Autoimmune Diseases That Affect the Musculoskeletal System - Chapter 15 Flashcards
Autoimmune Diseases
-occurs when the immune system turns against itself
Autoimmune Disease Triggers
- Virus exposure
- Environmental toxins
- Sun
- Genetics
- Hormonal changes
- Drugs
- Pregnancy
Myositis
-Chronic inflammation of muscles
Multiple Sclerosis
- Myelin is attacked causing inflammation and often permanent damage
- Nerve impulses can be completely disrupted
Symptoms of MS
- Vision and speech disturbances
- Extreme fatigue
- Bladder and bowel dysfunction
- Spasticity and tremor
- Pain
- Depression/mood changes
- Balance problems
Rheumatoid Arthritis
-Characterized by inflammation of the lining of the joints, pain, joint damage, and disability
Systemic Lupus Erythematosus
- ANA levels are elevated
- Has many different symptoms. called “the disease with 1000 faces”
Treatment of Autoimmune Diseases that Affect the Musculoskeletal System
- Suppress inflammation and reduce swelling and pain
- Slow progression of disease
Drugs That Suppress Inflammation ands Reduce Swelling and Pain
- Glucocorticosteroids
- NSAIDS
- Salicylates
Drugs that Slow Progression of Disease
- DMARDS
- BRM’s
Glucocorticosteroids Examples
- betamethasone
- dexamethasone
- hydrocortisone
- methylprednisolone
- prednisone
- prednisolone
- triamcinolone
Brand: Betaject, Celestone Soluspan
Generic: betamethasone acetate
Brand: Decadron, Dexasone
Generic: dexamethasone
Brand: Cortef, Solu-Cortef
Generic: hydrocortisone
Brand: Depo-Medrol, Medrol, Solu-Medrol
Generic: methylprednisolone
Brand: Winpred, Deltasone
Generic: prednisone
Brand: Pediapred
Generic: prednisolone
Brand: Aristospan, Kenalog-10, Kenalog-40
Generic: triamcinolone
Glucocorticosteroids ADR’s
- Gi ulceration
- Osteoporosis
- Acne
- Cataracts
- Poor wound healing
- Infection
- Insomnia
- Euphoria
- Edema
- Hypertension
- Nausea
- Weight gain
Glucocorticosteroid Warning Labels
- TAKE WITH FOOD
- DONT D/C ABRUPTLY
- TAKE AT THE SAME TIME EACH DAY
- TAKE WITH FULL GLASS OF WATER
NSAIDS and Aspirin (ASA) Examples
- acetylsalicylic acid
- celecoxib
- diclofenac
- diclofenac/misoprostol
- diflunisal
- etodolac
- floctafenine
- flurbiprofen
- ibuprofen
- indomethacin
- ketoprofen
- ketorolac
- mefenamic acid
- meloxicam
- nabumetone
- naproxen
- naproxen sodium
- oxaprozin
- piroxicam
- sulindac
- tenoxicam
- tiaprofenic acid
Brand: Aspirin
Generic: acetylsalicylic acid
Brand: Celebrex
Generic: celecoxib
Brand: Voltaren, Voltaren SR, Voltarin Rapide, voltaren Emugel, Cambia, Pennsaid
Generic: diclofenac
Brand: Arthrotec
Generic: diclofenac/misoprostol
Brand: diflunisal, Dolobid
Generic: diflunisal
Brand: etodolac, Ultradol
Generic: etodolac
Brand: floctafenine, Idarac
Generic: floctafenine
Brand: flurbiprofen, Ansaid, Froben
Generic: flubiprofen
Brand: Advil, Motrin
Generic: ibuprofen
Brand: indomethacin, Indocid
Generic: indomethacin
Brand: ketoprofen, Orudis SR
Generic: ketoprofen
Brand: Toradol
Generic: ketorolac
Brand: mefenamic acid, Ponstan
Generic: mefenamic acid
Brand: Mobicox
