Analgesics Part 1: NSAIDS | Pharmacology Help for Nursing Students

Summary

This video explains the role of analgesics, focusing on NSAIDs, acetaminophen (Tylenol), and aspirin. NSAIDs, such as ibuprofen and naproxen, reduce pain, fever, and inflammation by blocking cyclooxygenase enzymes, but can cause GI issues, kidney problems, and fluid retention. Aspirin offers similar benefits with an added anti-platelet effect, while acetaminophen only provides pain relief and fever reduction. Nursing considerations include monitoring kidney function, educating patients on taking NSAIDs with food to minimize GI upset, and being alert to signs of GI bleeding. Patients with asthma should avoid these medications due to potential bronchospasms.

Takeaways

• 😀 NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) help relieve pain, reduce inflammation, and lower fever. Common examples include ibuprofen (Advil) and naproxen (Aleve).
• 😀 Aspirin offers pain relief, reduces inflammation, and lowers fever, but also has an anti-platelet effect, making it different from other NSAIDs.
• 😀 Acetaminophen (Tylenol) provides pain relief and reduces fever but does not have anti-inflammatory or anti-platelet effects.
• 😀 NSAIDs work by inhibiting the enzyme cyclooxygenase (COX), which prevents the production of prostaglandins, substances that cause pain and inflammation.
• 😀 Common side effects of NSAIDs include gastrointestinal (GI) upset, such as nausea, vomiting, and acid reflux, due to the inhibition of COX-1, which protects the stomach lining.
• 😀 NSAIDs can impair kidney function (nephrotoxicity) by reducing renal blood flow, which can lead to fluid retention, hypertension, and potentially worsen heart failure.
• 😀 NSAID use can increase the risk of stroke and myocardial infarction (heart attack) due to impaired platelet function and fluid retention.
• 😀 NSAIDs should not be given to patients with asthma, as they can increase the risk of bronchospasms.
• 😀 Nursing considerations for NSAIDs include monitoring renal function, such as BUN and creatinine levels, and urinary output, with any output under 30 mL/hr requiring immediate attention.
• 😀 Patient education should emphasize taking NSAIDs with food to reduce GI upset and reporting symptoms of GI bleeding, such as black tarry stools or coffee-ground emesis.

Q & A

What does the term 'analgesic' mean?

The term 'analgesic' comes from the Greek prefix 'an-' meaning without, and 'algesia' meaning to feel pain. It refers to substances that help relieve pain.

How do NSAIDs, like ibuprofen or Advil, function as analgesics?

NSAIDs decrease pain by inhibiting the production of prostaglandins, hormone-like substances that are involved in pain and inflammation. They also have anti-inflammatory and antipyretic (fever-reducing) effects.

What are the key differences between NSAIDs, aspirin, and acetaminophen?

NSAIDs, such as ibuprofen, are analgesic, anti-inflammatory, and antipyretic, but do not have anti-platelet effects. Aspirin shares all these properties, plus it has anti-platelet effects. Acetaminophen (Tylenol) is an analgesic and antipyretic but lacks anti-inflammatory and anti-platelet effects.

What enzymes do NSAIDs target to reduce pain and inflammation?

NSAIDs target and inhibit the cyclooxygenase (COX) enzymes, particularly COX-1 and COX-2. COX-1 maintains the stomach lining, while COX-2 is responsible for inflammation and pain.

What are some common side effects of NSAIDs?

Common side effects of NSAIDs include gastrointestinal upset (nausea, diarrhea, vomiting, acid reflux), impaired renal function (nephrotoxicity), fluid retention, increased risk of stroke, and myocardial infarction.

What are the risks associated with NSAID use in patients with asthma?

NSAIDs can increase the risk of bronchospasms in patients with asthma, so they should be avoided in these individuals. The mnemonic 'ban these medications from asthma patients' can help remember this.

What should nurses monitor when administering NSAIDs to patients?

Nurses should monitor renal function (BUN and creatinine levels), urinary output (especially if below 30 mL/hour), and watch for signs of gastrointestinal bleeding, such as black, tarry stools, coffee ground emesis, or unresolved abdominal cramping.

How can patients reduce the risk of gastrointestinal upset when taking NSAIDs?

Patients should take NSAIDs with food to minimize stomach upset. Additionally, if stomach issues persist, they may use proton pump inhibitors (PPIs) like Omeprazole to help decrease acid reflux.

Why should patients report signs of GI bleeding immediately when taking NSAIDs?

GI bleeding can be a serious side effect of NSAIDs. Signs include black, tarry stools, coffee ground vomit, and unresolved abdominal cramping, all of which require immediate medical attention.

What is a key patient education point when prescribing NSAIDs?

Patients should be educated to take NSAIDs with food, monitor for signs of GI bleeding, and avoid using these medications if they have asthma or certain other contraindications, such as a history of heart failure or renal impairment.