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Pharm > MSK (exam 7 pharm) > Flashcards

MSK (exam 7 pharm) Flashcards

1
Q

Osteoporosis risk factors

A

menopause, over 60yo
family hx
systemic prolonged glucocorticoids and anticonvulsants
high alcohol and caffeine consumption
low vietamin D and Calcium intake
tobacco use
physical inactivity
testosterone deficiency

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2
Q

Two types of drugs for osteoporosis

A
  1. decrease bone reabsorption
  2. promote bone formation
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3
Q

drugs that decrease bone resorption

A

calcium and vitamin D
Estrogen replacement therapy
estrogen receptor modulators
biphosphonates
calcitonin

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4
Q

drugs that promote bone formation

A

teriparatide

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5
Q

Saldium supplement recommendation / day
ADR
Route for severe hypocalcemia

A

1000mg/day or 1200-1500 post menopause
ADR: hypercalcemia
Parenteral for severe

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6
Q

Vitamin D drug examples

A

calciferol
ergocalciferol

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7
Q

ADR of vitamin D

A

hypercalcemia

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8
Q

most common drug class for osteoporosis

A

bisphosphonates

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9
Q

bisphosphonates MOA

A

inhibit bone resorption by decreasing osteoclast activity

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10
Q

Bisphosphonates examples

A

ibandronate
alendronate

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11
Q

Bisphosphonates route

A

PO, on an empty stomach
or IV

Ibandronate PO 1/month
Ibandronate IV 1/ 3 months

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12
Q

Bisphosphonates ADR

A

esophagitis/esophageal ulcer

Atypical femoral fractures

osteonecrosis of jaw

ocular problems

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13
Q

Bisphosphonates PO instruction

A

in the morning at least 30 mins before intake

with full glass of water
remain upright for 30 mins

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14
Q

Estrogen replacement

A

HRT (hormone replacement therapy)

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15
Q

selective estrogen recepter modifier (SERM) drug

A

raloxifene

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16
Q

Raloxifene MOA

A

binds to estrogen receptors, blocks receptors on uterus and breast

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17
Q

raloxifene ADR

A

thrombolytic events
DVT and PE

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18
Q

Calcitonin is secreted from the

A

thyroid gland

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19
Q

Calcitonin MOA

A

lowers serum calcium by moving calcium to the bone

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20
Q

Calcitonin route

A

SC or nasal spray

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21
Q

teriparatide is a form of what?

A

PTH

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22
Q

Teriparatide does

A

creates bone formation (increase bone deposition by osteoblasts)

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23
Q

teriparatide ADR:

A

arthralgia/back pain/leg cramps
orthostatic hypotension 4 hours after injection
osteosarcoma
daily

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24
Q

Denosumab is what type of drug?

A

monoclonal antibody

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25
Q

Denosumab action

A

decrease formation and function of osteoclasts

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26
Q

denocumab admin route

A

SQ 1x per month

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27
Q

denosumab ADR

A

back pain
hypocalcemia
infection
derm reactions
osteonecrosis of jaw

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28
Q

Drug classes to treat RA

A

NSAIDS
Glucocorticoids
disease modifying anti rheumatic drugs (DMARD)

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29
Q

Nsaids in RA management

A

Do not prevent joint damage
do not slow disease progress
releives symptoms

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30
Q

Glucocorticoids in RA

A

can slow disease progression, limited to short term intervention
rapid symptom releif

31
Q

DMARDs in RA

A

reduce joint destruction
slow progression
onset takes several weeks

32
Q

RA treatment plan

A

take NSAID until DMARD kicks in in wks to months

start DMARD early within diagnosis

33
Q

Nsaids inhibit ….?
This causes

A

prostaglandin
decreased pain, fever, vasodilation, cap perm

34
Q

what promotes synthesis of prostaglandin?

A

COX 1 and 2

35
Q

2nd gen NSAIDs block which cox?

