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Module 4 > Musculoskeletal Pharm > Flashcards

Musculoskeletal Pharm Flashcards

1
Q

what is calcium in the blood good for

A

clot factors, muscle contraction, and nerve function

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2
Q

osteoblasts

A

create and set the bone

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3
Q

osteoclasts

A

break down the bone (reabsorb)

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4
Q

where do osteoblasts and class originate

A

in the bone marrow

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5
Q

what is calcium absorption increased by

A

parathyroid hormone and vitamin D

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6
Q

what decreases calcium absorption

A

glucocorticoids

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7
Q

what eliminates calcium (excretes)

A

calcitonin

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8
Q

what happens if there is TOO much serum calcium

A

give calcitonin to get rid of it

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9
Q

how are calcium levels regulated

A

PTH
Vitamin D
Calcitonin

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10
Q

where is calcium absorbed

A

small intestines

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11
Q

where is calcium excreted

A

kidneys

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12
Q

what are the 4 drugs for disorders involving calcium

A

calcium salts
Vitamin D
Calcitonin-salmon
Bisphosphonates

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13
Q

what are the 3 names of calcitonin-salmon

A

calcimar, miacalcin, fortical

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14
Q

what do the bisphosphonates typically end in and what is the main one we will look at

A

“ate”; alendronate

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15
Q

bisphosphonates ______ bone resorption and the main side effect is_______

A

inhibits; gastritis

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16
Q

what is the proper administration of bisphosphonates (alendronate)

A

take with full glass of water
take 30 minutes before food or other meds
remain upright for at least 30 minutes

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17
Q

why do you take bisphosphonates on empty stomach and why should they remain upright after admin

A

food decreases absorption; prevents esophageal irritations

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18
Q

calcitonin ____ bone resorption and is secreted by the ______

A

inhibits; thyroid gland

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19
Q

what is the proper administration of calcitonin

A

give IM form at night to minimize side effects
alternate nostrils when using nasal form
MUST use calcium supplement with it

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20
Q

why do you have to take calcium supplement with calcitonin

A

because pt will be at high risk for secondary hyperparathyroidism

21
Q

mimics estrogen by reducing bone reabsorption without stimulating tissue or breast or uterus

A

reloxifene (SERM)

22
Q

also given to REDUCE osteoporosis, uterine cancer, treat post menopausel

A

Raloxifene

23
Q

what are the side effects of reloxifene

A

leg cramps, hot flashes, and blood clots

24
Q

what is denosumab used for

A

used in women for high risk fractures

monoclonal antibody against formation of osteoclasts (birth control for osteoclasts)

25
Q

what is given most often for people on LONG TERM corticosteroid therapy

A

denosumab

26
Q

what is one of the WORST side effects of raloxifene

A

venous thromboembolism (VTE) so can not take this med while immobilized

27
Q

what is the only drug that increases bone formation

A

teriparatide (forteo)

28
Q

what does teriparatide do

A

increases osteoblasts

29
Q

what is the greatest concern when laying down new bone

A

osteosarcoma (bone cancer)

30
Q

what are the drugs that weaken the bacterial cell wall

A

cephalosporins and vancomycin

31
Q

what are the most widely used group of antibiotics and are similar to penicillin structure

A

cephalosporins

32
Q

what do cephalosporins cause and what is important about their toxicity

A

drug causes lyses and death; toxicity is low

33
Q

cephalosporins bind to _____ binding proteins, disrupts ___ ____ synthesis, and cause cell ____

A

penicillin; cell wall; lyses

34
Q

which of the cephalosporins are active against broad spectrum antibiotics

A

beta-lactum (3rd and 4th)

35
Q

what are the ceph generations in order

A

first gen= cefazolin
second gen= cefaclor
third gen= cefoperazone
fourth gen= cefepime

36
Q

which generations can reach the cerebral spinal fluid

A

3rd- 5th

37
Q

how should you give cephalosporins if long term

A

through PICC or Central Line

38
Q

what are first and second generation cephs typically used for

A

pre op as prophylaxis

39
Q

what generation of cephs is the only one to treat MRSA

A

5th- ceftarolene

40
Q

what is the action of vancomycin and how should it be given

A

inhibits cell wall synthesis; given iv cause not absorbed from the gut

41
Q

vancomycin treats…

A

MRSA or staph

42
Q

why would oral version vanc be used

A

for C diff if metronidazole was ineffective

43
Q

what is main adverse effects of vancomycin

A

ototoxicity
red mans (if given to fast)
thrombophlebitis
RENAL FAILURE

44
Q

bacteriocidal inhibitors of protein synthesis

A

aminoglycosides (gentamicin, tobramycin, amikacin)

45
Q

what is the use of aminoglycosides

A

aerobic gram neg bacilli and is a narrower spectrum antibiotic

46
Q

do ahminoglycosides cross CSF

A

NO

47
Q

what are the adverse effects of aminoglycosides

A

oto and nephrotoxicity

48
Q

why should you get a peak and trough on ahminoglycosides and vancomycin

A

wanna know the trough because this is what the serum level is BEFORE you give the dose

49
Q

peak levels must be ___ enough to kill bacteria; through levels must be ___ enough to minimize toxicity

A

high; low

Module 4 (8 decks)

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