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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
Denosumab action
decrease formation and function of osteoclasts
26
denocumab admin route
SQ 1x per month
27
denosumab ADR
back pain hypocalcemia infection derm reactions osteonecrosis of jaw
28
Drug classes to treat RA
NSAIDS Glucocorticoids disease modifying anti rheumatic drugs (DMARD)
29
Nsaids in RA management
Do not prevent joint damage do not slow disease progress releives symptoms
30
Glucocorticoids in RA
can slow disease progression, limited to short term intervention rapid symptom releif
31
DMARDs in RA
reduce joint destruction slow progression onset takes several weeks
32
RA treatment plan
take NSAID until DMARD kicks in in wks to months start DMARD early within diagnosis
33
Nsaids inhibit ....? This causes
prostaglandin decreased pain, fever, vasodilation, cap perm
34
what promotes synthesis of prostaglandin?
COX 1 and 2
35
2nd gen NSAIDs block which cox?
COx2
36
COX 2 deals with
inflamation pain fever renal function
37
Cox 1 inhibits what
platelet aggregation
38
NSAID for RA
Celecoxib
39
Celecoxib increases risk for ... because of ...
MI and CVA suppression of vasodilation
40
Side effects of NSAIDS
GI upset and bleeding inhibits platelet aggregation renal impairment peripheral edema
41
DMARD meds
Methotrexate Sulfasalazine Hydrosychloroquine Enteracept Infiximab
42
Methotrexate
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
Methotrexate ADR
hepatotoxic nephrotoxic pneumonitis Bone marrow suppression GI ulcer
44
Monitor ..... when taking methotrexate
hep/neph function +CBC
45
Sulfasalazine ADR
GI (NVD plus anorexia) Dermatologic bone marrow suppression hepatotoxic
46
Sulfasalazine should not be given to pts with a .....
sulfa allergy
47
Hydroxychloroquine use
DMARD for pts with mild symptoms antimalarial given in combo with methotrexate
48
hydroxychloroquine toxicity
renal damage and blindness
49
TNF blockers
Adalimumab Etanercept Imfliximab
50
Adalimumab, etanercept, imfliximab are given to
neutralize TNF which contributes to pathology of RA
51
TNF blocker ADR
Serious systemic infection (fungal infection) allergic reaction hematologic disorders (neutropenia, thrombocytopenia, aplastic anemia) hepatotoxicity
52
Gout NSAIDS
Indomethacin Naproxen
53
Glucocorticoids for Gout
prednisone
54
Anti inflammatory agent specific for gout
colchincine
55
Colchincine
specific for gout, not an analgesic inhibits migration of leukocytes to inflamed site NSAIDS are more effective
56
Colchicine ADR
GI NVD and ABD pain
57
prevention of future gout attacks meds:
allopurinol febuxostat probenecid
58
Allopurinol MOA and pt ed
inhibits UA biosynthesis encourage fluid intake
59
Febuxostat
lowers uric acid, alternative to allopurinol
60
Probenecid
increase rate of uric acid excretion, inhibits reabsorption used for chronic gout, not acute attacks
61
Muscle spasticity meds
baclofen, diazepam, tizanidine dantrolene (acts on skeletal muscle)
62
Baclofen acts on
CNS
63
Diazepam acts on
CNS
64
Tizanidine acts on
CNS
65
Dantrolene acts on
directly on skeletal muscle
66
Baclofen MOA
suppress hyperactive reflexes on reg of muscle movement by mimicking GABA no direct effect on skeletal muscle will not decrease muscle strenth
67
Baclofen ADR
CNS depressant drowsiness/dizziness weakness fatigue overdose = coma/ resp depress
68
Pts taking Baclofen should avoid
alcohol and CNS depressants
69
Baclofen withdrawal causes
hallucinations, paranoid ideations, seizures
70
Dantrolene MOA and ADR
MOA= direct on skeletal muscle without effect on cardiac or smooth IV = malignant hyperthermia ADR= hepatotoxic, drowsy, muscle weakness
71
Muscle spasm drugs
NSAIDS centrally acting skeletal muscle relaxants
72
Centrally acting skeletal muscle relaxants
cyclobenzaprine carisoprodol methocarbamol diazepam
73
cyclobenzaprine
works on brainstem and reduces tonic motor activity does not treat spasticity
74
cyclobenzaprine ADR
CNS depress disturb card rythm seretonin syndrome anticholinergic effects

Pharm (9 decks)

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