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Pharm > Musculoskeletal Drugs > Flashcards

Musculoskeletal Drugs Flashcards

1
Q

Calcium Supplements Prototype

A

calcium citrate (Citracal), calcium carbonate (Tums)

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2
Q

Calcium Supplements Therapeutic Uses

A

Calcium replacement, antacid

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3
Q

Calcium Supplements Administration

A

PO or Iv slowly

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4
Q

Calcium Supplements EPA

A
  • provide calcium
  • act as a base
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5
Q

Calcium Supplements ADRs

A

hypercalcemia = N/V, constipation, polyuria, depression, renal stones

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6
Q

Calcium Supplements Contraindications and Interactions

A

Avoid in hypercalcemia OR hypophosphatemia. Caution with kidney stones, cardiac dysrhythmias, slow genetic motility
Interactions: Digoxin, thiazide diuretics. Some foods

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7
Q

Calcium Supplements RN Interventions and Client Education

A

Monitor serum calcium levels
Monitor for and educate client about s/sx of hypercalcemia
Administer supplement ca+ 1hr before or 2hrs after
Glucocorticoids
Thyroid supplements
Tetracycline and quinolone antibiotics
Do not take more than 600mg at a time
Chew tablet, take w/ 8ox of water

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8
Q

Hypocalcemic: Calcitonin Prototype

A

calcitonin-salmon (Miacalcin, Calcimar)

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9
Q

Calcitonin Therapeutic Uses

A

treats established postmenopausal osteoporosis. Also hypercalcemia, and hyperparathyroidism. Paget’s disease

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10
Q

Calcitonin Administration

A

IM, subQ, intranasal

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11
Q

Calcitonin EPA

A

inhibits actions of osteoclasts. Increases excretion of calcium

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12
Q

calcitonin ADRs

A

allergy to salmon protein or gelatin diluent. Hypocalcemia. Nasal dryness and irritation. HA, epistaxis
- Injection site rxns, N/V, polyuria

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13
Q

Calcitonin RN interventions and client education

A

Prior nasal administration, inspect nares (irritation and ulceration)
Diet - high in calcium and vitamin D
Prior to therapy initiation - intradermal allergy test
Erythema w/in 15 min
Antihistamines, epi, O2 available
Keep parenteral forms in fridge, protect from light
Nasal form - prime pump
Educate client on s/sx of hypocalcemia
May need regular bone density testing

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14
Q

Calcitonin Contraindications and Interactions

A

Allergy to salmon/fish proteins
Interactions with lithium
If taken bisphosphate previously may have lower effectiveness

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15
Q

Bisphosphonates Prototype and Other Drug Names

A

alendronate (Fosamax)
Others: risedronate (Actonel), ibandronate (Boniva)

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16
Q

Bisphosphonates Therapeutic Uses

A

postmenopausal, age-related, and glucocorticoid osteoporosis

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17
Q

Bisphosphonates Administration

A

PO for alendronate

18
Q

Bisphosphonates EPA

A

directly inhibits activity of osteoclasts = decreased bone absorption

19
Q

Bisphosphonates ADRs

A

GI disturbances (N/V, abd pain, esophagitis). Muscle and joint pain

20
Q

Bisphosphonates Contraindications and Interactions

A

Esophageal disorders. Renal insufficiency. Hypocalcemia
Calcium supplements and dairy reduce absorption!!!

21
Q

Bisphosphonates RN interventions and client education

A

Monitor for S/sx of esophagitis = reflux, pain with swallowing and dysphagia
Must take with a full glass of water (risk for esophageal ulcers). 90 degree angle for 30 minutes
Give 30 min prior to other meds, food, drink
Monitor for muscle/joint pain = mild analgesic
Educate client to report vision changes (rare ADR)

22
Q

Selective Estrogen Receptor Modulators (SERMs) Prototype

A

raloxifene (Evista)

23
Q

SERMs therapeutic uses

A

postmenopausal osteoporosis. Also for reducing risk of estrogen receptor-positive breast cancer

24
Q

SERMS administration

A

PO daily

25
Q

SERMs EPA

A

activate estrogen receptor in some tissue and blocks receptors in others (breasts)

26
Q

SERMs ADRs

A

increased risk of stroke, PE, DVT, hot flashes

27
Q

SERMs RN intervention and client education

A

Monitor for and educate pt to call provider if s/sx of thrombo-emboli
SOB, chest pain, pain/cramping in extremities, unilateral extremity swelling, redness in extremity
Encourage calcium and vit D intake
Encourage weight bearing activities
If using for breast cancer prevention, educate on hot flashes

28
Q

SERMs contraindications and interactions

A

Teratogenic! Including breastfeeding. Counsel on contraception
Do not give to pt that have hx of PE/DVT if it develops need to discontinue
Caution w/ HLD, concurrent estrogen use

29
Q

Biologic DMARDS Prototype and other names

A

etanercept (Enbrel)
Others: infliximab (Remicade), adalimumab (Humira)

30
Q

Biological DMARDs Therapeutic Uses

A

decrease joint inflammation and subsequent damage

31
Q

Biological DMARDS Administration

A

subQ once weekly

32
Q

Biological DMARDS EPA

A

inactivates tumor necrosis factor (TNF)

33
Q

Biological DMARDS ADRs

A

immunosuppression, pancytopenia, heart failure, dizziness, abdominal pain, psoriasis

34
Q

Biological DMARDS RN intervention and client education

A

Monitor for s/sx of infection
Monitor injection site
Monitor for s/sx of heart failure
SOB, edema, cough - pink frothy sputum
TB test prior to therapy initiation
Monitor lab values

35
Q

Biological DMARDS contraindications and interactions

A

No live vaccines!
contraindicated: active infection, hematological disorders, malignancy
Interactions: chemotherapeutics = bone marrow suppression. Do not give with Anikinra (Kineret)

36
Q

Nonbiological (Traditional) DMARDs Prototype

A

methotrexate (Rheumatrexate)

37
Q

Nonbiological DMARDS therapeutic uses

A

decrease inflammation/joint damage

38
Q

Nonbiological DMARDS EPA

A

immunosuppression

39
Q

Nonbiological DMARDS Administration

A

PO, IV, subQ
Once a week

40
Q

Nonbiological DMARDS ADRs

A

dizziness, HA, blurred vision, N/V, hepatotoxic, renal damage, infection, bone marrow suppression (decreased blood cells), GI bleeding, pulmonary fibrosis

41
Q

Nonbiological DMARDS RN intervention and client education

A

Monitor lab values - CBC, platelets, creatine, LFT
Monitor respiratory status
Educate pt to call provider immediately for Jaundice, s/sx of, infection, Shortness of breath, Abnormal bleeding.
Clients of childbearing age should take contraceptive
Educate client to hydrate - 2L per day

42
Q

Nonbiological DMARDS contraindications and interactions

A

Teratogenic
Caution in people with peptic ulcer disease, ulcerative colitis
Infections. Liver disease, heavy ETOH use
Med interactions: warfarin, digoxin, NSAIDS
Caffeine can reduce effectiveness

Pharm (13 decks)

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