NSG 533 | NSG533 Exam 2 Questions
and Answers Graded A+ | Latest 2024 |
Wilkes
NSAID Mechanism and Precautions
Nonselective NSAIDs inhibit COX-1 and COX-2, with COX-2 inhibition responsible for anti-inflammatory effects. Precautions include increased GI and renal toxicity and peptic ulcers.
Acetaminophen (APAP) Use and Precautions
Indicated for mild-moderate pain, inhibits prostaglandin synthesis,
with restrictions for maximum daily doses and contraindications for certain health conditions and alcohol use. Overdose and liver issues can happen.
Adjuvant Analgesics
Medications with non-pain indications but useful for pain management, especially for chronic and neuropathic pain, including examples like gabapentin and antidepressants like duloxetine Pain Classification
Categories include acute, chronic, nociceptive, neuropathic, and malignant pain, each with distinct characteristics and treatment approaches.
Non-pharmacological Pain Approaches
Methods such as stretches, ice, and heat used as alternatives or complements to medication for pain management.
WHO Three-Step Ladder Approach
1. Non-opioid plus optional adjuvant analgesic
2. Weak opioid plus non-opioid and adjuvant analgesics
3. Strong opioid plus non-opioid and adjuvant analgesics
Opioids Mechanism of action
Opioids stimulate CNS opioid receptors for analgesia. Pure agonists (morphine) bind to u-receptors to produce analgesia that increases with dose and does not have ceiling effects. Partial agonists such as tramadol at the u-receptor cause less conformational change and receptor activation than full antagonists.
Equianalgesic Doses and Opioid Rotation
Converting total daily opioid dose to morphine equivalents, considering incomplete cross tolerance and the need for opioid rotation in some cases.
Migraine and Cluster Headache Classification
Classification of migraine headaches with and without aura, and cluster headaches according to the International Headache Society (IHS).
Migraine Management Approach
Stepwise approach involving NSAIDs, triptans, and preventative strategies, considering factors like contraindications and comorbidities.
Osteoarthritis (OA) Presentation and Goals Typical presentation includes joint pain and morning stiffness, with
therapy goals focused on pain relief, mobility maintenance, and quality of life improvement.
OA Treatment Approach
Stepwise treatment including non-pharmacological interventions, NSAIDs as first-line therapy, and opioids for severe pain or contraindications to other treatments.
NSAID Introduction and COXib Use
NSAIDs are first-line therapy, with COX-2 inhibitors preferred for patients at high risk for GI complications, while COX-1 inhibitors provide pain and inflammation relief.
NSAIDs
First-line therapy for pain and inflammation relief
COX-1
Responsible for adverse effects on gastric mucosa, kidney, and platelets
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