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Pharmacology Exam #1 > Musculoskeletal Medications > Flashcards

Musculoskeletal Medications Flashcards

1
Q

What drug therapy can be used for Rheumatoid Arthritis (RA)?

A

non-steroidal anti-inflammatory drugs (NSAIDs), Glucocorticoids, disease modifying anti-rhematic drugs (DMARDs)

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2
Q

methotrexate (Rheumatrexate): class

A

Nonbiological (Traditional) DMARD

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3
Q

methotrexate (Rheumatrexate): Use

A

decrease inflammation/ joint pain

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4
Q

methotrexate (Rheumatrexate): EPA

A

immunosuppression, takes weeks to take effect

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5
Q

methotrexate (Rheumatrexate): ADR

A

dizzy, headache, blurred vision, N/V, hepatotoxic, renal damage, infection, bone arrow suppression, GI bleeding, pulmonary fibrosis

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6
Q

methotrexate (Rheumatrexate): RN Interventions

A

monitor lab values, take contraceptives, hydrate 2L a day, report adverse reactions, monitor respiratory status

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7
Q

methotrexate (Rheumatrexate): contraindications

A

Teratogenic. Caution in w/ peptic ulcer disease, ulcerative colitis. Infections. Liver disease, heavy ETOH use.
Med Interactions: Warfarin, Digoxin, NSAIDs
Caffeine can reduce effectiveness!

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8
Q

etanercept (Enbrel): class

A

biological DMARDs

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9
Q

biological DMARDs

A

etanercepts (Enbrel), infliximab (Remicade), adalimumab (Humira)

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10
Q

etanercept (Enbrel): use

A

decrease joint inflammation and subsequent damage, once weekly

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11
Q

etanercept (Enbrel): EPA

A

inactivates tumor necrosis factor (TNF)

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12
Q

etanercept (Enbrel): ADR

A

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

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13
Q

etanercept (Enbrel): RN Interventions

A

monitor for infection, monitor for heart failure, TB test prior to start of therapy, monitor lab values

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14
Q

etanercept (Enbrel): contraindications

A

NO live vaccines, active infection, hematological disorders, malignancy, interacts with chemotherapeutics = bone marrow suppression, do not give with Anikinra (Kineret)

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15
Q

What medications treat osteoporosis?

A

SERMs, Bisphosphonates, calcitonin, calcium supplements

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16
Q

raloxifene(Evista): class

A

Selective Estrogen Receptor Modulators (SERMs)

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17
Q

raloxifene(Evista): Use

A

bone reabsorption inhibitor, postmenopausal osteoporosis, reducing risk of estrogen receptor-positive breast cancer

18
Q

raloxifene(Evista): EPA

A

activate estrogen receptors in some tissue and blocks receptors in others (breast)

19
Q

raloxifene(Evista): ADR

A

increased risk of stroke, PE, DVT, Hot flashes

20
Q

raloxifene(Evista): Contraindications

A

teratogenic, do not give with history of PE/DVT, caution with HLD, and concurrent estrogen use

21
Q

raloxifene(Evista): RN Interventions

A

monitor and report s/sx of thrombi-emboli, encourage calcium and vitamin D intake, do weight bearing activates, educate on hot flashes

22
Q

alendronate (Fosamax): class

A

bisphosphonates

23
Q

bisphosphonate medications

A

alendronate (fosamax), risedronate (actonel), ibandronate (Boniva)

24
Q

alendronate (fosamax): use

A

postmenopausal, age-related and glucocorticoid osteoporosis

25
Q

alendronate (fosamax): EPA

A

bone reabsorption inhibitor, inhibits osteoclast activity - decrease bone absorption

26
Q

alendronate (fosamax): ADR

A

GI distress, muscle and joint pain

27
Q

alendronate (fosamax): contraindications

A

esophageal disorders, renal insufficiency, hypocalcemia, calcium supplements & dairy reduce absorption

28
Q

alendronate (fosamax): RN Interventions

A

monitor for esophagitis, take with full glass of water, sit at a 90 degree angle for 30 minutes, 30 minutes prior to other food, report vision changes

29
Q

calcitonin-salmon (Miacalcin, Calcimar): class

A

Hypocalcemic: Calcitonin

30
Q

calcitonin-salmon (Miacalcin, Calcimar): Use

A

treats established postmenopausal osteoporosis, hypercalcemia, hyperparathyroidism, Paget’s disease

31
Q

calcitonin-salmon (Miacalcin, Calcimar): EPA

A

inhibits actions of osteoclasts, increase excretion of calcium

32
Q

calcitonin-salmon (Miacalcin, Calcimar): ADR

A

allergy to salmon protein or gelatin diluent, hypocalcemia, nasal dryness and irritation, headache, epistaxis, N/V, polyuria

33
Q

calcitonin-salmon (Miacalcin, Calcimar): contraindications

A

allergy to salmon/fish proteins, interaction with lithium, may have lower effectiveness if bisphosphonate previously taken

34
Q

calcitonin-salmon (Miacalcin, Calcimar): RN Interventions

A

inspect nares, diet high in calcium and vitamin D, intradermal allergy test, keep some forms in fridge and protected from light, s/sx hypocalcemia, regular bone density testing

35
Q

What is Hypocalcemia and what does it present as?

A

calcium level lower than 9.0
CATS: convulsions, arrhythmias, tetany, stridor and spasms

36
Q

What is Hypercalcemia and what does it present as?

A

calcium level higher than 10.5
Moans, bones, stones, groans, other: N/V, constipation, pancreatitis, weakness, bone pain, fractures, polyuria, nephrocalcinosis, confusion, poor concentration, secondary hypertension, short QT

37
Q

calcium citrate (Citracal) or calcium carbonate (Tums): class

A

calcium supplements

38
Q

calcium citrate (Citracal) or calcium carbonate (Tums): use

A

calcium replacement, antacid

39
Q

calcium citrate (Citracal) or calcium carbonate (Tums): EPA

A

provide calcium, acts as a base

40
Q

calcium citrate (Citracal) or calcium carbonate (Tums): ADR

A

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

41
Q

calcium citrate (Citracal) or calcium carbonate (Tums): contraindications

A

Avoid in hypercalcemia OR hypophosphatemia. Caution w/ kidney stones, cardiac dysrhythmias, slow gastric motility.
Interactions: above meds. Digoxin, thiazide diuretics. Some foods.

42
Q

calcium citrate (Citracal) or calcium carbonate (Tums): RN Interventions

A

monitor calcium levels, give IV Slowly, administer 1 hr before or 2 hrs after other medications, do not take more than 600mg at a time, chew and take with water

Pharmacology Exam #1 (4 decks)

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