Musculoskeletal Drug List Flashcards
Tramadol
Trade Name: Ultram, ConZip
Classification: synthetic opioid analgesic
Common use: Moderate to severe pain
Common Side/Adverse Effects: dizziness, vertigo, nausea, drowsiness
Nursing Interventions: Monitor pulse, BP, kidney and liver function. Assist with ambulation if dizziness occurs. Assess for relief of symptoms.
Teaching points: Avoid alcohol and OTC medications. Avoid tasks that requires mental alertness. Report severe constipation, palpitations, weakness, sedation, and difficulty breathing.
Ibuprofen
Black Box Alert
Trade Name: Advil, Caldolor, Motrin
Classification: NSAID; antirheumatic, analgesic, antipyretic, antidysmenorrheal
Common use: fever, rheumatoid disorders, osteoarthritis, mild to moderate pain
Common Side/Adverse Effects: n&v, dyspepsia, rash, dizziness, metabolic acidosis
Black Box Alert: Increases risk of thrombotic events (MI, CVA). Increases risk of severe GI reactions.
Nursing Interventions: Monitor CBC, renal and liver function. Assess for rash, any signs of bleeding, Evaluate for therapeutic response.
Teaching points: Avoid aspirin and alcohol. Report tinnitus, persistent abd pain, dyspnea, unusual bleeding/bruising, chest pain, or palpitations. Take with food, milk, or antacids.
Risedronate
Trade Name: Actonel, Atelvia
Classification: calcium regulator
Common use: To inhibit bone osteoclast activity- bone resorption.
Common Side/Adverse Effects: arthralgia (joint pain), rash, GI upset, peripheral edema, hypocalcemia
Nursing Interventions: Monitor serum electrolytes. Monitor I&O, BUN, and creatinine in pts w/ renal failure. Assess symptoms of Paget’s disease.
Teaching points: Take med with full glass of water (6-8 fl oz), first thing in the morning, at least 30 min before ingesting any other food, drink, or med. Taking med with other liquids significantly decreases the absorption of med. Do not like down for at least 30 min after taking med.
Cyclobenzaprine
Trade Name: Amrix, Fexmid
Classification: skeletal muscle relaxant
Common use: muscle spasm associated w acute painful musculoskeletal conditions
Common Side/Adverse Effects: drowsiness, dry mouth, dizziness
Nursing Interventions: Assest with ambulation. Assess for therapeutic response and reduced symptoms.
Teaching points: Avoid activities that require mental alertness. Avoid alcohol and other depressants. Avoid sudden movements do reduce dizziness.
Gabapentin
Trade Name: Neurotin, Gralise, Horizant
Classification: anticonvulsant, antineuralgic
Common use: To reduce seizure activity and neuropathic pain
Common Side/Adverse Effects: Fatigue, drowsiness, dizziness, ataxia
Nursing Interventions: Seizure precautions. Monitor seizure duration/frequency, kidney function, weight. Monitor for s/s of depression, suicidal ideation, or unusual behavior.
Teaching points: Do not abruptly stop taking drug. Avoid tasks that require mental alertness, and alcohol. Carry and identification card/bracelet to indicate seizure disorder or anticonvulsant therapy.
Pregabalin
Trade Name: Lyrica
Classification: Anticonvulsant, antineuralgic, Schedule V analgesic
Common use: adjunct therapy for partial-onset seizures; neuropathic pain.
Common Side/Adverse Effects: dizziness, drowsiness, ataxia, peripheral edema
Nursing Interventions: Seizure precautions. Assess for improvement of pain. Assess for signs of peripheral edema.
Teaching points: Don’t abruptly stop taking drug- increases risk of seizure frequency. Avoid tasks that require mental alertness, and alcohol. Carry and identification card/bracelet to indicate seizure disorder or anticonvulsant therapy.
Dexamethasone
Trade Name: Ozurdex, Maxidex, DexPak 6 Day
Classification: long-acting glucocorticoid; corticosteriod
Common use: for inflammation
Common Side/Adverse Effects: GI upset, vomiting, headache, insomnia, muscle wasting
Nursing Interventions: Monitor I&O, weight, serum glucose and serum electrolytes. Assess for signs of edema. Be alert to infection. Assess ability to sleep.
Teaching points: Don’t change dose/schedule or abruptly stop taking drug. Report any fever, sore throat, muscles aches, edema, sudden weight gain, and exposure to measles/chickenpox. Avoid alcohol and limit caffeine.
