Muskuloskeletal pharm Flashcards
Alendronate class, indications, MOA
- bisphosphonates
- Reduce fractures by 50%
- Binds perm to surfaces of bones and inhibits osteoclast activity
Alendronate SE and NC
- GI (N/V/D), esophageal ulcerations
- stay sitting up after for 30 min; take with water to prevent ulcer
- don’t take Ca or vits for 2h after bc can very low bioavail
- take weekly
Raloxifene class, indications, MOA
- SERM (selective estrogen rec modulator)
- For prevention and tx of post-meno; dec spinal fracs
- Mimics estrogen by inc bone density (binds to est); inhibits bone resorption
Raloxifene SE and NC
- Hot flashes, leg cramp; BLACK BOX stroke
- need adequate Ca and vit D to work
- d/c 72h before planned procedures and any long immobilization period or high risk of blood clotting
- don’t smoke or drink
- no preg
Calcitonin-Salmon indications and MOA
- Tx only; dec spinal fracs
- Inhibits bone removal by osteoclasts; slows bone loss and inc spinal bone density
Calcitonin-Salmon SE and NC
Nasal irritation
- benefits after taking for 5y
- intranasal
Prednisone class and indications
- glucocorticoids
- Rapid suppression of inflam when sx NOT controlled w/ NSAIDs
Prednisone SE and NC
Immune supp, slow wound
- not best for long term therapy
- usually small doses under 10mg/day
- buffalo hump, cataracts, wt gain, hyperG, inc risk of infx, thin bones, suppressed adrenal gland hor prod (fatigue, loss of appetite, nausea, muscle weak)
- thin skin, bruise, slow wound healing, hirsutism, striae
Methotrexate class, indications, MOA
- DMARD, Antineoplastic, anti-rheumatic
- RA
- immunosuppressive
Methotrexate SE and NC
- GI
- bone marrow suppression, short life expectancy
- interfere with folate metab (need supp)
- PO or SQ/IV
- weekly for safety
- kid and liver tox - monitor AST, ALT, alk phos; NO ALC
- monitor bone levels
- 11 black box warnings
- teratogenic - 2 form birth control
- inc risk infx
- aplastic anemia risk w/ NSAIDs so monitor levels
Hydroxychloroquine class and MOA
- DMARD, antimalarial and anti-rheumatic, SLE
- Unknown, anti-inflam process; dampens macrophage, t cell, and cytokine activity
Hydroxychloroquine SE and NC
- retinopathy (rare)
- slows prog of RA esp when used with other DMARDs
- fewer SE
Biologic response modifiers
- Target parts of the immune sys that trigger inflam that cause joint and tissue damage
- SE: Skin infx, lung infx, skin cancers, serious allergic rxn
- often given with methotrexate
allopurinol class, indications, MOA
- xanthine inhibitors
- Pt with gout r/t excess uric acid prod; PREVENTION
- Inhibits the xanthine oxidase enzyme which prevents uric acid prod
allopurinol SE and NC
- Usually well-tolerated; Rash, agranulocytosis, aplastic anemia, fatal skin rxn (SJS/TENS–anaphylactic)
- monitor uric acid levels
- can inc DM meds like metformin and warfarin; can cause hypoglycemia–but may die down with time
- monitor WBCs
