MSK drugs

Question 1

what are the 3 key actions of NSAID

Answer 1

antiinflammatory
antipyretic
analgesic

Question 2

what are some examples of non-selective NSAIDS

Answer 2

Aspirin, Ibuprofen, Naproxen

Question 3

what are some examples of selective NSAIDS

Answer 3

celebrex

Question 4

common side effects of opioid include:

Answer 4

Respiratory depression
Constipation, nausea/vomiting, urinary retention
Confusion, drowsiness
Risk of tolerance, dependence, misuse

Question 5

glucocorticoids has ___ & ___ effects

Answer 5

Anti-inflammatory and immunosuppressive effects

Question 6

glucocorticoids inhibit ___, ___, &__, hence has greater antiinflammatory effect than NSAIDs

Answer 6

prostaglandins, histamine and leukotrienes

Question 7

what are the adverse effects of glucocorticoids?

Answer 7

adrenal insufficiency
prolonged use cause osteoporosis
mask underlying infection
increase blood glucose level
NA+ and water retention, hypokalemia
psychological effects: insomnia, delirium
myopathy
glaucoma
peptic ulcer disease

Question 8

What are the adverse effects of bisphosphonate?

Answer 8

Nausea
Abdominal pain
Loose bowel movements
Small risk of esophageal ulcers if not taken properly
Osteonecrosis of jaw (rare)
Atypical femur fractures (in a patient c/o of new hip, thigh or groin pain need to rule out partial femur fracture)

Question 9

What’s the main adverse effect of SERM?

Answer 9

risk of DVT/PE

Question 10

what type of drug is denosumab?

Answer 10

bone metabolism regulator
to treat osteoprososis
human monoclonal antibody

Question 11

MOA of denosumab

Answer 11

Anti-resorptive drug: prevents RANKL-RANK interaction & inhibits activation of osteoclasts

Question 12

how’s denosumab administered?

Answer 12

injection by HCP twice a year

Question 13

Increased calcium supplementation is associated with

Answer 13

kidney stones, vascular calcification, constipation/digestive issues

Question 14

what’s the recommended daily calcium intake for
men 51-70
women >50
men > 70

Answer 14

1000mg/daily
1200mg/daily
1200mg/daily

Question 15

what’s the recommended Vitamin D intake ?

Answer 15

Age 19-50 (includes pregnant or breast feeding): 400-1000 IU/day

Age > 50 or young adults @ high risk (i.e. osteoporosis, vit D malabsorption condition): 800-2000 IU/ day

Question 16

4 types of bisphophonates

Answer 16

Aledronate (Fosamax)
Etidronate (Didrocal)
Risedronate (Actonel)
Zoledronic Acid (Aclasta) – given IV usually annually
all end with ____dronate

Question 17

how should fosamax be taken to prevent erosion of esophagua

Answer 17

It is to be taken on an empty stomach with a full glass of water only & to sit up for 30-60 min after taking medication to prevent erosion of esophagus

Question 18

what’s the dosage schedule for Fosamax
treating patient diagnosed with osteoporosis
treating patient for prevention of osteoporosis

Answer 18

To treat a patient with diagnosed osteoporosis you could prescribe: Fosamax 70mg PO Q week (to be taken on same day each week) or 10 mg PO OD

To treat a postmenopausal woman for prevention of osteoporosis you could prescribe: Fosamax 35 mg PO once weekly or 5 mg PO OD

Question 19

What are the adverse effects of SERMs

Answer 19

Induces hot flashes, leg cramps, risk of DVT/PE

Question 20

does SERMs increase the risk of breast or endometrial CA?

Answer 20

No