Lewis 68 - Musculoskeletal Problems Flashcards
MOA/Class
Prednisone, methylprednisolone
Steroids stabilize leukocytes (WBCs) preventing the release of intracellular chemical/inflammatory mediators
Restore/increase bronchial responsiveness to beta-adrenergic receptor stimulation
Systemic glucocorticoid/corticosteroid
Tucker 36
Side Effects
Prednisone, methylprednisolone
Growth suppression, elevated blood glucose, weight gain
GI upset (tolerated best in AM with food/milk)
Osteoporosis (long-term use)
Tucker 36
Nursing Considerations
Prednisone, methylprednisolone
Taper dose when stopping to prevent adrenal insufficiency
Tucker 36
Indications
Prednisone, methylprednisolone
Used to gain control of inflammatory musculoskeletal conditions.
Tucker 36
MOA/Class
ibuprofen, naproxen, ketorolac, indomethacin, celecoxib
Inhibit cyclooxygenase thus inhibiting inflammatory symptoms
NSAID
Tucker 16
Side Effects
ibuprofen, naproxen, ketorolac, indomethacin, celecoxib
GI upset/ulcers/bleeding, risk for thrombotic events
Tucker 16
Nursing Considerations
ibuprofen, naproxen, ketorolac, indomethacin, celecoxib
Monitor renal (and hepatic) function
Increased bleeding risk when combined with alcohol, anticoagulants, some herbals
Take with food
Misoprostol can help decrease risk for ulcers with chronic NSAID use
Stop NSAIDs several days prior to surgery/dental work
Celcoxib has less risk of GI irritation as it is a COX-2 inhibitor.
Tucker 16
Indications
ibuprofen, naproxen, ketorolac, indomethacin, celecoxib
Pain due to inflammation
Tucker 16
MOA/Class
cyclobenzaprine, tizanidine
Acts on the brainstem to decrease muscle spasms
Centrally-acting muscle relaxant
Tucker 25
Side Effects
cyclobenzaprine, tizanidine
CNS depression; may have some anticholinergic effects
Tucker 25
Nursing Considerations
cyclobenzaprine, tizanidine
Do not combine with alcohol or other CNS depressants.
Tucker 25
Indications
cyclobenzaprine, tizanidine
Short-term/intermittent treatment of acute muscle spasms/injuries.
Tucker 25
MOA/Class
duloxetine
Inhibits serotonin and norepinephrine reuptake in the CNS
SNRI
Tucker 21
Side Effects
duloxetine
Serotonin syndrome, neuroleptic malignant syndrome, Stevens-Johnson syndrome
Hepatotoxicity, drowsiness, constipation, dry mouth
Tucker 21
Nursing Considerations
duloxetine
Do not use within 14 days of MAOI medications
Taper dose to discontinue
Tucker 21
Indications
duloxetine
Antidepressant and nerve pain management
Tucker 21