Musculoskeletal Flashcards

1
Q

What is rheumatoid arthritis?

A

inflammation around the joint, especially in the synovial fluid

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2
Q

What is osteoporosis

A

loss of bone density

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3
Q

What are causes of osteoporosis

A

overuse /long-term use of corticosteroids
natural or surgical menopause, leading to decrease in the production of estrogen
gradual loss of bone mass
overuse of caffeine, alcohol, and tobacco

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4
Q

What is the building of bone called?

A

osteoblastic activity (blasts build)

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5
Q

What is the reabsorption of bones?

A

Osteoclastic activity? (clasts consume bone)

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6
Q

Whend oes BMD peak?

A

ages 25 to 30

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7
Q

What are the three main types of drugs to treat rheumatoid arthritis?

A

NSAIDs, glucocorticoids, and disease-modifying antirheumatic drugs (DMARDs)

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8
Q

What are drugs that decrease joint inflammation and joint dammage?

A

DMARDs. They also delay the progression of RA

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9
Q

What do nonbiologic DMARD drugs do?

A

they exert their immunosuppressive effect by interfering with normal B and T lymphocyte activity

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10
Q

What are the prototypes for nonbiologic DMARDs?

A

methotrexate

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11
Q

What are the prototypes of biologic DMARDs?

A

etanercept (enbrel)
Humera

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12
Q

How do biologic DMARDs work?

A

They inactivate tumor necrosis factor drugs resulting in reduced inflammation and immunosuppression by bein antagonists in the receptors in the synovial joint

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13
Q

What are the four main types of drugs to prevent or treat osteoporosis?

A

selective estrogen receptor modulators (SERMs), bisphosphonates, calcitonin, and calcium supplements

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14
Q

What does SERMs treat?

A

postmenopausal osteoporosis
cancer
estrogen-dependent/ receptor-positive cancer

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15
Q

What is the prototype for SERMs?

A

raloifene aka EvistaW

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16
Q

What is the classification for SERMs?

A

bone resorption inhibitor

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17
Q

How do SERMs work?

A

they activate estrogen receptor in some tissue and block receptors in other tissue

18
Q

What are bisphosphonates used for?

A

precention and treatment of postmenopausal osteoporosis in women
age-related osteoporosis in men
glucocorticoid-related osteoporosis

19
Q

What is the prototype drug for bisphosphonates?

A

alendronate (Fosamax)

20
Q

How do bisphosphonates work?

A

Expected pharmacologic action is to decrease bone resorption by inhibiting activity

21
Q

What are some ADRs for bisphosphonates?

A

GI disturbances
esophagitis, n/v
ab pain
eye pain and vision changes in some
joint pain

22
Q

bisphosphonates interventions

A

monitor for decreased bone resorption and changes in vision and esophagitis

23
Q

client administration for bisphosphonates

A

30 minutes before any oral intake with full glass of water
sitting or standing position afterward
no calcium supplement or antacid with this drug

24
Q

contraindication for bisphosphonates

A

those who cannot sit or stand after the medication
esophageal structures or disorders or those who can’t swallow

25
Q

interactions with bisphosphonates

A

Calcium supplements and dairy products will decrease absorption.

26
Q

What are therapeutic uses of calitonin?

A

treating established postmenopausal osteoporosis and hypercalcemia secondaery to hyperparathyroidism

27
Q

What is the prototype of calcitonin?

A

calcitonin-salmon (Miacalcin, Calcimmar)

28
Q

How does calcitonin work?

A

decreases bone resorption by increasing excretion of calcium

29
Q

What and when secretes calcitonin?

A

when CA is high, then the thyroid secretes calcitonin

30
Q

What does calcitonin do?

A

decreases osteoclast activity
kidney increase calcium excretion
hypocalcemia

31
Q

What class are calcium supplements?

A

mineral and electrolyte supplements

32
Q

What are the two prototypes of calcium supplements?

A

Calcium citrate (citrate)
calcium carbonate (Tums)

33
Q

Calcium supplements are effective in doing what?

A

Neutralizing gastric acids

34
Q

What are some symptoms of hypercalcemia?

A

nausea, vomiting, constipation,
polyuria depression
kidney stones

35
Q

what are some interventions for calcium?

A

monitor for gastric and instestinal motility
n/v and constipation
oliguria, flank pain and blood in urine

36
Q

Client teaching for calcium supplements

A

fiber supplement/stool softener
intake plenty of water
flank pain/blood in urine
take one to two hours after glucocorticoids, thyroid supplements, and tetracycline and quinolone antibiotics

37
Q

When should calcium-based antacids be taken?

A

chew it one after after meals and at bedtime
They are highly water soluble.

38
Q

why are calcium supplements contraindicated for people with high phosphate levels?

A

phosphate has a reverse relationship with calcium

39
Q

What drug can calcium supplements interact with to increase the risk of toxicity?

40
Q

What foods decrease the absorption of calcium?

A

cereals
rhubarb
spinach