Module 5 Musculoskeletal Flashcards
Opiates and Opioids are used for what level of arthritis
Moderate to Severe arthritis
Inhibits prostaglandin synthesis, cyclooxygenase, arachidonic conversion
Salicylates
Aspirin is an example of a
Salicylates
arachidonic conversion + cyclooxygenase =
Prostaglandin
Where do Salicylates come from
bark of willow tree
Avg dose of Aspirin is
81mg-650mg
What is the max dose for Aspirin as an anti-inflammatory and what is it used for
3g/day Arthritis
What is the max dose for Aspirin as an Non-narcotic analgesic and what is it used for
650mg 1 4-6 hrs Moderate mild pain
What is the max dose for Aspirin as an Antipyretic
650mg q 4 hrs
What is the max dose for Aspirin as an Antiplatelet
81mg or 325mg / day
Viral infection causes fatty liver
Reyes Syndrome
Acute poisoning in Salicylates can lead to
Rhabdomyolysis, acute renal failure
If poisoning occurs in Salicylates what can we use to absorb substances
Activated charcoal
A non-Salicylates is also called
NSAIDS
Ibuprofen max dose is (for arthritis)
1200mg-2400mg q 4-6 hrs
Ibuprofen max dose for pain is
400-800mg q 4-6 hrs
Naproxen max dose is
500-1000mg / day
How should Indocin be administered
50-200 mg/day in 2-3 doses
Diclofenac should be administered
100-200 mg/day
Misoprostol is a combination drug that includes
Cytotec
Celecoxib is used to treat
Osteoarthritis and Rheumatoid arthritis
What is the max dose for Acetaminophen
4 grams a day
What is the max dose for Acetaminophen for a patient with ETOH
2 grams a day
Drug used to lower the effects of Acetaminophen
Mucomyst
If meds are +10days for Acetaminophen what should patient do
consult prescriber
What should we monitor for a patient taking DMARDS
Blood sedimentation rate
Gold salts are used in
Chrysotherapy
Chrysotherapy is used to
Decrease tenderness, swelling, pain
How long should it take for full therapeutic effect in Chrysotherapy
6 months
Auranofin is a drug used in …. and can only be given
Chrysotherapy .. PO LARGE MUSCLE MASS
If protein gets in blood during Chrysotherapy what should be done
d/c tx.
4 side effects of Chrysotherapy
Stomatitis
loose stools
Bone marrow suppression
Bluish green skin discoloration
We should report any use of gold salts prior to what test
TB test
Chrysotherapy causes what type of reaction
Nitroid reaction
Cytokine produced by macrophages, results in inflammation and cartilage erosion
Tumor Necrosis Factor
Decreases immune system response, used for psoriasis and arthritis
TNF inhibitors
4 side effects of TNF inhibitors
Leukemia
Lymphoma
Hepatitis B infection
TB
Etanercept, Adalimumab, and Golimumab are examples of what kind of drug class
TNF inhibitor
How do we infuse TNF inhibitors
over 2 hours, 2 weeks - 6 - 8
Penicillamine should be taken how … and not with what
on an empty stomach … not with antacids
Chelator med
Penicillamine
How long does it take to see improvement with Methotrexate
3-6 weeks
Triple therapy with Methotrexate includes what other 2 drugs
Hydroxychloroquine and sulfasalazine
Hydroxychloroquine can be toxic to
eyes
sulfasalazine should be given how
With food, Full glass of water
Sulfasalazine can cause (2)
Male infertility
yellow orange skin discoloration
Patients with gout should decrease foods that contain
Purine
Uric acid in gout should be what #
less than 6mg/dl
Used to treat/prevent acute flares of gout
Colchicine
When should we d/c Colchicine
when patient reaches 8mg
In gout patient can use what uric acid inhbitor
Allopurinol
Allopurinol can also be called a
Hypouricemic
4 side effects of Allopurinol
alopecia
SJS
purpuric rash
Bone marrow supression
This drug is used to enhance uric acid excretion
Probenecid
Probenecid can also be called a
Uricosuric
How should we give Probenecid
With food OR antacid
What is the action of a Bisphosphonate
Increases bone density
How should we give Bisphosphonates
Full glass of water on empty stomach.
What is something a person should not do after taking a Bisphosphonate
Do not lay down for 30 minutes
What are 3 side effects of Bisphosphonates
Esophageal Ulcerations
Bone pain
Headache
What is something a person should not consume if taking Bisphosphonates
Milk
Alendronate, Risedronate, Zoledronic Acid, and Ibandronate are examples of what drug class
Bisphosphonates
Raloxifene is an example of what drug
Selective Estrogen Receptor Modulator (SERM)
Selective Estrogen Receptor Modulator (SERM) drugs are used for
Bone, Uterine cancer
Forteo (Teriparatide) is what kind of drug
Bone Formation Agent
Forteo contributes what hormone and what can it cause
Contributes parathyroid hormone and can cause hypercalcemia
What is the major adverse effect of Central Acting drugs
Drowsiness, Dizziness, Ataxia
Define Ataxia
inability to control muscle
Inhibits skeletal muscle contraction by blocking conduction within the spinal cord
Central Acting drugs
Muscle spams, epilepsy, electrolyte imbalance can all be treated with what drug group
Central Acting drugs
Central Acting drugs should be given
With food
Titrate means
Start slow, gradually increase
Taper means
Decrease slowly
Methocarbamol a central acting drug can cause what
Greenish, Brownish, Black, urine discoloration
Neuromuscular blockers are different from central acting drugs because
Acts on receptor site, peripheral acting
interrupts transmission at skeletal neuromuscular junction
Neuromuscular blockers
Agonist Depolarizing Neuromuscular blockers, differ from Competitive Non Depolarizing Neuromuscular blockers because
Competitive Non Depolarizing Neuromuscular blockers REQUIRE MED TO REVERSE ACTIVITY
Muscle spasms require Peripheral or Central
Peripheral
It is important to tell patient that Neuromuscular blockers
Have no effect on pain or consciousness
Dantrolene is an example of a
Direct Acting drug
A major adverse effect of Dantrolene is
Malignant hyperthermia
Skeletal muscle stimulants can cause (2)
increase in saliva
increase in sweat
