Chapter 21 exam

Question 1

what are bisphosphonates?

Answer 1

Nonhormonal agents

Question 2

how do bisphosphonates work?

Answer 2

◦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

Question 3

ex of bisphosphonated…

Answer 3

◦alendronate (Fosamax) and ibandronate (Boniva)

Question 4

ex of parathyroid hormone…

Answer 4

◦teriparatide (Forteo)

Question 5

what is teriparatide?

Answer 5

an injectable form of parathyroid hormone approved for postmenopausal women and men with osteoporosis at a high risk for having a fracture

Question 6

what do parathyroid hormones do?

Answer 6

◦Increases GI calcium absorption and renal tubular reabsorption of calcium, increasing bone mineral density, bone mass, and strength

Question 7

what forms are Calcitonin-Salmon available in?

Answer 7

nasal spray (Miacalcin) or as a subcutaneous injection

Question 8

what are functions of calcitonin-salmon ?

Answer 8

involved with calcium regulation, increases spinal bone density, and provides an analgesic effect in acute vertebral fractures

Question 9

when is calcitonin-salmon used?

Answer 9

◦Reserved for women who refuse or cannot tolerate HRT or in whom HRT is contraindicated

Question 10

Estrogens-HRT-

Answer 10

estrogen with or without progestin, is recommended for postmenopausal osteoporosis prevention only when unable to take other agents, and when benefits outweigh risks

Question 11

what do Selective Estrogen Receptor Modifiers (SERMs)-do?

Answer 11

◦Increase bone mineral density, decrease bone reabsorption, and reduce fracture risk without promoting breast or endometrial cancer

Question 12

ex of SERMs

Answer 12

◦raloxifene (Evista)

Question 13

definition of SERMs

Answer 13

selective estrogen receptor modifier with estrogen agonist activity on bone and lipids and estrogen antagonist activity on breast and uterine tissue

Question 14

what does estrogen before menopause do?

Answer 14

helps to maintain a normal bone reabsorption rate in women

Question 15

Osteoporosis Therapy includes-

Answer 15

◦ Therapy includes calcium, vitamin D, and prescription medications

Question 16

osteoporosis def

Answer 16

◦ 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

Question 17

who does osteoporosis most commonly affect?

Answer 17

◦Most commonly affects postmenopausal women

Question 18

what is osteoporosis diagnosis determined by?

Answer 18

◦Diagnosis is determined by measuring bone mineral density (BMD)

Question 19

what is an example of a COX-2 Inhibitor?

Answer 19

celecoxib (Celebrex)

Question 20

def of celecoxib?

Answer 20

NSAID that exhibits anti-inflammatory, analgesic, and antipyretic activities

Question 21

why would celecoxib be chosen over other NSAIDs?

Answer 21

Causes fewer gastric problems and less GI bleeding than other NSAIDs

Question 22

what does celecoxib do on a chemical level?

Answer 22

Selectively inhibits cyclooxygenase-2 (COX-2) prostaglandin synthesis

Question 23

FDA warning regarding the OTC non-selective NSAIDs-

Answer 23

◦ Should be used in strict accordance with label directions

◦ Self-treatment should not exceed ten days, unless directed by a physician

Question 24

what is an example of salicylates?

Answer 24

aspirin

Question 25

salicytes def….

Answer 25

are the oldest drug in this category with analgesic, anti-inflammatory, and antipyretic effects

Question 26

NSAIDS like ibuprofen…

Answer 26

inhibit synthesis of prostaglandins

Question 27

What drugs are used to treat arthritis, bursitis, gout, or muscle strains and sprains?-

Answer 27

NSAIDS/anti-inflammatories

Question 28

ex of NSAIDS

Answer 28

ex: ibuprofen, naproxen, indomethacin)

Question 29

how are NSAIDs given?

Answer 29

◦ Frequently given for lengthy time periods in maintenance doses as low as possible for effectiveness

Question 30

Anti-Inflammatory Drugs-

Answer 30

◦ Treat disorders in which the musculoskeletal system is not functioning properly due to inflammation

Question 31

Neuromuscular Blocking Agents-

Answer 31

◦ Muscle relaxants that cause a direct effect on the muscles including the diaphragm

Question 32

when are neuromuscular blocking agents used?

Answer 32

◦ Used during surgical, endoscopic, or orthopedic procedures

Question 33

what level of danger are neuromuscular blocking agents?

Answer 33

◦ Potentially very dangerous

Question 34

what can neuromuscular blocking agents result in?

Answer 34

◦ Can result in respiratory arrest because of the potential to paralyze the diaphragm

Question 35

with neuromuscular blocking agents…._______+_______ are given concurrently

Answer 35

◦ analgesics and sedatives given concurrently

Question 36

◦ MRs are given……

Answer 36

on a short term basis

Question 37

with MRs after acute pain subsides….

Answer 37

then prescribed exercises to strengthen the weak muscles

Question 38

most SMRs affect….

Answer 38

the central nervous system (brain + spinal cord)

Question 39

SMRs and central nervous system

Answer 39

◦ 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

Question 40

◦ Centrally acting drugs used to treat acute, painful musculoskeletal conditions

Answer 40

◦ diazepam (Valium)
◦ cyclobenzaprine (Flexeril)
◦ Used in management of spasticity from MS or cerebral palsy – dantrolene (Dantrium)