MSK Pharmacology Flashcards
DMARD =
Disease modifying antirheumatic drugs
What do DMARDs do?
stop progression of rheumatic disease
When are DMARDs used?
Early in the disease process to slow progression prior to widespread damage of affected joints
How do DMARDs induce remission?
Modifying pathology and inhibiting immune response responsible for dz
Implications for PT: DMARDs
High incidence of toxicity
Side effects of DMARDs
- nausea
- HA
- jt pain/swelling
- TOXICITY
- GI distress
- sore throat
- fever
- liver dysfunction
- hair loss
- retinal damage
- potential for SEPSIS
How do glucocorticoids work?
- Hormonal, anti-inflammatory, and metabolic effects including suppression of articular and systemic diseases
- reduce inflammation in chronic conditions
- vasoconstriction
Indications for glucocorticoids
- endocrine dysfunction
- anti-inflammatory
- immunosuppressant
- tx of rheumatic, respiratory, and other disorders
Indications for PT: glucocorticoids
- wear mask due to weakened immune system
- toxicity: look for moonface, buffalo hump, personality changes
- at risk for OP and mm wasting
PT indications: tx for pts with joints injected with glucocorticoids
Require special care due to ligament/tendon laxity/weakening
Side effects of glucocorticoids
- mm atrophy
- GI distress
- glaucoma
- adrenocortical suppression
- drug-induced Cushing syndrome
- weakening/breakdown of supporting tissues (bone, ligament, tendon, skin)
- mood changes
- HTN
How do opioids work?
stimulate opioid receptors in the CNS to prevent pain impulses from reaching their destinations
Indications for opioids
- mod to severe pain
- induction of conscious sedation
- mgmt of opioid dependence
- relief of severe and persistent cough (codeine)
Side effects of opioids
- mood swings
- sedation
- confusion
- vertigo
- dulled cognitive function
- orthostatic hypotension
- constipation
- incoordination
- physical dependence/tolerance
Opioids: implications for PT
- monitor for side effects, esp respiratory depression
- painful tx should be scheduled 2 hrs after administration to maximize analgesic benefits
What’s the class?
Rheumatrex (methotrexate)
DMARD
Dermacort (hydrocortisone or cortisol)
Glucocorticoids
What’s the class?
Dexamethasone
Glucocorticoids
What’s the class?
Roxanne, Demerol, OxyContin, sublimaze (fentanyl), paternal (codeine)
Opioid agents
What’s the class?
Antimalarial drugs (chloroquine, plaquenil)
DMARD
What’s the class?
Tylenol, NSAIDs, aspirin, Aleve, Advil
Nonopioids agents
How do nonopioids work?
Promote reduction in prostaglandin formation that decreases the inflammatory process, decreases uterine contractions, lowers fever, and minimizes impulse formation of pain fibers
Nonopioid agents: side effects
- nausea
- vomiting
- vertigo
- abdominal pain/GI distress or bleeding
- ulcer formation
- potential for Reye syndrome in children (aspirin only)
Nonopioid agents: PT implications
- at risk for masked pain that would allow movement beyond limitation or false understanding of level of mobility
- ℅ stomach pain should be taken seriously with referral to MD
Which nonopioid agent is used for reduction of MI?
Aspirin
