Okay.
We are still working through our nervous system medications.
We will now be talking about analgesics.
If you are following along with our flashcards, we are on flashcard number 69.
So in this video, we will talk about antipyretics, NSAIDs, and salicylates.
Alright.
Let's first talk about an antipyretic medication, which is acetaminophen or Tylenol is the brand
name.
Acetaminophen is used for mild to moderate pain and for a fever.
It works by inhibiting prostaglandin synthesis in the CNS.
It doesn't have many side effects, but the one important side effect that it does have
is hepatotoxicity with large doses.
So it actually carries a black-box warning because of this risk for hepatotoxicity.
So it's going to be really important that your patient not exceed 4 grams a day of acetaminophen.
And keep in mind that many over-the-counter products, like for colds, do contain acetaminophen
as well.
So if your patient is using acetaminophen for pain and also using a cold product with
acetaminophen, they can get too much of that.
They may exceed that 4 grams a day.
So definitely keep an eye on that and provide that education to your patient.
And also keep in mind that acetylcysteine is the antidote for an acetaminophen overdose.
Alright.
Now, let's talk about NSAIDs, which are non-steroidal anti-inflammatory drugs.
Medications that fall within this class include ibuprofen, naproxen, ketorolac, as well as
indomethacin.
You would use an NSAID for mild to moderate pain, fever, or inflammation.
So you'll notice when we talked about acetaminophen, we didn't include inflammation because it
really doesn't work that well for that purpose.
But NSAIDs can help decrease inflammation.
In addition, indomethacin can help close a patent ductus arteriosus, or PDA, in premature
babies.
In terms of the mode of action, NSAIDs work to inhibit prostaglandin synthesis.
Side effects are definitely more numerous than what we saw with acetaminophen.
So side effects can include GI upset, GI bleeding, renal toxicity, a rash, and possible headache.
So some important teaching-- if your patient has peptic ulcer disease or any other kind
of bleeding disorder, then NSAIDs would really be contraindicated because of that risk of
GI bleeding.
In addition, you should counsel your patient to avoid alcohol, as this can also increase
the risk for a GI bleed when using NSAIDs.
Alright.
Let's talk about another NSAID that is a COX-2 inhibitor.
The medication that falls within this class is celecoxib or brand name Celebrex.
This medication can be used for osteoarthritis as well as rheumatoid arthritis.
It works by inhibiting the COX-2 enzyme which decreases prostaglandin synthesis, and that
in turn causes a decrease in pain and inflammation.
So my little tip for remembering this medication is that, "with celecoxib you can celebrate,
since you don't have any more arthritis pain."
Possible side effects include an increased risk for thrombosis, which can lead to an
MI or stroke.
It also carries a risk for GI bleeding and the development of a rash.
So it's important to note that celecoxib would be contraindicated if your patient has an
allergy to aspirin, NSAIDs, or sulfonamides.
Now let's talk about a salicylate, which is aspirin.
So aspirin is used to treat pain, inflammation, fever, it can also be used to treat Kawasaki
disease and it could be used to prevent an MI in patients who are at risk.
So there's plenty of patients out there that get a little baby aspirin every day to help
prevent a myocardial infarction.
The mode of action of aspirin is to inhibit prostaglandin synthesis.
It also decreases platelet aggregation.
Side effects for aspirin are important to know.
They include tinnitus which is ringing in the ear, GI upset, GI bleeding, as well as
a rash.
So if your patient has peptic ulcer disease or some kind of bleeding disorder, then you
would not want to give aspirin to them.
Also, you would not give aspirin to children with a fever due to the risk for Reye's syndrome.
And then, it's important to monitor your patient for signs of salicylism which include tinnitus,
nausea and vomiting, and respiratory alkalosis.
So the Cool Chicken hint that's at the top of this card uses the word aspirin to help
you remember some of the key side effects.
So in the word aspirin, A stands for abdominal pain or GI upset which we talked about.
S stands for salicylism which is a key thing we're going to be looking for in a patient
who is taking aspirin.
P stands for peptic ulcer disease.
I stands for intestinal blood loss.
So that's our GI bleed.
R stands for Reye's syndrome which is something we want to avoid, which is why we're not giving
it to children.
And then, I stands for itchy rash.
And then, N stands for noise.
In this case, tinnitus, which is that ringing in the ears.
So hopefully, that will help you remember some of the key side effects with aspirin.
So in my next video, we will go over some more important analgesics.
Thanks so much for watching and hang in there with me!