Pain, Inflammation, and Infection Medications

• This module focuses on medications for managing pain, controlling inflammation, and treating infections, addressing prevalent health concerns. Using these medications significantly improves the quality of life for patients with various conditions.

Module Objectives

• Recognize common medications for pain, inflammation, or infection which are the base of pharmacologic therapy in clinical practice like analgesics, anti-inflammatory drugs, and antibiotics.
• Contrast various classes of medications prescribed for pain, inflammation, or infection by detailing the differences between over-the-counter and prescription options, and understanding how each class functions within the body to alleviate symptoms and address underlying causes.
• Recognize indications, pharmacokinetics, lab monitoring, and side effects of commonly prescribed medications, which allows healthcare professionals to make informed decisions about individual patient care and tailor treatments that are both effective and safe.
• Discuss accepted nursing practice for clients taking medications for pain, inflammation, or infection, emphasizing the vital role of nurses in medication administration, patient education, and monitoring for efficacy and potential adverse effects.
• Explain common adverse reactions and client education for frequently prescribed medications, ensuring patients understand the importance of adherence to prescribed regimens, recognizing side effects, and knowing when to seek further medical attention.

Readings

• Chapters 15, 16, 17, and 26 from the Tucker textbook provide foundational knowledge and insights into the pharmacology of medications commonly used in practice, including real-world applications and considerations.

Activities

• Concepts in Action Animation: Acute Inflammation, Immune Response, which offers a visual and interactive representation of the physiological processes involved in inflammation and the immune system's response, facilitating deeper understanding.
• One-Minute Nurse Videos and Quizzes: NSAIDS, Fever, Naloxone, providing quick, focused educational content and assessments to reinforce learning and application of key principles related to medication management.
• Lippincott Advisor for Education; Drugs: Morphine, Pentazocine, Naloxone, Diphenhydramine, Fexofenadine, Aspirin, Ibuprofen, Celecoxib, Acetaminophen, Hydrocortisone, Prednisone, Allopurinol, Probenecid, serves as a comprehensive resource for nurses to reference detailed information about these drugs, including dosing, contraindications, and patient education points.
• Estimated time to complete the module is 11 hours and 45 minutes.
• Students are expected to come to class prepared.

Chapter 15: Introduction to the Immune Response and Inflammation Learning Objectives

• List four natural body defenses against infection.
• Describe the cells associated with the body’s fight against infection and their basic functions.
• Outline the sequence of events in the inflammatory response.
• Correlate the events in the inflammatory response with the clinical picture of inflammation.
• Outline the sequence of events in an antibody-related immune reaction and correlate these events with the clinical presentation of such a reaction.

