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DPT 753 - Pharmacology > Musculoskeletal Considerations > Flashcards

Musculoskeletal Considerations Flashcards

1
Q

What are the main topics covered in the musculoskeletal considerations lecture?

A

Medications, corticosteroids, anabolic steroids, psychotropic meds, rheumatological meds, muscle relaxants, neuropathic medications, post-op joint replacement and fracture management, patient case examples, education on medications.

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2
Q

What are the considerations for chronic pain management?

A

Long-term use of medications, managing side effects, appropriate medication combinations, and monitoring for adverse events.

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3
Q

What are common pain medications used post-operatively?

A
  • opioids
  • acetaminophen
  • anticoagulants
  • muscle relaxants
  • antibiotics
  • stool softeners
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4
Q

What are the main goals of drug therapy for rheumatoid arthritis (RA)?

A
  • decrease joint inflammation
  • stop disease progression
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5
Q

What are the three main categories of drugs used for RA?

A

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

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6
Q

How do NSAIDs work in RA management?

A

Inhibit the COX enzyme, added pain relief, inhibition of prostaglandin synthesis.

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7
Q

What are the adverse effects of chronic NSAID use?

A

Stomach irritation, gastric ulceration, hemorrhage.

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8
Q

What is the controversy around intra-articular glucocorticoids for RA?

A

They may produce harmful catabolic effects in joints weakened by arthritic changes.

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9
Q

How do glucocorticoids reduce joint inflammation?

A
  • Inhibiting the production of pro-inflammatory substances
  • Increasing anti-inflammatory proteins
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10
Q

What are the adverse effects of glucocorticoids?

A

Muscle wasting, osteoporosis, hypertension, aggravation of diabetes, glaucoma, cataracts, increased infection risk.

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11
Q

What is the primary focus of DMARDs in RA treatment?

A

Delay disease progression, promote remission, control synovitis and erosive changes.

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12
Q

What are some common DMARDs used for RA?

A
  • Antimalarials (Chloroquine, Hydroxychloroquine)
  • Gold compounds (Auranofin)
  • Non-biological (Methotrexate)
  • Biological (Adalimumab, Infliximab)
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13
Q

What is Methotrexate commonly used for?

A

RA and cancer, slows RA effects, decreases synovitis and bone erosion, reduces joint space narrowing.

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14
Q

What are the adverse effects of Methotrexate?

A

GI issues, nausea, headache, long-term users may experience pulmonary problems, liver dysfunction, and hair loss.

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15
Q

How can diet affect RA symptoms?

A

Diets high in fatty acids and antioxidants can control inflammation, while meat and protein may exacerbate RA.

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16
Q

What is osteoarthritis (OA)?

A

A common joint disease caused by intrinsic defects in joint cartilage and subchondral bone remodeling.

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17
Q

How is OA commonly managed?

A

Pain management, maintaining an active lifestyle, using acetaminophen and NSAIDs, and topical treatments.

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18
Q

What are disease-modifying osteoarthritis drugs (DMOADs)?

A

Viscosupplementation with hyaluronan, glucosamine, and chondroitin sulfate supplements.

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19
Q

What are the rehab considerations for patients with RA and OA?

A

Medications should facilitate exercise and functional activity, be aware of adverse effects, and use ROM and strengthening exercises to avoid further injuries.

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20
Q

What are skeletal muscle relaxants used for?

A

Treat spasticity and muscle spasms, decrease muscle excitability and contraction.

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21
Q

What is the difference between spasticity and spasms?

A
  • Spasticity is related to spinal cord or brain injuries
  • Spasms are involuntary muscle contractions often after MSK injuries
22
Q

What are anti-spasm drugs?

A

Diazepam, centrally acting drugs like Metaxalone, Cyclobenzaprine, and Methocarbamol.

23
Q

What are the adverse effects of anti-spasm drugs?

A

Sedation, dizziness, nausea, light-headedness, ataxia, and headache.

24
Q

What is Baclofen used for?

