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Which therapies may benefit patients with chronic inflammatory states?
Management of nutrition is not important for patients with gastrointestinal inflammation.
False
What type of diet may a dietitian recommend for patients with chronic inflammation?
Anti-inflammatory diet
Patients may need to decrease consumption of foods high in __________ and cholesterol.
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Match the complementary health approaches with their benefits:
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Which of the following therapies are supported for patients with inflammatory bowel disease?
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Pharmacologic therapies are primarily focused on enhancing the inflammatory response in the body.
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What are the primary chemical mediators most anti-inflammatory drugs aim to decrease?
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Moderate inflammation and pain can be treated with __________ NSAIDs.
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Match the following drug types with their usage:
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What is one common side effect of long-term corticosteroid use?
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Corticosteroids have a milder effect than cortisol.
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What syndrome can long-term use of corticosteroids lead to, characterized by fat deposits in the cheeks?
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Corticosteroids inhibit the synthesis of __________ to suppress the immune response.
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Match the following side effects with their descriptions:
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What is a primary effect of aspirin?
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Acetaminophen can cause gastrointestinal symptoms similar to those of aspirin.
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What condition should aspirin not be given to children under age 19?
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Nonsteroidal anti-inflammatory drugs (NSAIDs) inhibit the synthesis of a precursor of __________.
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Match the following drugs with their effects:
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What is a major risk associated with large doses of acetaminophen?
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Selective COX-2 inhibitors do not cause GI symptoms.
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What should be considered when administering aspirin to patients on anticoagulants?
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What serious adverse effect can result from long-term use of corticosteroids?
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Which statement best describes the primary action of corticosteroids in the body?
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Which of the following is NOT a common side effect of corticosteroid therapy?
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What is a potential risk of corticosteroids related to infections?
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Which of these effects is characteristic of Cushing syndrome caused by corticosteroid use?
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What therapeutic effect does aspirin NOT provide?
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What is a serious risk associated with overdose of acetaminophen?
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Why should children under age 19 avoid aspirin during viral infections?
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Which of the following is an advantage of acetaminophen over aspirin?
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What class of drugs specifically avoids affecting the COX-1 enzyme?
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What condition is associated with the long-term use of corticosteroids?
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Which enzyme do nonsteroidal anti-inflammatory drugs (NSAIDs) inhibit to reduce pain and inflammation?
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What should be carefully considered when prescribing NSAIDs to a patient?
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Study Notes
Acute Inflammatory Response
- Patients may require hospitalization.
- Healthcare team may include a surgeon, respiratory therapist, and a specialist in the underlying disease process.
Chronic Inflammatory State
- Often associated with aging and obesity.
- Patients may benefit from a balanced diet and exercise.
- Registered dietitians and physical therapists may be involved.
Anti-inflammatory Diet
- Dietitians can advise patients on consuming an anti-inflammatory diet.
- This diet includes omega-3 fatty acids, antioxidant vitamins, and probiotics.
- It should decrease consumption of pro-inflammatory foods, including saturated fats, cholesterol, and high glycemic index foods.
Physical Therapy
- Physical therapists can help patients build muscle strength and increase overall physical health.
- They encourage exercise and physical activity.
- They can also help patients regain the use of limbs affected by inflammation-related loss of function.
Complementary and Alternative Medicine (CAM)
- Management of nutrition is vital for managing GI inflammation and similar illnesses.
- There is conflicting evidence on the use of CAM in inflammatory disease.
- Probiotics, acupuncture, cognitive-behavioral therapies, and exercise have shown some support for use in Inflammatory Bowel Disease (IBD).
- These integrative therapies help control different aspects of the disease process, including mental health components.
### Complementary Health Approaches for GI Inflammation
- Probiotics, acupuncture, cognitive-behavioral therapies, and exercise have shown to be helpful in managing Inflammatory Bowel Disease (IBD)
- These therapies help address both physical and mental health aspects of IBD
- While data is conflicting, there's evidence suggesting their effectiveness in managing inflammatory conditions.
Pharmacologic Therapy for Inflammation
- Pharmacologic therapies are primarily aimed at decreasing inflammation, pain, and fever.
- The focus is on reducing the production of prostaglandins, which contribute to inflammation by increasing capillary permeability, attracting white blood cells, and causing pain and fever.
- Nonprescription salicylates, nonprescription nonopioid analgesics, nonprescription and prescription Nonsteroidal Anti-inflammatory Drugs (NSAIDs), and prescription corticosteroids are used to manage inflammation and pain.
- Nonprescription options are effective for mild to moderate inflammation, pain, and fever.
- Prescription NSAIDs are used for moderate inflammation and pain.
- Severe inflammation is treated with oral or parenteral corticosteroids.
- Opioids, discussed in a separate module, are used to manage severe pain.
Salicylates
- Aspirin (acetylsalicylic acid, ASA) is a common analgesic, anti-inflammatory, and antipyretic drug.
- Aspirin inhibits COX-1 and COX-2 enzymes, preventing prostaglandin production.
- Enteric-coated aspirin helps minimize GI irritation and bleeding.
- Aspirin's antiplatelet effect prohibits use with anticoagulants.
- Children under 19 should avoid aspirin during flu, flu-like illnesses, or chickenpox due to Reye syndrome risk.
