Pharmacological Management of the Musculoskeletal System

Question 1

What is the action of disease modifying Antirheumatic drugs (DMARD)?

Answer 1

Slow or halt the progression of rheumatic disease

Inhibit the immune response responsible for rheumatic disease

Question 2

List 11 side effects associated with disease modifying antirheumatic drugs.

Answer 2

Nausea
Headache
Joint pain and swelling 
Toxicity 
GI distress 
Sore throat 
Fever 
Liver dysfunction
Hair loss 
Potential for sepsis 
Retinal damage

Question 3

List 3 common examples of disease modifying antirheumatic drugs.

Answer 3

Methotrexate
Humira
Plaquenil

Question 4

What is important for PTs to know about disease modifying antirheumatic drugs?

Answer 4

Many DMARDs have high incidence of toxicity

Question 5

What is the action of glucocorticoid agents (corticosteroids)?

Answer 5

Provide hormonal, anti-inflammatory and metabolic effects including suppression of articular and systemic disease

Reduce inflammation in chronic tissue

Question 6

List short term (5) and long term (1) side effects associated with glucocorticoid agents (corticosteroids).

Answer 6

Short term: weight gain, puffy face, nausea, mood swings, and trouble sleeping

Long term: osteoporosis

Question 7

List 5 common examples of corticosteroid drugs.

Answer 7

Prednisone 
Hydrocortisone 
Prednisolone 
Methlyprednisolone 
Dexamethasone

Question 8

What is important for PTs to know about corticosteroids?

Answer 8

Signs of toxicity: Moon face, buffalo hump, personality changes

Increased risk for muscle wasting and osteoporosis

Question 9

What is the most common medication for pain relief for musculoskeletal dysfunction?

Answer 9

Non-steroidal anti-inflammatory drugs (NSAIDs)

Question 10

What is the action of NSAIDs?

Answer 10

Provide analgesic, anti-inflammatory and antipyretic capabilities.

Question 11

List 4 common examples of NSAIDs.

Answer 11

Ibuprofen
Naproxen sodium (Aleve)
Salsalate (Discalced)
Indomethacin (Indocin

Question 12

List 4 side effects associated with NSAIDs.

Answer 12

GI irritation
Fluid retention
Renal or liver problems
Prolonged bleeding

Question 13

What is the action of muscle relaxants?

Answer 13

Act on the CNS to reduce skeletal muscle tone by depressing the internuncial neurons of the brain stem and spinal cord

Question 14

List 4 side effects associated with muscle relaxants.

Answer 14

Drowsiness
Lethargy
Ataxia
Decreased altertness

Question 15

List 3 common examples of muscle relaxants.

Answer 15

Cyclobenzaprine HCL (Flexeril)
Methocarbamol (Robaxin)
Carisoprodol (Soma)

Question 16

What medications are typically prescribed for pain when NSAIDs are contraindicated?

Answer 16

Nonnarcotic analgesics

Question 17

What is the action of nonnarcotic analgesic drugs?

Answer 17

Act on CNS to alter response to pain and have anti-pyretic (fever reducing) capabilities

Question 18

List 2 side effects of nonnarcotic analgesics if they are taken in excess.

Answer 18

Liver disease

Acute liver shutdown

Question 19

List 3 common examples of nonnarcotic analgesics.

Answer 19

Tylenol (acetaminophen)
Aspirin
Celebrex

Question 20

What is the action of narcotic analgesics (opioids)?

Answer 20

Prevent pain input by binding to the CNS opioid pain receptors

Question 21

List 8 side effects associated with narcotic analgesics (opioids).

Answer 21

Sedation
Confusion 
Vertigo 
Orthostatic hypotension
Constipation
Incoordination 
Physical dependence 
Tolerance

Question 22

List 5 common examples of narcotic analgesics (opioids).

Answer 22

Codeine 
Hydrocodone
Oxycodone
Hydromorphone
Fentanyl

Question 23

List the signs and symptoms of the ‘opioid overdose triad.’

Answer 23

Pinpoint pupils
Respiratory depression
Unconsciousness