, which helps to reduce the blood flow and pressure in the affected area, relieving pain. Inhibiting the release of proinflammatory neuropeptides helps to reduce inflammation and pain. This dual mechanism of action makes sumatriptan effective in treating migraines and cluster headaches.

The correct answer is daily PT/INR. PT/INR stands for prothrombin time/international normalized ratio, which measures the clotting ability of the blood. Warfarin is an anticoagulant medication that works by thinning the blood, so monitoring the PT/INR levels is crucial to ensure that the patient is receiving the appropriate dosage of warfarin. Daily monitoring is necessary because the patient is at an increased risk of bleeding due to the combination of aspirin and warfarin. Monitoring urine output, respiratory rate, and CBC every other day are not directly related to the patient's anticoagulation therapy.

Acetaminophen overdose can cause liver damage, and acetylcysteine is the antidote for acetaminophen toxicity. It helps to prevent or reduce liver damage by replenishing glutathione, a substance that helps the liver process toxins. Therefore, the nurse should expect to administer acetylcysteine to the patient who attempted suicide by swallowing acetaminophen.

It is important for a 70-year-old patient prescribed with aspirin for arthritis treatment to return for lab tests every 6 months because aspirin can potentially affect kidney and liver function. Regular lab tests can help monitor any changes in these organs and ensure the safety and effectiveness of the medication.

It is important to explain to the patient that the medication should not be crushed if they have difficulty swallowing. Crushing the medication may alter its absorption and effectiveness.

Celecoxib is the correct answer because it is a selective COX-2 inhibitor, which means it specifically targets the enzyme responsible for inflammation without affecting the COX-1 enzyme that protects the stomach lining. This selective action reduces the incidence of gastrointestinal adverse effects compared to other non-selective NSAIDs like naproxen, diclofenac sodium, and mefenamic acid.

The patient should have all of the above lab tests done periodically because acetaminophen can have potential side effects on the liver and kidneys. CBC (complete blood count) can help monitor any changes in blood cell counts, liver function tests can assess the liver's health and detect any potential liver damage, and kidney function tests can evaluate the kidney's ability to filter waste products from the blood. Regular monitoring of these lab tests can ensure the patient's safety and detect any adverse effects of long-term acetaminophen use.

Patients receiving sumatriptan should be taught not to take the medication for ordinary headaches because sumatriptan is specifically indicated for the treatment of migraines. Taking sumatriptan for ordinary headaches may lead to unnecessary medication use and potential side effects. It is important for patients to understand the appropriate use of sumatriptan and to consult their healthcare provider for guidance on managing different types of headaches.

Patients with nasal polyps and asthma are at an increased risk for aspirin-induced bronchospasm when undergoing aspirin therapy. Aspirin can trigger an exaggerated response in the airways, leading to narrowing and constriction of the bronchial tubes, resulting in bronchospasm. This can cause difficulty in breathing, wheezing, and coughing. It is important for healthcare providers to be aware of this potential risk and take necessary precautions when prescribing aspirin to patients with nasal polyps and asthma.

Patients receiving ibuprofen on a regular basis should be told to contact the physician or nurse practitioner immediately if they note unusual bruising. This is because ibuprofen can affect blood clotting and increase the risk of bleeding. Unusual bruising may indicate a problem with blood clotting or a potential bleeding disorder, and it is important for the patient to seek medical attention promptly to prevent any further complications.

The analgesic effects of ibuprofen typically start to occur within 2 to 4 hours after administration. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that works by reducing inflammation and pain. It inhibits the production of prostaglandins, which are responsible for causing pain and inflammation in the body. While ibuprofen may start to provide some relief within 30 minutes, it usually takes a few hours for the full analgesic effects to be felt. The duration of these effects can vary from person to person, but they generally last for around 4 to 6 hours.

The usual dosage of aspirin is 650 mg every 4 to 6 hours. This means that a person should take 650 mg of aspirin every 4 to 6 hours as directed.

Ketorolac is the NSAID that can be administered both orally and intramuscularly (IM). This means that it can be taken by mouth as well as injected into the muscle. Ketoprofen, mefenamic acid, and naproxen, on the other hand, are typically only available in oral formulations and cannot be administered intramuscularly. Therefore, ketorolac is the correct answer as it offers both oral and IM administration options.

Celecoxib is a nonsteroidal anti-inflammatory drug (NSAID) that selectively inhibits the enzyme cyclooxygenase-2 (COX-2). Unlike other NSAIDs, celecoxib does not have antiplatelet activity, meaning it does not interfere with the normal clotting function of platelets. This is an important distinction as many other NSAIDs, such as aspirin, do have antiplatelet activity and can increase the risk of bleeding. Therefore, the correct statement is that celecoxib does not have antiplatelet activity.

Acetaminophen should not be taken by individuals who consume alcohol regularly or excessively. This is because both alcohol and acetaminophen can cause liver damage, and when used together, they can increase the risk of liver toxicity. Since John is an alcoholic, it is advisable for him to avoid taking acetaminophen to prevent further harm to his liver.

Salicylate poisoning may occur in adults with a dose of 10 - 30 g. Salicylates are found in aspirin and other medications, and they can be toxic in high doses. Symptoms of salicylate poisoning include nausea, vomiting, tinnitus, rapid breathing, and confusion. In severe cases, it can lead to respiratory distress, seizures, and even death. It is important to seek medical attention if salicylate poisoning is suspected, as treatment may involve gastric decontamination, administration of activated charcoal, and supportive care.

The patient being a steroid-dependent asthmatic suggests that their asthma is severe and requires long-term steroid therapy to control symptoms. Aspirin is known to inhibit the production of substances that cause inflammation in the body, which can be beneficial for asthma. However, in some individuals, aspirin can worsen asthma symptoms. Therefore, to achieve the desired anti-inflammatory effect, the patient may need to increase their aspirin dose.

Patients with depression would have an increased risk for adverse effects when taking sibutramine. This is because sibutramine is a medication used for weight loss, and depression is a mental health disorder that can be associated with changes in appetite and weight. Therefore, the use of sibutramine in patients with depression may exacerbate their symptoms or have negative effects on their mental health.

While the patient receives NSAIDs for tendonitis, it is important to monitor for the loss of hypertension control. Propranolol is a beta-blocker commonly used to treat hypertension, and NSAIDs have the potential to reduce the effectiveness of antihypertensive medications. Therefore, monitoring for the loss of hypertension control is crucial to ensure that the patient's blood pressure remains well-controlled while receiving treatment for tendonitis.

NSAIDs (nonsteroidal anti-inflammatory drugs) have a longer duration of action compared to salicylates. This means that the effects of NSAIDs last longer in the body than those of salicylates. This can be beneficial for managing pain and inflammation as it reduces the frequency of medication dosing. It is important to note that this statement does not imply that if one NSAID does not work, none of them will be effective. Each NSAID has its own unique properties and may work differently for different individuals.

Celecoxib is a type of nonsteroidal anti-inflammatory drug (NSAID) just like ibuprofen. However, unlike ibuprofen, celecoxib does not have the same blood-thinning effects. Since the patient is switching from ibuprofen to celecoxib, it is important to add an additional 81 mg of aspirin a day to ensure that the patient continues to receive the blood-thinning benefits. This is especially important for older patients who may be at a higher risk for cardiovascular events. Therefore, the patient should be advised to take an additional 81 mg of aspirin a day.