A

Reducing muscle spasticity, especially in conditions like MS, with fewer generalized weakness effects.

25
Q

What are the adverse effects of Baclofen?

A

Drowsiness, confusion, hallucinations, more common in older adults or post-CVA patients.

26
Q

What is Intrathecal Baclofen used for?

A

Used for reducing muscle spasticity, delivered directly into the subarachnoid space in the spinal cord.

27
Q

What are the adverse effects of Intrathecal Baclofen?

A

Pump malfunctions, delivery catheter problems, withdrawal symptoms, tolerance due to long-term use.

28
Q

What is Dantrolene Sodium used for?

A

Used for severe spasticity, inhibits calcium channel opening in skeletal muscle.

29
Q

What are the adverse effects of Dantrolene Sodium?

A

Generalized muscle weakness, drowsiness, dizziness, nausea, diarrhea.

30
Q

What is Gabapentin used for?

A

Originally an antiseizure drug, used for neuropathic pain, inhibits calcium into nerve terminals.

Now can be used as an antispasticity drug

31
Q

What are the adverse effects of Gabapentin?

A

Sedation, fatigue, dizziness, ataxia.

32
Q

What is Tizanidine used for?

A

Used for controlling spasticity from spinal lesions, chronic headaches, fibromyalgia.

33
Q

What are the adverse effects of Tizanidine?

A

Sedation, dizziness, dry mouth, less generalized weakness than Baclofen or Diazepam.

34
Q

How are muscle relaxants absorbed and metabolized?

A

Absorbed easily in the GI tract, metabolized by hepatic enzymes, excreted through kidneys.

35
Q

What are the rehab considerations for muscle relaxants?

A

Compliment PT treatments, reduce spasticity to improve participation, avoid long-term use, monitor for sedation and muscle weakness.

36
Q

What are the common types of anesthesia?

A

General (inhaled, IV), local (injection, topical), regional (spinal anesthesia).

37
Q

What are the stages of anesthesia?

A
  • Stage I: Analgesia
  • Stage II: Excitement (Delirium)
  • Stage III: Surgical Anesthesia
  • Stage IV: Medullary Paralysis.
38
Q

What are the side effects of general anesthesia?

A

Confusion, delirium, muscle weakness, bronchial secretions, long-term cognitive effects.

39
Q

How do local anesthetics work?

A

Block nerve conduction by inhibiting sodium channels in the nerve membrane.

40
Q

What are common local anesthetics?

A

Lidocaine, Procaine, Bupivacaine.

41
Q

What are the adverse effects of local anesthetics?

A

Allergic reactions, CNS toxicity, cardiovascular effects.

42
Q

How do psychotropic medications affect MSK conditions?

A

Affect neurotransmitter levels, which can influence pain perception and mood, impacting MSK conditions.

43
Q

What are the common psychotropic medications used in MSK conditions?

A

Antidepressants, antipsychotics, mood stabilizers, anxiolytics.

44
Q

What are the adverse effects of psychotropic medications?

A

Sedation, dizziness, weight gain, dry mouth, constipation, blurred vision.

45
Q

How do gut-liver complications affect medication metabolism?

A

Medications metabolized by the liver can be affected by gut-liver complications, altering their effectiveness and safety.

46
Q

What are common gut-liver complications related to medications?

A

Cirrhosis, hepatitis, fatty liver disease, drug-induced liver injury.

47
Q

What are the rehab considerations for patients with gut-liver complications?

A

Adjust medication dosages, monitor liver function, be aware of potential interactions.

48
Q

How do neuropathic medications work?

A

Inhibit nerve signal transmission involved in pain perception, often through calcium or sodium channels.

49
Q

What are common neuropathic medications?

A

Gabapentin, Pregabalin, Amitriptyline.

50
Q

What are the adverse effects of neuropathic medications?

A

Sedation, dizziness, fatigue, ataxia, nausea.

DPT 753 - Pharmacology (16 decks)

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