Musculoskeletal Flashcards
How do NSAIDs work?
They block the cyclooxygenase enzymes COX-1 and 2 which are involved in the inflammatory pathways
What are some of the common adverse effects of NSAIDs?
Gastric irritation, kidney damage, hypersensitivity reactions
NSAID nursing considerations
Instruct patient not to crush or chew tablets or take them on an empty stomach
How does Aspirin reduce BP?
It blocks the COX enzyme in the inflammatory pathway which blocks the formation of thromboxane which causes platelet aggregation and vasoconstriction
Aspirin side effects
Increased RR, epigastric pain, rash, tinnitus, prolonged bleeding time, GI bleeding, liver toxicity
Aspirin nursing considerations
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
What are some of the roles of calcium?
Nerve impulses, provides stability and movement, prevents muscle spasms
Hypocalcaemia symptoms
Prolongation of QT interval on EKG, increased risk of arrythmias, nerve impulse excitability, cramping, tremors, paraesthesia, convulsions, abnormal behaviours
What is vitamin D responsible for?
Calcium absorption
Calcium carbonate nursing considerations
Interacts with digoxin, must be given slowly through IV to avoid dysrhythmias and cardiac arrest
What is Calcitriol?
A vitamin D bone resorption inhibitor
What is OA?
Osteoarthritis
How does OA work?
Breakdown of synovial joint cartilage over time which can also break down bone
Which 3 kinds of medications are used to treat OA?
NSAIDs and Corticosteroids (injected into joint). Also paracetamol
Paracetamol mechanism of action
Unknown. Thought to produce analgesia by blocking the generation of nerve impulses, probably by inhibiting prostaglandin synthesis or action
Paracetamol side effects
Severe liver damage in toxic dose, hypoglycaemia, rash.
What causes Gout?
Build up of uric acid crystals in the joints
What two groups can gout medications be divided into?
Preparations that inhibit uric acid production
Preparations that increased uric acid excretion
What is Allopurinol?
A xanthine oxidase inhibitor which prevents the conversion of oxypurines to uric acid which in turns deposits in the joints and causes gout
What does Probenecid do?
Lowers the serum concentration of uric acid by increasing excretion at the proximal renal tubule
What does Colchecine do?
Inhibits the release of lysomal enzymes, pro-inflammatory enzymes and other mediators
What is RA?
Rheumatoid arthritis
What are DMARDs?
Disease-Modifying Antirheumatic Drugs
How long is the DMARDs onset of action?
6 weeks - 6 months
What is methotrexate?
An antimetabolite, antineoplastic agent that decreases swelling, pain, swelling and stiffness associated with RA
What is Alendronate sodium?
A bone resorption drug for osteoporosis
What is Raloxifene?
A selective oestrogen receptor modulator which is used to prevent osteoporosis
How does morphine treat Pulmonary Oedema?
It reduces cardiac preload and afterload as well as calms the patient
Opioid side effects
Constipation, nausea, vomiting, sedation, impaired cognition, respiratory depression. Postural hypotension
What effects to opioids have on the PNS?
Decreased gut motility, spasms of sphincter muscles, suppression of some spinal reflexes, release of histamine
