Musculoskeletal

Question 1

How do NSAIDs work?

Answer 1

They block the cyclooxygenase enzymes COX-1 and 2 which are involved in the inflammatory pathways

Question 2

What are some of the common adverse effects of NSAIDs?

Answer 2

Gastric irritation, kidney damage, hypersensitivity reactions

Question 3

NSAID nursing considerations

Answer 3

Instruct patient not to crush or chew tablets or take them on an empty stomach

Question 4

How does Aspirin reduce BP?

Answer 4

It blocks the COX enzyme in the inflammatory pathway which blocks the formation of thromboxane which causes platelet aggregation and vasoconstriction

Question 5

Aspirin side effects

Answer 5

Increased RR, epigastric pain, rash, tinnitus, prolonged bleeding time, GI bleeding, liver toxicity

Question 6

Aspirin nursing considerations

Answer 6

Shouldn’t be take within 7 days of before any invasive procedure. Main GI problems can be avoided by administering with a glass of water

Question 7

What are some of the roles of calcium?

Answer 7

Nerve impulses, provides stability and movement, prevents muscle spasms

Question 8

Hypocalcaemia symptoms

Answer 8

Prolongation of QT interval on EKG, increased risk of arrythmias, nerve impulse excitability, cramping, tremors, paraesthesia, convulsions, abnormal behaviours

Question 9

What is vitamin D responsible for?

Answer 9

Calcium absorption

Question 10

Calcium carbonate nursing considerations

Answer 10

Interacts with digoxin, must be given slowly through IV to avoid dysrhythmias and cardiac arrest

Question 11

What is Calcitriol?

Answer 11

A vitamin D bone resorption inhibitor

Question 12

What is OA?

Answer 12

Osteoarthritis

Question 13

How does OA work?

Answer 13

Breakdown of synovial joint cartilage over time which can also break down bone

Question 14

Which 3 kinds of medications are used to treat OA?

Answer 14

NSAIDs and Corticosteroids (injected into joint). Also paracetamol

Question 15

Paracetamol mechanism of action

Answer 15

Unknown. Thought to produce analgesia by blocking the generation of nerve impulses, probably by inhibiting prostaglandin synthesis or action

Question 16

Paracetamol side effects

Answer 16

Severe liver damage in toxic dose, hypoglycaemia, rash.

Question 17

What causes Gout?

Answer 17

Build up of uric acid crystals in the joints

Question 18

What two groups can gout medications be divided into?

Answer 18

Preparations that inhibit uric acid production

Preparations that increased uric acid excretion

Question 19

What is Allopurinol?

Answer 19

A xanthine oxidase inhibitor which prevents the conversion of oxypurines to uric acid which in turns deposits in the joints and causes gout

Question 20

What does Probenecid do?

Answer 20

Lowers the serum concentration of uric acid by increasing excretion at the proximal renal tubule

Question 21

What does Colchecine do?

Answer 21

Inhibits the release of lysomal enzymes, pro-inflammatory enzymes and other mediators

Question 22

What is RA?

Answer 22

Rheumatoid arthritis

Question 23

What are DMARDs?

Answer 23

Disease-Modifying Antirheumatic Drugs

Question 24

How long is the DMARDs onset of action?

Answer 24

6 weeks - 6 months

Question 25

What is methotrexate?

Answer 25

An antimetabolite, antineoplastic agent that decreases swelling, pain, swelling and stiffness associated with RA

Question 26

What is Alendronate sodium?

Answer 26

A bone resorption drug for osteoporosis

Question 27

What is Raloxifene?

Answer 27

A selective oestrogen receptor modulator which is used to prevent osteoporosis

Question 28

How does morphine treat Pulmonary Oedema?

Answer 28

It reduces cardiac preload and afterload as well as calms the patient

Question 29

Opioid side effects

Answer 29

Constipation, nausea, vomiting, sedation, impaired cognition, respiratory depression. Postural hypotension

Question 30

What effects to opioids have on the PNS?

Answer 30

Decreased gut motility, spasms of sphincter muscles, suppression of some spinal reflexes, release of histamine