:: SCC-Nephrology Continuing Education ::


New User? Register Here...

CLICK HERE

User Name:
Password:

Forgot your password?

SUBMIT

Want to take this course? Click here to sign up!

Title

Pharmacology for Dialysis Practitioners, Part 3: Analgesics and Anti-inflammatories (1.5 credit hours)

Abstract

This course focuses on the pharmacological suppression of pain and inflammation, with attention to the distinction between analgesic (pain suppression) and anti-inflammatory effects. First, the author examines the mechanisms of action and efficacy of opioid and non-opioid analgesics. This is followed by description and analysis of the distinctions between the anti-inflammatory and immunosuppressant effects of glucocorticoids, with attention to side effects and their relation to the use of steroid preps prior to stressful medical treatment.

Planners, content specialists and feedback personnel have declared that there is no conflict of interest in the preparation and content of this module. There is no commercial support for or endorsement of products in this module.

Author

Dan Becker, D.D.S

Dr. Becker received his bachelor of science in zoology from Ohio University in 1968 and his doctor of dental surgery from Ohio State University in 1972. Although Dr. Becker is a dentist, his interest always centered on academia and he began teaching biology at Sinclair Community College (Dayton, OH) as a part-time instructor in the autumn of 1972. He accepted a full-time faculty position in the Dental Hygiene department in 1976, but continued his teaching within the Biology department as well.

Dr. Becker's interest in pharmacology and anesthesia attracted him to Miami Valley Hospital where he became involved with their dental residency instructing dental residents and learning from mentors during rotations within departments of anesthesia and emergency medicine. During this time, he developed and taught courses in pharmacology and pathophysiology for nursing and other allied health programs until his teaching at Sinclair became entirely devoted to these subject areas. Currently he is a full professor at Sinclair Community College and Associate Director of Education at Miami Valley Hospital. He has published in numerous scientific journals and textbooks, and lectures extensively throughout the United States and Canada.

Objectives

Compare and contrast aspirin, ibuprofen and acetaminophen in terms of action, and both primary and secondary effects.
Distinguish opioid and non-opioid analgesics in terms of mechanism of action and efficacy.
Distinguish the antiinflammatory and immunosuppressant effects of glucocorticoids. Discuss their side effects, including their influence on the HPA axis, and relate these to the concepts of alternate-day therapy and the use of steroid preps prior to stressful medical treatment.

Resources

Bibiography

Abramowicz M. (Editor) Drugs for pain. In: The Medical Letter on Drugs and Therapeutics. 2001;43:138-150.

Abramowicz M. (Editor) Acetaminophen safety. In: The Medical Letter on Drugs and Therapeutics. 2002;44:91-93

Allison MC, Howatson AG, Torrance CJ, Lee FD, Russell RI. Gastrointestinal damage associated with the use of nonsteroidal antiinflammatory drugs. N Engl J Med 1992; 327:749-754.

Brooks PM, Day RO. Nonsteroidal antiinflammatory drugs - differences and similarities. N Engl J Med 1991;324(24):1716-1725.

Gutstein HB, Akil H. Opioid analgesics. In: Hardman JG, Limbird LE. Eds. Goodman and Gilman's The Pharmacological Basis of Therapeutics. 10th edition. New York: McGraw-Hill, 2001.

Malmberg AB, Yaksh TL. Hyperalgesia mediated by spinal glutamate or substance P receptor blocked by spinal cyclooxygenase inhibition. Science 1992;257:1276-9.

Roberts LJ, Morrow JD. Analgesic-antipyretic and antiinflammatory agents and drugs employed in the treatment of gout. In: Hardman JG, Limbird LE, Eds. Goodman and Gilman's The Pharmacological Basis of Therapeutics. 10th edition. New York: McGraw-Hill, 2001.

Schimmer BP, Parker KL. Adrenocorticotropic hormone; Adrenocortical steroids and their synthetic analogs; Inhibitors of the synthesis and actions of adrenocortical hormones. In: Hardman JG, Limbird LE, Eds. Goodman and Gilman's The Pharmacological Basis of Therapeutics. 10th edition. New York: McGraw-Hill, 2001.

Stein CS. The control of pain in peripheral tissue by opioids. N Engl J Med 1995;332(25):1685-1690.

Whitcomb DC, Block GD. Association of acetaminophen hepatotoxicity with fasting and ethanol. JAMA 1994;272(23):1845-50.

Webliography

General Info

Non-Opioid Analgesics

Page Name: Aspirin: A New Look at an Old Drug
URL: http://www.fda.gov/fdac/features/1999/299_asp.html
Notes: A short history of aspirin and discussion of contemporary (1994) research on aspirin.

Page Name: Physicians, Fads, and Pharmaceuticals: A History of Aspirin
URL: http://www.mjm.mcgill.ca/issues/v02n02/aspirin.html
Notes: A more thorough history of aspirin

Page Name: acetaminophen
URL: http://www.bartleby.com/65/ac/acetam.html
Notes: very brief description/definition of acetaminophen.

Opioid Analgesics

Page Name: endorphins
URL: http://www.bartleby.com/65/en/endorphi.html
Notes: Short definition of endorphins.

Anti-inflammatory Drugs

Page Name: cortisol
URL: http://www.bartleby.com/65/co/cortisol.html
Notes: short definition, explanation of cortisol.

Page Name: Prednisone
URL: http://asthma.about.com/health/asthma/library/weekly/aa071299.htm
Notes: Description of and explanation of uses/side effects of prednisone

Want to take this course? Click here to sign up!