Musculoskeletal Medications Flashcards
Bisphosphonates action
Decrease number and action of osteoclasts resulting in bone resorption
Bisphosphonates medications (4)
- Alendronate: daily/weekly
- Risedronate: daily/weekly/monthly
- Ibandronate: monthly/every 3 months
- Zoledronate: IV annually
Bisphosphonates uses (3)
- Prevent/treat osteoporosis
- Paget’s disease
- Hypercalcemia due to malignancy
Bisphosphonates precautions (3)
- Not used during lactation
- Patients with esophageal stricture/dysphagia can only take zoledronate
- Absorption decreased when taken with calcium supplements, antacids, orange juice, caffeine
Bisphosphonates side/adverse effects (5)
- Musculoskeletal pain
- Esophagitis
- GI discomfort
- Jaw pain (zoledronate)
- Afib (zoledronate)
Bisphosphonates nursing interventions (4)
- Give in the morning on an empty stomach
- Drink at least 8 oz non-carbonated water
- Stay upright for 30 minutes after taking medication
- Consume adequate amount of vitamin D
Disease modifying anti-rheumatic drugs (DMARDs) (5)
- Methotrexate
- Hydroxychloroquine
- Etanercept
- Infliximab
- Adalimumab
DMARDs action
Interrupt complex immune responses preventing disease progression
Glucocorticoid medications (2)
- Prednisone
- Prednisolone
Glucocorticoid action
Decrease inflammation by suppressing leukocytes and fibroblasts and reversing capillary permeability
NSAIDS (4)
- Ibuprofen
- Indomethacin
- Naproxen
- Celecoxib
NSAIDS action
Block prostaglandin synthesis causing decreased inflammatory response
DMARDS use
- Slow joint degeneration and progression of rheumatoid arthritis
DMARDS precaution
- Methotrexate contraindicated in pregnancy, kidney/liver failure, psoriasis, alcohol use disorder, hematologic dyscrasias
DMARDS side/adverse effects (2)
- Methotrexate: increased risk of infection, bone marrow suppression, GI ulceration
- Hydroxychloroquine: retinal damage
DMARDS nursing interventions (6)
- Teach infection prevention
- Monitor liver function tests
- Use reliable contraception
- Initial effects can take 3-6 weeks and full therapeutic effects can take several months
- Give with food
- Retinal exams every 6 months while on hydroxychloroquine
Glucocorticoid use
- Symptom relief from inflammation and pain
Glucocorticoid precautions (3)
- Not to be used during systemic fungal infections
- Don’t give live virus vaccines
- Used for short durations
Glucocorticoid side/adverse effects (7)
- Risk of infection
- Osteoporosis
- Adrenal suppression
- Fluid retention
- GI discomfort
- Hyperglycemia
- Hypokalemia
Glucocorticoid nursing interventions (5)
- Don’t skip doses
- Monitor bp, fluid/electrolytes, weight, signs of bleeding, GI discomfort
- Take calcium supplements, maintain vitamin D levels
- Take with food
- Don’t stop abruptly
- Provide immune protection
NSAIDS use
Provide rapid symptom relief from inflammation and pain
NSAIDS precautions (2)
- Hypersensitivity to aspirin and other NSAIDS
- Can increase the risk of MI, stroke
NSAIDS side/adverse effects (4)
- GI discomfort
- GI ulceration
- Renal impairment
- Photosensitivity
NSAIDS nursing interventions (4)
- Give with food and full glass of water
- Don’t lay down for 30 minutes after taking medication
- Only used as needed
- Use sunscreen
Anti-gout medications (2)
- Allopurinol
- Colchicine
Allopurinol action
Blocks production of uric acid
Allopurinol use
Chronic gouty arthritis
Colchicine action
Blocks processes to prevent leukocytes from invading joints
Colchicine use
Acute gouty arthritis
Anti-gout precautions (2)
- Use caution in patients with renal, cardiac, GI dysfunction
- Don’t combine with theophylline
Anti-gout side/adverse effects (3)
- GI distress
- Rash, fever
- Decreased metabolism of warfarin
Anti-gout nursing interventions (4)
- Avoid foods high in purines to reduce uric acid
- Monitor CBC, uric acid levels
- Avoid aspirin
- Give with meals
