Arthritis, Osteoporosis, and Gout Meds Spark Notes Flashcards
Acetaminophen priority assessment
- CMP/BMP for liver function
- Alcoholism
- Use of barbiturates, carbamazepine, hydantoins, or rifampin (lower doses when used with acetaminophen)
Etanercept administration teaching
- Not for anyone who already has an impaired immune system
- Not for those with an acute infection, cancer, sepsis, TB, hep, myelosuppression, demyelinating disorders, prego and lactation, hepatic and renal disorders, HF, and latex allergy
- Do not take corticosteroids
Medication of choice for Gout attacks
Colchicine
Bisphosphonates instructions
-Take on arising in the morning with water 30-60 mins before other food or drinks and remain upright for at least 30 mins to prevent esophageal erosion
Colchicine medication intercations
- Avoid magnesium-containing antacids, cholestyramine or mineral oil, and digoxin
Role of Vitamin D in the prevention of osteoporosis
Sufficient levels of Vit D ensure proper mineralization of bone tissue, contributing to overall bone strength and integrity
- Needed for bone formation
- Enhances calcium absorption
Leflunomide and lab studies
- Leflunomide: DMARDS, Isoxazole derivative prototype
- Routine liver function studies because severe liver toxicity is an AE
DMARDS and Adverse reactions
DMARDS = often the 1st line for RA as it is aggressive
Methotrexate: Bone marrow suppression (check CBC), hepatic and renal toxicity (check CMP)
- N/V/D, anorexia, headache, fatigue, alopecia
Hydroxychloroquine: Visual changes from retinal damage (regular visual screenings), cardiomyopathy (arrhythmias + chest pain)
- headache, dizziness, N/V, ototoxicity
Leflunomide: Severe hepatic toxicity (routine liver function studies)
- rash
Calcitriol and common side effects
Calcitriol = Antihypocalemic agent
AE: Weakness, headache, N/V, dry mouth, constipation, muscle pain, bone pain, metallic taste
NSAIDs and Loop diuretics assessment
NSAIDs and loop diuretics can cause decreased diuretic effect
- Check med list of patients beforehand!
Hydroxychloroquine teachings
- Regular visual screenings are needed because of retinal damage
- Can cause arrhythmias and chest pain which can be a sign of cardiomyopathy
- Can be given to prego patients for RA
NSAIDs medication interactions
- Decreased diuretic effect when taken with loop diuretics
- Decreases antihypertensive effect of beta-blockers
- Risk of lithium toxicity when taken with ibuprofen
- Increased bleeding with anticoags, alcohol, or glucocorticoids
Methotrexate and folic acid teachings
Take methotrexate significantly after folic acid
Acetaminophen antidote
Acetylcysteine
Older adults and anti-inflammatories considerations
- Report OTC meds
- Naproxen, ketoprofen, and ketorlac should not be used in older adults because of increased toxicity
Symptoms of salicylism
N/V, tinnitus, hyperventilation
NSAIDs and lab studies
- CBC (bone marrow suppression), kidney functions (CMP, excretion), liver functions (CMP/BMP, metabolism), coag studies (platelet inhibition), prego tests (crosses)
Priority assessment questions related to bleeding
- Anticoags? Antiplatelets? NSAIDs? Aspirin? Acetaminophen?
- Bruise easy? Blood in stool?
Lab studies related to arthritis meds
- Hepatic and renal function studies (CMP/ BMP)
- Platelete/ Coag studies (CBC, PTT, INR)
- Prego tests (contraindicated for many)
Lab studies related to osteoporosis meds
- Hepatic and renal studies (CMP/ BMP)
- Prego tests (contraindication)
Lab studies related to gout meds
- Hepatic and renal function studies
- Coag studies (PTT, INR)
- CBC for blood disorders
Methotrexate and reproductive health education
- Don’t take if prego or lactating
- Folic acid supplements decrease the action of methotrexate
Lab studies for anti-inflammatories
- hepatic function (BMP/CMP)
