Chapter 21 exam Flashcards
what are bisphosphonates?
Nonhormonal agents
how do bisphosphonates work?
◦Act directly to inhibit bone reabsorption, increasing bone mineral density at the spine and hip, and decreasing incidence of first and future fracture
◦ Bind strongly to and accumulate in bone, creating a reservoir of drug that is released back into systemic circulation gradually over a period of months or years after treatment is stopped
ex of bisphosphonated…
◦alendronate (Fosamax) and ibandronate (Boniva)
ex of parathyroid hormone…
◦teriparatide (Forteo)
what is teriparatide?
an injectable form of parathyroid hormone approved for postmenopausal women and men with osteoporosis at a high risk for having a fracture
what do parathyroid hormones do?
◦Increases GI calcium absorption and renal tubular reabsorption of calcium, increasing bone mineral density, bone mass, and strength
what forms are Calcitonin-Salmon available in?
nasal spray (Miacalcin) or as a subcutaneous injection
what are functions of calcitonin-salmon ?
involved with calcium regulation, increases spinal bone density, and provides an analgesic effect in acute vertebral fractures
when is calcitonin-salmon used?
◦Reserved for women who refuse or cannot tolerate HRT or in whom HRT is contraindicated
Estrogens-HRT-
estrogen with or without progestin, is recommended for postmenopausal osteoporosis prevention only when unable to take other agents, and when benefits outweigh risks
what do Selective Estrogen Receptor Modifiers (SERMs)-do?
◦Increase bone mineral density, decrease bone reabsorption, and reduce fracture risk without promoting breast or endometrial cancer
ex of SERMs
◦raloxifene (Evista)
definition of SERMs
selective estrogen receptor modifier with estrogen agonist activity on bone and lipids and estrogen antagonist activity on breast and uterine tissue
what does estrogen before menopause do?
helps to maintain a normal bone reabsorption rate in women
Osteoporosis Therapy includes-
◦ Therapy includes calcium, vitamin D, and prescription medications
osteoporosis def
◦ A systemic skeletal disease
◦ Characterized by low bone mass and deterioration of bone tissue, leading to bone fragility and increased susceptibility to fracture, especially of the hip, spine, and wrist
who does osteoporosis most commonly affect?
◦Most commonly affects postmenopausal women
what is osteoporosis diagnosis determined by?
◦Diagnosis is determined by measuring bone mineral density (BMD)
what is an example of a COX-2 Inhibitor?
celecoxib (Celebrex)
def of celecoxib?
NSAID that exhibits anti-inflammatory, analgesic, and antipyretic activities
why would celecoxib be chosen over other NSAIDs?
Causes fewer gastric problems and less GI bleeding than other NSAIDs
what does celecoxib do on a chemical level?
Selectively inhibits cyclooxygenase-2 (COX-2) prostaglandin synthesis
FDA warning regarding the OTC non-selective NSAIDs-
◦ Should be used in strict accordance with label directions
◦ Self-treatment should not exceed ten days, unless directed by a physician
what is an example of salicylates?
aspirin
salicytes def….
are the oldest drug in this category with analgesic, anti-inflammatory, and antipyretic effects
NSAIDS like ibuprofen…
inhibit synthesis of prostaglandins
What drugs are used to treat arthritis, bursitis, gout, or muscle strains and sprains?-
NSAIDS/anti-inflammatories
ex of NSAIDS
ex: ibuprofen, naproxen, indomethacin)
how are NSAIDs given?
◦ Frequently given for lengthy time periods in maintenance doses as low as possible for effectiveness
Anti-Inflammatory Drugs-
◦ Treat disorders in which the musculoskeletal system is not functioning properly due to inflammation
Neuromuscular Blocking Agents-
◦ Muscle relaxants that cause a direct effect on the muscles including the diaphragm
when are neuromuscular blocking agents used?
◦ Used during surgical, endoscopic, or orthopedic procedures
what level of danger are neuromuscular blocking agents?
◦ Potentially very dangerous
what can neuromuscular blocking agents result in?
◦ Can result in respiratory arrest because of the potential to paralyze the diaphragm
with neuromuscular blocking agents…._______+_______ are given concurrently
◦ analgesics and sedatives given concurrently
◦ MRs are given……
on a short term basis
with MRs after acute pain subsides….
then prescribed exercises to strengthen the weak muscles
most SMRs affect….
the central nervous system (brain + spinal cord)
SMRs and central nervous system
◦ No direct effect on skeletal muscle
◦ Reduces muscle spasm, causes alterations in the perception of pain, and produces a sedative effect, promoting rest and relaxation
◦ Centrally acting drugs used to treat acute, painful musculoskeletal conditions
◦ diazepam (Valium)
◦ cyclobenzaprine (Flexeril)
◦ Used in management of spasticity from MS or cerebral palsy – dantrolene (Dantrium)
