Drugs affecting the Musculoskeletal System

Question 1

Arthritis Medication

Answer 1

1) Narcotic Analgesics
2) Non-narcotic Analgesics
- Salicylates
- Non-salicylates
- Acetaminophen
3) Corticosteroids
4) DMARDS
5) Anti-Gout

Question 2

Salicylates

Answer 2

Action: Inhibits prostaglandid synthesis
Inhibits cycloxgenase
Inhibit arachiodonic acid conversion

Synthetic: origin-bark of the willow tree
Acetylsalicyclic Acid(Asprin, ASA)-prototype

Dose:81-650mg depending on indication

Question 3

Salicylate Drug:

ASA(Asprin)

Answer 3

1) Anti-inflammatory: Arthrits, Dose: up to 3g
2) Non-narcotic Analgesic: mild-moderate pain, dose 650mg q4-6hrs
3) Anti-pyretic: reduce fever, Dose: 650mg q4h
4) Anti-platelet: prolonged clotting time, prophylaxis-CVA,MI,Dose:81mg or 325mg per day

Question 4

Salicylates Adverse Reactions

Answer 4

Hypersensitivity: mild to severe- itiching, rash,swollen tongue/throat(angioedema)

Gastrotoxcity- NVD,ulcers in gi tract, bleeding
Neurotoxcity-buzzing,ringing in ear
Hematologic reaction-bleeding can occur
Hepatotoxcity-
Reyes Syndrome: occurs with children with viral syndrome

Question 5

Salicylism

Answer 5

• Acute Poisoning
• Early symptoms: Nausea, vomitting,tinnitus,headaches, and hyperventiliation

Later symptoms: hyperactivity,fever,confusion,and seizures
Rhabdomyolysis, acute renal failure, and respiratory failure may eventually develop

Chronic poisoning

• subtle confusion, changes in mental status,fever,dehydration
• elderly
• therapeutic blood serum levels -10-20mg

Question 6

NSAID

Non-Steroidal Anti-Inflammatory drugs

Answer 6

• non salicylates
• action: inhibit prostaglandin synthesis
• indication: same as ASA
• chronic pain
• Dysmennorhea(pain during menstrual cycle)

Question 7

NSAID Adverse Reactions

Answer 7

• same as ASA
• cardiotoxic=increases with long term use @risk for Mi/CVA
• SJS
• gastrotoxcitiy-loss of appetite can still gain weight

Question 8

NSAID Drug:

Ibuprofen(Advil,Motrin)

Answer 8

Dose: q4-6hrs

• Arthritis
  
  • 1200-2400mg/day
  • decrease to 800-1200mg/day
• Mild to mod fever, 400-800mg
• taken with food or milk for gastrotoxcity

Question 9

NSAID Drug:

Naproxen(Aleve,Naprosyn)

Answer 9

• dose: q8-12hrs
• 500-1000mg/day
• controlled release tablets is 750-1000 mg/day
• minimize number of time patient has to take it
• NSAIDS require patient education and 10days or more

Question 10

NSAID Drug:

Diclofenac and Misoprostol(Cytotec)=(Arthrotec)

Answer 10

Dose(diclofenac/misoprostal)
50mg/200g
75mg/200g

• -ordered recieving on long term
• prevent ulcer
• protect gastric lining
• not going to use on pregnant female

Question 11

NSAID Drug:

Celecoxib(Celebrex)

Answer 11

Dose:

• ostearthritis
• 100mg twice daily or 200mg as a single dose
• Rheumatoid arthritis
• 100-200mg twice daily
• cox inhibitor minimize risk for ulcer
• very cardiotoxic
• use for bone disease

Question 12

Acetaminophen(tylenol)

Answer 12

• non salicylate
• action: unknown
• indication: mild to mod pain, reduce fever, DOES NOT reduce inflammation