Nonopioid Analgesics
- Acetaminophen is a non-aspirin, non-opioid analgesic and antipyretic, reducing fever by inhibiting the hypothalamus' temperature control center.
- Its advantage over aspirin is the lack of GI symptoms and suitability for children with the flu.
- Acetaminophen overdose can cause liver damage, potentially fatal.
NSAIDs (Nonsteroidal Anti-inflammatory Drugs)
- NSAIDs are both prescription and non-prescription drugs with anti-inflammatory, analgesic, and antipyretic effects.
- They inhibit prostaglandin precursor synthesis by blocking COX-1 and COX-2 enzymes.
- Side effects include gastric ulcers, GI bleeding, and increased stroke or myocardial infarction risk.
- Selective COX-2 inhibitors have the same effects as other NSAIDs but do not block COX-1, avoiding GI symptoms and blood clotting issues.
- NSAIDs have fewer adverse effects than corticosteroids.
- NSAIDs should not be combined with anticoagulants due to platelet effects.
Corticosteroids
- Cortisol, secreted by the adrenal gland cortex, has natural anti-inflammatory properties.
- Corticosteroids are potent drugs, much stronger than cortisol, effectively treating autoimmune diseases and severe inflammation.
- Corticosteroids broadly suppress the immune response by inhibiting prostaglandin synthesis, histamine release, and phagocyte/lymphocyte function.
- Adverse effects include hyperglycemia, mood swings, cataracts, peptic ulcers, electrolyte imbalance, weight gain, acne, nausea, insomnia, impaired wound healing, and osteoporosis.
- Long-term use can suppress adrenal function leading to Cushing syndrome, characterized by facial fat deposits, extremity thinning, muscle wasting, abdominal obesity, poor wound healing, growth suppression in children, facial hair growth, and amenorrhea in women.
- Corticosteroids can mask underlying infections by reducing inflammation signs and symptoms.
- Due to their wide-ranging cellular effects, corticosteroids require careful management.
Salicylates
- Aspirin (acetylsalicylic acid, ASA) is the most frequently used analgesic and anti-inflammatory drug.
- Aspirin has antipyretic effects, decreasing fever.
- Aspirin inhibits COX-1 and COX-2 enzymes, which normally produce a precursor of prostaglandins.
- Aspirin is useful for treating mild to moderate pain and inflammation.
- Large doses of aspirin can cause GI irritation and bleeding, but enteric-coated aspirin can minimize these symptoms.
- Aspirin has an antiplatelet effect, so its use is contraindicated in patients taking anticoagulant drugs.
- Children under 19 should not be given aspirin for flu, flulike illness, or chickenpox due to the risk of Reye syndrome, which can be fatal.
Nonopioid Analgesics
- Acetaminophen is a nonaspirin, nonopioid analgesic with antipyretic effects.
- Acetaminophen decreases fever by inhibiting the temperature control center of the hypothalamus.
- Acetaminophen is useful for treating mild to moderate pain and reducing fever.
- It avoids the GI symptoms caused by aspirin and can be given to children with the flu.
- Overdose can occur easily due to the number of medications containing acetaminophen.
- Large doses can cause liver damage, which can be fatal.
NSAIDs
- Nonsteroidal anti-inflammatory drugs (NSAIDs) are both nonprescription and prescription drugs with anti-inflammatory, analgesic, and antipyretic effects.
- They are widely prescribed for mild to moderate inflammation and pain.
- NSAIDs inhibit the synthesis of a precursor of prostaglandins by blocking COX-1 and COX-2 enzymes.
- Side effects of NSAIDs include gastric ulcers, GI bleeding, and increased risk of stroke or myocardial infarction.
- Selective COX-2 inhibitors have the same effects but selectively block COX-2, avoiding GI symptoms and blood clotting problems.
- NSAIDs have fewer adverse effects than corticosteroids.
- NSAIDs can affect platelets, so they should not be given to someone on anticoagulant drugs.
Corticosteroids
- The adrenal gland cortex secretes cortisol, which has natural anti-inflammatory effects.
- Corticosteroids are powerful drugs that are more effective than cortisol.
- Corticosteroids are the most effective medications for treating autoimmune diseases and severe or life-threatening inflammation.
- Corticosteroids suppress the immune response by inhibiting prostaglandin synthesis, suppressing histamine release, and inhibiting phagocytes and lymphocytes.
- Corticosteroids can have serious adverse effects, including:
- Hyperglycemia
- Mood swings
- Cataracts
- Peptic ulcers
- Electrolyte imbalance
- Weight gain
- Acne
- Nausea
- Insomnia
- Impaired wound healing
- Osteoporosis
- Long-term use can suppress adrenal gland function, causing Cushing syndrome with characteristic features like:
- Fat deposits in the cheeks
- Thinning of the extremities
- Muscle wasting and weakness
- Abdominal obesity
- Poor wound healing
- Growth suppression in children
- Dark facial hair and amenorrhea in females
- Corticosteroids can mask underlying infections due to their anti-inflammatory effects.
- Corticosteroid use must be managed carefully due to their effects on nearly every cell in the body.
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Description
This quiz covers the acute and chronic inflammatory response, including the roles of healthcare professionals and the benefits of an anti-inflammatory diet. It also highlights the importance of physical therapy in managing inflammation-related conditions and improving overall health. Test your knowledge on the interdisciplinary approach to treating inflammation.