Key Terms

• Antibodies: Immunoglobulins produced by B-cell plasma cells and memory cells in response to a specific protein, reacting with that protein to cause its destruction directly or through activation of the inflammatory response.
• Antigen: Composed of proteins, peptides, and polysaccharides, often portions of cell walls, with the potential to facilitate an immune response.
• Arachidonic Acid: Released from injured cells to stimulate the inflammatory response through activation of various chemical substances.
• Autoimmune Disease: A disorder in which the body responds to specific self-antigens, producing antibodies or cell-mediated responses against its own cells.
• B Cells: Lymphocytes programmed to recognize specific proteins; when activated, they cause the production of antibodies to react with that protein.
• Calor: Heat, one of the four cardinal signs of inflammation, caused by activation of the inflammatory response.
• Chemotaxis: The property of drawing neutrophils to an area.
• Complement Proteins: A series of cascading proteins that react with the antigen–antibody complex to destroy the protein or stimulate an inflammatory reaction.
• Dolor: Pain, one of the four cardinal signs of inflammation, caused by activation of the inflammatory response.
• Hageman Factor: The first factor activated when a blood vessel or cell is injured; it starts the cascading reaction of the clotting factors, activates the conversion of plasminogen to plasmin to dissolve clots, and activates the kinin system responsible for activation of the inflammatory response.
• Interferon: A type of cytokine released in response to viral invasion, blocking viral replication and helping to modulate inflammation.
• Interleukins: Chemicals released by white blood cells (WBCs) to communicate with other WBCs and to support the inflammatory and immune reactions.
• Kinin System: A system activated by Hageman factor as part of the inflammatory response, including bradykinin.
• Leukocytes: White blood cells, including neutrophils, basophils, or eosinophils.
• Lymphocytes: White blood cells with large, varied nuclei, including T cells, B cells, or natural killer cells.
• Macrophages: Mature leukocytes capable of phagocytizing an antigen (foreign protein), also called monocytes or mononuclear phagocytes.
• Major Histocompatibility Complex: The genetic identification code carried on a chromosome, producing several proteins or antigens that allow the body to recognize cells as being self-cells.
• Mast Cells: Fixed basophils found in the respiratory and gastrointestinal tracts and in the skin, releasing chemical mediators of the inflammatory and immune responses when stimulated by local irritation.
• Myelocytes: Leukocyte-producing cells in the bone marrow that can develop into neutrophils, basophils, eosinophils, monocytes, or macrophages.
• Phagocytes: Neutrophils and macrophages that are able to engulf and digest foreign material.
• Phagocytosis: The process of engulfing and digesting foreign organic materials.
• Pyrogen: A fever-causing substance.
• Rubor: Redness, one of the four cardinal signs of inflammation, caused by activation of the inflammatory response.
• T Cells: Lymphocytes programmed in the thymus gland to recognize self-cells; they may be effector T cells, helper T cells, or suppressor T cells.
• Tumor: Swelling, one of the four cardinal signs of inflammation, caused by activation of the inflammatory response.

Key Points

• The response to inflammatory stimuli involves local vasodilation, increased capillary permeability, and the stimulation of pain fibers. These reactions alert the person to the injury and increase blood flow to the area.
• The immune response provides a specific reaction to foreign cells or proteins.
• T cells can be cytotoxic (destroying nonself-cells), helper (augmenting an immune reaction), or suppressor (dampening the immune response).
• B cells produce antibodies in response to exposure to specific antigens or proteins.
• Antibodies react with the specific antigen to produce an antigen–antibody complex that activates complement proteins. This results in the destruction of the antigen.
• Other mediators that affect the immune and inflammatory responses include interferons, tumor necrosis factor, and interleukins.
• The immune and inflammatory responses work together to protect the body.

Summary

• The body’s defense mechanisms against injury or foreign invasion include the skin, mucous membranes, normal flora, gastric acid, and the inflammatory and immune responses.
• The inflammatory response is a general response to any cell injury, involving activation of various chemicals and neutrophil activity, particularly Hageman factor, to stimulate the kinin system and histamine release from injured cells.
• Clinical signs of an inflammatory reaction include heat (calor), redness (rubor), swelling (tumor), and pain (dolor).
• The immune response is specific to an antigen or protein and involves B cells, antibodies, and T cells.
• Types of T cells: effector or cytotoxic T cells, helper T cells, and suppressor T cells.
  • Effector or cytotoxic T cells immediately destroy foreign cells.
  • Helper T cells stimulate immune and inflammatory reactions.
  • Suppressor T cells dampen the immune and inflammatory responses.
• B cells recognize specific proteins or foreign antigens and, upon contact, produce antibodies (immunoglobulins) that react directly with the protein.
• The reaction of an antibody with the protein activates the complement cascade and lyses the associated protein or precipitates an aggressive inflammatory reaction.
• Chemicals involved in communication among the immune system parts alter the immune response.
• T cells, B cells, and inflammatory reactions work together to protect the body from invasion, limit the response, and restore homeostasis.
• Patient problems within the immune system include neoplasms, viral invasions, autoimmune diseases, and transplant rejections.

This module explores common medications used to treat pain, inflammation, and infection. It covers medication classes, indications, pharmacokinetics, lab monitoring, and side effects. Accepted nursing practices, adverse reactions, and client education are also discussed.