A

COx2

36
Q

COX 2 deals with

A

inflamation
pain
fever
renal function

37
Q

Cox 1 inhibits what

A

platelet aggregation

38
Q

NSAID for RA

A

Celecoxib

39
Q

Celecoxib increases risk for … because of …

A

MI and CVA
suppression of vasodilation

40
Q

Side effects of NSAIDS

A

GI upset and bleeding
inhibits platelet aggregation
renal impairment
peripheral edema

41
Q

DMARD meds

A

Methotrexate
Sulfasalazine
Hydrosychloroquine
Enteracept
Infiximab

42
Q

Methotrexate

A

Preferred DMARD
takes 3-6 wks to work

is a chemotherapy drug but in small doses can cause immunosuppression
Admin 1/wk PO or Injection

43
Q

Methotrexate ADR

A

hepatotoxic
nephrotoxic
pneumonitis
Bone marrow suppression
GI ulcer

44
Q

Monitor ….. when taking methotrexate

A

hep/neph function +CBC

45
Q

Sulfasalazine ADR

A

GI (NVD plus anorexia)
Dermatologic
bone marrow suppression
hepatotoxic

46
Q

Sulfasalazine should not be given to pts with a …..

A

sulfa allergy

47
Q

Hydroxychloroquine use

A

DMARD for pts with mild symptoms

antimalarial

given in combo with methotrexate

48
Q

hydroxychloroquine toxicity

A

renal damage and blindness

49
Q

TNF blockers

A

Adalimumab
Etanercept
Imfliximab

50
Q

Adalimumab, etanercept, imfliximab are given to

A

neutralize TNF which contributes to pathology of RA

51
Q

TNF blocker ADR

A

Serious systemic infection
(fungal infection)
allergic reaction
hematologic disorders (neutropenia, thrombocytopenia, aplastic anemia)
hepatotoxicity

52
Q

Gout NSAIDS

A

Indomethacin
Naproxen

53
Q

Glucocorticoids for Gout

A

prednisone

54
Q

Anti inflammatory agent specific for gout

A

colchincine

55
Q

Colchincine

A

specific for gout, not an analgesic

inhibits migration of leukocytes to inflamed site

NSAIDS are more effective

56
Q

Colchicine ADR

A

GI NVD and ABD pain

57
Q

prevention of future gout attacks meds:

A

allopurinol
febuxostat
probenecid

58
Q

Allopurinol MOA and pt ed

A

inhibits UA biosynthesis

encourage fluid intake

59
Q

Febuxostat

A

lowers uric acid, alternative to allopurinol

60
Q

Probenecid

A

increase rate of uric acid excretion, inhibits reabsorption

used for chronic gout, not acute attacks

61
Q

Muscle spasticity meds

A

baclofen, diazepam, tizanidine

dantrolene (acts on skeletal muscle)

62
Q

Baclofen acts on

A

CNS

63
Q

Diazepam acts on

A

CNS

64
Q

Tizanidine acts on

A

CNS

65
Q

Dantrolene acts on

A

directly on skeletal muscle

66
Q

Baclofen MOA

A

suppress hyperactive reflexes on reg of muscle movement by mimicking GABA

no direct effect on skeletal muscle

will not decrease muscle strenth

67
Q

Baclofen ADR

A

CNS depressant
drowsiness/dizziness
weakness fatigue
overdose = coma/ resp depress

68
Q

Pts taking Baclofen should avoid

A

alcohol and CNS depressants

69
Q

Baclofen withdrawal causes

A

hallucinations, paranoid ideations, seizures

70
Q

Dantrolene MOA and ADR

A

MOA= direct on skeletal muscle without effect on cardiac or smooth

IV = malignant hyperthermia

ADR= hepatotoxic, drowsy, muscle weakness

71
Q

Muscle spasm drugs

A

NSAIDS
centrally acting skeletal muscle relaxants

72
Q

Centrally acting skeletal muscle relaxants

A

cyclobenzaprine
carisoprodol
methocarbamol
diazepam

73
Q

cyclobenzaprine

A

works on brainstem and reduces tonic motor activity

does not treat spasticity

74
Q

cyclobenzaprine ADR

A

CNS depress
disturb card rythm
seretonin syndrome
anticholinergic effects

Pharm (9 decks)

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