Mobility Flashcards
Bisphosphonates
Often used to treat osteoporosis
Prevent Bones from getting weaker by slowing the natural breakdown of bone
Lower risk of spine fractures and lower risk of hip fractures
Side effects of bisphosphonates
Nausea heartburn swallowing problems irritation of esophagus pain in muscles joints bones or stomach
Serious but rare side effect of bisphosphonates
ONJ= osteonecrosis of jaw
Severe breakdown of the bone in the jaw usually after a major dental procedure
Fractures of the thigh bone
what makes treating Parkinson’s disease difficult.
patients build up resistance to the medications used for treatment.
Over time, the medications lose effectiveness and treatment becomes more difficult.
it requires many different classifications of medications used in combination. These drug combos have many side effects requiring use of even more medications that are used to treat these side effects.
dopaminergic for PD
Dopaminergics “mimic” dopamine. Dopamine in its true form cannot cross the blood brain barrier. Dopaminergic drugs can cross the BBB where once in the brain, they are converted to dopamine.
Levadopa is the most common of these drugs.
Dopamine agonists
are given to enhance the action of dopamine on the dopamine receptors in the brain.
Carbidopa is given with levodopa to make the levodopa work better.
The two medications are usually given in a combination oral tablet know by the brand name Sinemet.
anticholinergics for PD
block the action of acetylcholine. This action reduces tremors and makes movement smoother. These drugs may also reduce drooling that may occur in Parkinson’s disease.
Benztropine is an example of an anticholinergic.
monoamine oxidase inhibitors (MAOIs) for PD
block monoamine oxidase, an enzyme that breaks down dopamine in the brain. This increases the amount of dopamine that is available in the brain to aid in muscle movement.
Patients teaching for levodopa/carbidopa
should be taught to avoid taking these medications with protein as protein will reduce the absorption of the drugs.
Teaching for MAOI
1) many drug to drug interactions. When given with certain medications, for example, nasal decongestants, severe hypertensive episodes may occur.
2) Hypertensive crises can also occur when MAOIs are taken with foods containing tyramine. These are foods that are aged or pickled, including yeast, aged cheeses, preserved meats, beer and wine, yogurt
Allopurinol for gout
inhibits the synthesis of uric acid by inhibition of the xanthine oxidase enzyme. Xanthine oxidase enzyme is essential for purine metabolism that ends with uric acid formation.
It is a very cheap and effective medication.
But, never use allopurinol during the acute attacks of gout because it may worsen the attack.
Allopurinol may show some side effects, such as fever, diarrhea, allergy, and bone marrow depression.
Probenecid for gout
increases the excretion of uric acid in urine. Alkalization of urine is essential with probenecid to avoid the development of renal stones.
We can achieve urine alkalization by sodium or potassium citrate.
NSAIDS for gout
first-line medications in acute attacks of gout
But, we should avoid aspirin; it may worsen the attack because it alters the uric acid level.
Colchicine for gout
relieves gout pain.
decreases the swelling around the affected joint and decreases the synthesis and deposition of uric acid crystals in the joint.
It is useful for those who can’t tolerate NSAIDs due to any cause, such as hypertension, bronchial asthma, or peptic ulcer.
Colchicine isn’t analgesic; thus, don’t use it in any painful condition without prescription from your doctor. It is effective at lower doses (1.2 mg for the first time, then 0.6 mg one hour later). In higher doses, some side effects may occur, such as diarrhea and vomiting.
Patients with kidney failure should avoid colchicine.
Short term steroids for gout
as effective as NSAIDs, but doctors don’t prefer them due to their side effects.