Vitamin D3
Trade Name: Drisdol, Calciferol, cholecalciferol
Classification: vitamin D supplement
Common use: Increase absorption of calcium and phosphorus
Common Side/Adverse Effects: side effects are uncommon, but may lead to hypercalcemia
Nursing Interventions: Monitor serum urinary calcium levels, phosphate, magnesium, BUN, creatinine. Ensure adequate fluid intake. Monitor for s/s of vitamin D intoxication.
Teaching points: Adequate calcium intake should be maintained. Foods high in phosphorus are to be restricted. Avoid excessive doses. Report any s/s of hypercalcemia (headache, weakness, drowsiness, n&v, muscle/bone pain.
Alendronate
Trade Name: Fosamax, Binosto
Classification: Don resorption inhibitor, calcium regulator
Common use: osteoporosis
Common Side/Adverse Effects: back or abd pain, constipation, abd distention, diarrhea
Nursing Interventions: Monitor labs ( serum calcium, phosphorus, alkaline phosphate levels)
Teaching points: Take med with full glass of water (6-8 fl oz), first thing in the morning, at least 30 min before ingesting any other food, drink, or med. Taking med with other liquids significantly decreases the absorption of med. Do not like down for at least 30 min after taking med.
Calcium
Trade Name:
Classification: antacid, antihypocalcemic, antihyperkalemi, antihyper magnesemic, antihyperphosphatemic
Common use: for hypocalcemia, calcium channel blocker overdose, antacid
Common Side/Adverse Effects: pain, rash, mild constipation, peripheral edema, n&v
Nursing Interventions: Monitor serum BMP, calcium, magnesium, phosphate, BP, heart rhythms, renal function. Monitor s/s of hypercalcemia.
Teaching points: Avoid excessive intake of alcohol, caffeine, or tobacco. Don’t take w/in 1-2 hrs of other oral meds, or fiber-rich foods.
Raloxifine
Black Box Alert
Trade Name: Evista
Classification: selective estrogen receptor modulator; osteoporosis preventive
Common use:prevention of osteoporosis and risk of invasive breast cancer
Common Side/Adverse Effects: hot flashes, flu-like symptoms, arthralgia, pneumonia
Black Box Warning: Increases risk of DVT. Women w/ coronary hr disease are at increased risk for death due to stroke
Nursing Interventions: Monitor total cholesterol, calcium, inorganic phosphate, protein, albumin, platelet count, and bone mineral density.
Teaching points: Avoid prolonged periods of not moving while traveling. Take calcium and vitamin D. Engage in weight-bearing exercise.
Baclofen
Black Box Alert
Trade Name: Gablofen, Lioresal
Classification: skeletal muscle relaxer; antispastic, analgesic (for trigeminal neuralgia)
Common use: muscle spasms
Common Side/Adverse Effects: transient drowsiness, asthenia, dizziness, n&v
Black Box Warning: Abrupt withdrawal of intrathecal form may result in severe hyperpyrexia, obtundation, rebound/exaggerated spasticity, muscle rigidity, leasing to organ failure and possibly death.
Nursing Interventions: Monitor BMP, LFT, blood counts. Assess for contradicting reaction. Watch for drowsiness, dizziness, and ataxia. Assist w ambulation.
Teaching points: Avoid tasks that require mental alertness. Dont abruptly stop taking med, may cause muscle rigidity, rebound spasticity, fever, and altered mental status. Avoid alcohol.
Hydrocodone-acetaminophen
Trade Name: Vicodin, Vicodin ES, Hycet, Lortab
Classification: narcotic analgesic, antitussive
Common use: moderate to severe pain
Common Side/Adverse Effects: n&v, dizziness, constipation, lethargy
Nursing Interventions: Initiate deep breathing and coughing. Assess for improvement of pain. Encourage fiber-rich foods.
Teaching Points: Change positions slowly. Avoid tasks that required mental alertness. Avoid alcohol and OTC meds that contain ACE.
Diazepam
Trade Name: Valium, Diastat, Diazepan Intensol
Classification: benzodiapine; antianxiety, anticonvulsant, skeletal muscle relaxer
Common use: anxiety, seizures
Common Side/Adverse Effects: drowsiness, fatigue, ataxia
Nursing Interventions: Monitor vitals, mental status. Evaluate for therapeutic response.
Teaching Points: Avoid alcohol, limit caffeine intake, Avoid tasks that require mental alertness. Don’t abruptly stop taking med after prolonged use.
