Musculoskeletal Pharm Flashcards
what is calcium in the blood good for
clot factors, muscle contraction, and nerve function
osteoblasts
create and set the bone
osteoclasts
break down the bone (reabsorb)
where do osteoblasts and class originate
in the bone marrow
what is calcium absorption increased by
parathyroid hormone and vitamin D
what decreases calcium absorption
glucocorticoids
what eliminates calcium (excretes)
calcitonin
what happens if there is TOO much serum calcium
give calcitonin to get rid of it
how are calcium levels regulated
PTH
Vitamin D
Calcitonin
where is calcium absorbed
small intestines
where is calcium excreted
kidneys
what are the 4 drugs for disorders involving calcium
calcium salts
Vitamin D
Calcitonin-salmon
Bisphosphonates
what are the 3 names of calcitonin-salmon
calcimar, miacalcin, fortical
what do the bisphosphonates typically end in and what is the main one we will look at
“ate”; alendronate
bisphosphonates ______ bone resorption and the main side effect is_______
inhibits; gastritis
what is the proper administration of bisphosphonates (alendronate)
take with full glass of water
take 30 minutes before food or other meds
remain upright for at least 30 minutes
why do you take bisphosphonates on empty stomach and why should they remain upright after admin
food decreases absorption; prevents esophageal irritations
calcitonin ____ bone resorption and is secreted by the ______
inhibits; thyroid gland
what is the proper administration of calcitonin
give IM form at night to minimize side effects
alternate nostrils when using nasal form
MUST use calcium supplement with it
why do you have to take calcium supplement with calcitonin
because pt will be at high risk for secondary hyperparathyroidism
mimics estrogen by reducing bone reabsorption without stimulating tissue or breast or uterus
reloxifene (SERM)
also given to REDUCE osteoporosis, uterine cancer, treat post menopausel
Raloxifene
what are the side effects of reloxifene
leg cramps, hot flashes, and blood clots
what is denosumab used for
used in women for high risk fractures
monoclonal antibody against formation of osteoclasts (birth control for osteoclasts)
what is given most often for people on LONG TERM corticosteroid therapy
denosumab
what is one of the WORST side effects of raloxifene
venous thromboembolism (VTE) so can not take this med while immobilized
what is the only drug that increases bone formation
teriparatide (forteo)
what does teriparatide do
increases osteoblasts
what is the greatest concern when laying down new bone
osteosarcoma (bone cancer)
what are the drugs that weaken the bacterial cell wall
cephalosporins and vancomycin
what are the most widely used group of antibiotics and are similar to penicillin structure
cephalosporins
what do cephalosporins cause and what is important about their toxicity
drug causes lyses and death; toxicity is low
cephalosporins bind to _____ binding proteins, disrupts ___ ____ synthesis, and cause cell ____
penicillin; cell wall; lyses
which of the cephalosporins are active against broad spectrum antibiotics
beta-lactum (3rd and 4th)
what are the ceph generations in order
first gen= cefazolin
second gen= cefaclor
third gen= cefoperazone
fourth gen= cefepime
which generations can reach the cerebral spinal fluid
3rd- 5th
how should you give cephalosporins if long term
through PICC or Central Line
what are first and second generation cephs typically used for
pre op as prophylaxis
what generation of cephs is the only one to treat MRSA
5th- ceftarolene
what is the action of vancomycin and how should it be given
inhibits cell wall synthesis; given iv cause not absorbed from the gut
vancomycin treats…
MRSA or staph
why would oral version vanc be used
for C diff if metronidazole was ineffective
what is main adverse effects of vancomycin
ototoxicity
red mans (if given to fast)
thrombophlebitis
RENAL FAILURE
bacteriocidal inhibitors of protein synthesis
aminoglycosides (gentamicin, tobramycin, amikacin)
what is the use of aminoglycosides
aerobic gram neg bacilli and is a narrower spectrum antibiotic
do ahminoglycosides cross CSF
NO
what are the adverse effects of aminoglycosides
oto and nephrotoxicity
why should you get a peak and trough on ahminoglycosides and vancomycin
wanna know the trough because this is what the serum level is BEFORE you give the dose
peak levels must be ___ enough to kill bacteria; through levels must be ___ enough to minimize toxicity
high; low
