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Ashland > musculoskeletal - pharm E4 > Flashcards

musculoskeletal - pharm E4 Flashcards

1
Q

what class is Aldendronate

A

biphosphates

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2
Q

biphosphates MOA

A

Binds permanently to surface of bones to inhibit osteoclast activity

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3
Q

Aldendronate indication

A

osteoporosis

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4
Q

Aldendronate SE

A

N/V/D
Esophageal ulceration

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5
Q

Aldendronate nursing considerations

A

do not lay down after taking d/t ulceration risk

do not take calcium (or other food/drinks) with this bc will lower bioavailability)

given 1x/wk

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6
Q

what class is Raloxifene

A

Selective estrogen receptor modulators (SERMs)

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7
Q

Selective estrogen receptor modulators (SERMs) MOA

A

Mimics estrogen by increasing bone density, inhibits bone resorption

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8
Q

Raloxifene indications

A

Preventing or treating postmenopausal osteoporosis

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9
Q

Raloxifene SE

A

Hot flashes
Leg problems
Stroke risk

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10
Q

Raloxifene nursing considerations

A

Safer than a hormone replacement, less affective the biphos

BBW: stroke risk

Need to take adequate calcium & vit D for this to work

Discontinue at least 72 hrs before planned procedures

Do not smoke or drink

Do not take if pregnant

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11
Q

what class is Calcitonin Salmon

A

calcitonin

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12
Q

Calcitonin Salmon MOA

A

Inhibits bone removal by osteoclasts

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13
Q

Calcitonin Salmon indication

A

Treatment of osteoporosis

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14
Q

Calcitonin Salmon SE

A

Nasal irritation

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15
Q

Calcitonin Salmon nursing consideration

A

Have to take for 5 years to see long term benefit

Slows done bone loss and increases spinal bone density

Given intranasal

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16
Q

what class is Methotrexate

A

DMARD ; antineoplastic, anti-rheumatic

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17
Q

Methotrexate MOA

A

Immunosuppressive -> interferes w/ folic acid metabolism

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18
Q

Methotrexate indication

A

RA

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19
Q

Methotrexate SE

A

GI
Bone marrow suppression
Shortened life expectancy

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20
Q

Methotrexate nursing consideration

A

Need folic acid replacement

1x/wk or deadly

Hepatotoxic -> monitor liver enzymes

Monitor RBCs & WBCs

11 BBW
-no alcohol
-teratogenic (need BC)
-high infection risk
-liver & kidney disease
-aplastic anemia w/ NSAID use

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21
Q

what class is Hydroxychloroquine

A

DMARD; antimalarial, anti rheumatic

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22
Q

Hydroxychloroquine MOA

A

Unknown but anti inflammatory processes

23
Q

Hydroxychloroquine indications

24
Q

Hydroxychloroquine SE

A

Retinopathy

25
Q

Hydroxychloroquine nursing considerations

A

Less side effects than methotrexate, Slow progression of RA when used in combo w/ other DMARDs

26
Q

what class is Biologic Agents

A

New generation DMARDs

27
Q

Biologic Agents MOA

A

Targets part of the immune system that triggers inflammation that causes joint and tissue damage

28
Q

Biologic Agents indication

29
Q

Biologic Agents SE

A

Increase risk of severe skin or lung infections, skin cancers, serious allergic rx

30
Q

Biologic Agents nursing considerations

A

Usually given w/ methotrexate

31
Q

what class is Allopurinol

A

Xanthine oxidase inhibitor

32
Q

Xanthine oxidase inhibitor MOA

A

Inhibits the xanthine oxidase enzyme, which prevents uric acid production

33
Q

Allopurinol indications

A

Gout related to excess uric acid production

34
Q

Allopurinol SE

A

Agranulocytosis
aplastic anemia
fatal skin reaction -> can cause Steven Johnson syndrome which can leads to TENs

35
Q

Allopurinol nursing considerations

A

Prevention drug

May cause hypoglycemia -> watch sugars

If on warfarin, monitor INR closely

Onset is 2-6 weeks

Monitor WBC & RBCs

36
Q

what class is Colchicine

37
Q

Colchicine MOA

A

Reduces inflammatory response to the deposits or urate crystals in joint tissue

38
Q

Colchicine indications

A

2nd line gout therapy

39
Q

Colchicine SE

A

GI bleeding
Urinary bleeding

40
Q

Colchicine nursing considerations

A

Powerful inhibitor of cell mitosis and can cause short term leukopenia

If have flu like sx / vomiting stop immediately because sign of toxicity

Contraindicated for any person with severe renal, gastrointestinal, hepatic disorders, cardiac disorders or bleeding disorders

41
Q

what class is probenecid

A

Uricosuric agent

42
Q

Uricosuric agent MOA

A

Inhibits reabsorption of uric acid in kidneys promoting excretion

43
Q

probenecid indications

A

Treats hyperuricemia w/ gout

44
Q

probenecid SE

A

GI upset
Dizziness or headache
Kidney/liver impairment
Lots of drug interactions

45
Q

probenecid nursing considerations

A

Take w/ food and plenty of fluids

Lots of drug interactions

46
Q

why is hormone therapy no longer used for osteoporosis

A

d/t risk of blood clots, breast cancer, & other canceres

47
Q

osteomyelitis pharm

A

abx fro 4-6 weeks-> nafcillin, cefazolin, vancomycin

48
Q

pharm for OA

A

manage pain & reduce swelling
mild to mod: acetaminophen, topical capsaicin, nsaids
mod to sev: rx nsaids, nsaids + colchinine, Tylenol + tramadol, opioids, steroid injections

49
Q

how do NSAIDs work

A

by reducing production of prostaglandins which promote inflammation, pain and fever

50
Q

what drugs are NSAIDs

A

aspirin
ibuprofen
naproxen
ketorolac
celecoxib

51
Q

NSAIDs facts

A

-use lowest effective dose
-can affect kidney function
-risk for GI bleed
-contraindicated for pts w/ PUD
-use w/ caution if pmh of GI bleeds or on anticoags

52
Q

goal of pharm for RA

A

-relieve pain and swelling
-slow or stop progression of disease
-long term drug therapy (NSAIDs, short term glucocorticoids, DMARDS)

53
Q

what is the steroid of choice for RA + facts

A

-prednisone
-rapid suppression of inflammation
-only use when sx cannot be controlled by NSAIDs
-used with DMARD

54
Q

what is the drug of choice for gout

A

NSAIDs bc of anti inflammatory

Ashland (110 decks)

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