Generic: meloxicam
Brand: nabumetone, Relafen
Generic: nabumetone
Brand: Naprosyn, Naprosyn SR, Naprelan
Generic: naproxen
Brand: Aleve, Anaprox, Anaprox DS
Generic: naproxen sodium
Brand: oxaprozin, Daypro
Generic: oxaprozin
Brand: piroxicam, Feldene
Generic: piroxicam
Brand: sulindac, Clinoril
Generic: sulindac
Brand: tenoxicam, Mobiflex
Generic: tenoxicam
Brand: tiaprofenic acid, Surgam
Generic: tiaprofenic acid
NSAIDS and ASA ADR’s
- Nausea
- GI bleeding
- Ulceration
- Dizziness
- Salicylism (aspirin)
- Hepatotoxicity (ketoralac)
NSAID Warning Labels
- TAKE WITH FOOD
- AVOID ASPIRIN AND RELATED PRODUCTS
- MAY CAUSE DIZZINESS
- SWALLOW WHOLE; DONT CRUSH OR CHEW
Different Types of Disease-Modifying Antirheumatic Drugs (DMARDS)
- Immunosuppressives
- Antimalarials
- Interleukin antagonists (BRM)
- Fusion Protein (BRM)
- TNFa inhibitors (BRM)
- Non TNF-a Inhibitors
Immunosuppressants Examples
- azathioprine
- cyclophosphamide
- cyclosporine
- chlorambucil
- methotrexate
- tacrolimus
Brand: Imuran
Generic: azathioprine
Brand: Cytoxan, Procytox
Generic: cyclophosphamide
Brand: Neoral, Sandimune I.V.
Generic: cyclosporine
Brand: Leukeran
Generic: chlorambucil
Brand: Rheumatrex
Generic: methotrexate
Brand: Prograf
Generic: tacrolimus
Immunosuppressant Warning Labels
- TAKE WITH FOOD
- AVOID PREGNANCY
- TAKE AT THE SAME TIME EACH DAY
- SWALLOW WHOLE; DONT CRUSH OR CHEW
- AVOID ASPIRIN AND NSAIDS (cyclophosphamide)
- AVOID ALCOHOL (cyclosporine)
- AVOID GRAPEFRUIT JUICE (cyclosporine)
Methotrexate Warning Labels
- AVOID ASA AND NSAIDS
- AVOID ALCOHOL
- AVOID PROLONGUE EXPOSURE TO SUNLIGHT
- AVOID PREGNANCY
Antimalarials Examples
- chloroquine
- hydroxychloroquine
Brand: chloroquine, Aralen
Generic: chloroquine
Brand: Plaquenil
Generic: hydroxychloroquine
Antimalarial Warning Labels
- AVOID ANTACIDS
- TAKE WITH FOOD
- AVOID PROLONGUED EXPOSURE TO SUNLIGHT
Additional DMARDS for RA Examples
- leflunomide
- sulfasalazine
- auranofin
- penicillamine
Brand: Arava
Generic: leflunomide
ADRs:
- liver toxicity
- fetal toxicity
- nausea
- hair loss
- liver disfunction
Brand: Salazopyrin
Generic: sulfasalazine
ADR’s:
- GI upset
- photosensitivity
- allergy
- crystalluria
- impaired folic acid absorption
- damage to white blood cells
Brand: Ridaura
Generic: auranofin
ADR’s: itching
- rash
- metallic taste
- photosensitivity
- sore mouth
- interstitial pneumonia
Brand: Cuprimine
Generic: penicillamine
ADR’s:
- rash
- GI upset
- nephrotoxicity
Biological Response Modifiers (BRM): Interleukin Antagonists Examples
-anakinra
Brand: Kineret
Generic: anakinra
Biological Response Modifiers (BRM): TNF-a Inhibitors Examples
- adalimumab
- infliximab
- certolizumab
- golimumab
- etanercept
Brand: Humira
Generic: adalimumab
Brand: Remicade, Remsima, Inflectra
Generic: infliximab
Brand: Cimzia
Generic: certolizumab
Brand: Simponi
Generic: golimumab
Brand: Enbrel
Generic: etanercept
Other DMARDS
- minocycline
- sodium aurothiomalate
Brand: Minocin
Generic: minocycline
Brand: Myochrisine, Sodium Aurothiomalate Inj.
Generic: sodium aurothiomalate
