Musculoskeletal

Question 1

Methotrexate (DMARD I)

Answer 1

Tx: RA
S/S: bone marrow suppression –> pancytopenia, liver and kidney damage, GI distress
Suppresses immune response
PPE is needed to handle
Take NSAIDs until therapeutic effect of drug takes place
Get CBCs

Question 2

Adalimumab, etanercept (DMARD II)

Answer 2

Tx: RA
Site pain is expected
S/S: bone marrow suppression
Avoid obtaining live vaccines

Question 3

Raloxifene, tamoxifen (Selective Estrogen Receptor Modulators)

Answer 3

Tx and prevention of osteoporosis
S/S: DVT, hot flashes
Don’t take with other estrogen-based medications

Question 4

Alendronate, resedronate (Bisphosphonate)

Answer 4

Take on a empty stomach with full glass of water
Remain upright for 30 minutes after
Tx: prevention of osteoporosis

Question 5

Calcitonin-salmon (calcitonin supplement)

Answer 5

Check for fish allergy
Tx: osteoporosis
Monitor for hypocalcemia
Prevents calcium from leaving the bones

Question 6

calcium citrate, calcium carbonate (Tums) (CALCIUM SUPPLEMENTS)

Answer 6

S/S: renal calculi –> cystitis, postrenal AKI
Don’t take with other medication since it can have numerous drug interactions and can affect absorption

Question 7

Neostigmine (CHOLINESTERASE INHIBITOR)

Answer 7

Increases muscle strength
S/S: cholinergic crisis –> excessive muscarinic stimulation = motility, salivation –> aspiration
Prepare atropine and suctioning equipment for cholinergic crisis