Skeletal Muscle, Bone, And Joint Disorder Drugs Flashcards
Alopecia
Abnormal loss of hair, baldness
Autoimmune
A response where antibodies are formed against one’s own body
Dyspepsia
Fullness or epigastric discomfort
Gout
A metabolic disorder resulting in increased levels of uric acid and causing severe joint pain
Musculoskeletal
Pertaining to the bones and muscles
Osteoporosis
Skeletal disorder characterized by porous bone, making weaker bone strength and greater risk of fracture of a bone
Paget disease
Condition where bones grow too large and become weak
Rheumatoid arthritis (RA)
Inflammatory changes in connective tissue
Skeletal muscle relaxants ex
Carisoprodol, baclofen, chlorzoxazone, diazepam, cyclobenzaprine, dantrolene, metaxalone, methocarbamol, orphenadrine, tizanidine
Cyclobenzaprine MOA
Has an effect on muscle tone, reducing muscle spasm
Skeletal muscle relaxants uses
Various acute painful musculoskeletal conditions (muscle strains and back pain)
Musculoskeletal disorders ex
Synovitis, arthritis, osteoarthritis, degenerative joint disease (DJD), gout, osteoporosis, hypercalcemia of malignancy, paget disease
Skeletal muscle relaxants side effects
Drowsiness
Diazepam side effects
Drowsiness, sedation, sleepiness, lethargy, constipation, diarrhea, bradycardia or tachycardia, or rash
Baclofen contraindications
Skeletal muscle spasm caused by rheumatic disorders
Carsiprodol is contraindicated in
Patients with recent myocardial infarction, cardiac conduction disorders, and hyperthyroidism
Cyclobenzaprine contraindications
Within 14 days of taking a MAOI,
Oral dantrolene contraindications
Lactation, active hepatic disease, muscle spasm caused by rheumatic disorders
Skeletal muscle relaxants precautions
Historia of cerebrovascular accident, cerebral palsy, parkinsonism, or seizure disorders, pregnancy (cat C)
Cyclobenzaprine precautions
Cardiovascular disease, pregnancy (cat B), lactation
Dantrolene pregnancy cat
C
Skeletal muscle relaxants interactions
Increased CNS depressants Effect (with alcohol, antihistamines, opiates, and sedatives)
Cyclobenzaprine interactions
MAOIs increase risk for high fever and convulsions
Orphenadrine interactions
Haloperidol increases psychosis
Tizanidine interactions
Increased risk of hypotension with antihypertensives
Muscle relaxants used for surgical procedures ex
Cisatracurium, mivacurium, pancuronium, rocuronium, succinylcholine, vecuronium
RA is treated using what
NSAIDs, corticosteroids, and DMARDs
When are DMARDs used
When immobility and pain of RA can no longer be controlled by pain-relief agents and anti inflammatory drugs, and can also treat Crohn disease and fibromyalgia
DMARDs ex
Methotrexate, sulfasalazine, hydroxychloroquine, and leflunomide
DMARDs MOA
Produce immunosuppression
Biologic DMARDs ex
Etanercept, adalimumab, infliximab, certolizumab, pegol, golimumab, abatacept, anakinra, certolizumab, tocilizumab
Cytotoxic drugs use
Reserved for slide threatening musculoskeletal problems, such as systemic vasculitis and are extremely toxic
Cytotoxic drugs ex
Azathioprine, cyclophosphamide, cyclosporine, and gold salts
DMARDs side effects
Nausea, stomatitis, alopecia
Sulfasalazine side effects
Ocular changes, GI upset, mild pancytopenia
Biologic DMARDs side effects
Flu-like symptoms, infectious diseases such as TB are a concern, when given by injection, skin irritation is common
Methotrexate contraindications
Renal insufficiency, liver disease, alcohol abuse, pancytopenia, or folate deficiency
Enteraceot contraindications
Connective heart failure, neurological demyelinating diseases
Adalimumab contraindications
Congestive heart failure, neurological demyelinating diseases
Infliximab contraindications
Congestive heart failure, neurological demyelinating diseases
Anakinra contraindications
Etanercept, adalimumab, or infliximab
DMARDs precautions
Obesity, diabetes, hepatitis B or C, pregnancy
DMARDs liver disease considerations
Sulfasalazine is selected over methotrexate with liver disease
Etanercept requires screening for
Pre existing TB
Adalimumab requires scanning for
Pre existing TB
Infliximab requires scanning for
Pre existing TB
With DMARDs, monitor
Routinely for infections
Methotrexate interactions
Sulfa antibiotics and aspirin and NSAIDs increase risk of methotrexate toxicity
Biophosphonates MOA
Inhibit normal and abnormal bone resorption, resulting depression n increased bone mineral density, reversing the progression of osteoporosis
Biophosphonates uses
Osteoporosis in postmenopausal men and women, hypercalcemia of malignant disease and bony metastasis of some solid tumors, paget disease
Biophosphonates Side effects
Nausea, diarrhea, increased or recurrent bone pain, headache, dyspepsia, acid regurgitation, dysphagia, abdominal pain
Alendronate contraindications
Hypocalcemia, pregnancy (cat C), delayed esophageal emptying, renal impairment, in people with hormone replacement therapy
Risedronate contraindications
Hypocalcemia, delayed esophageal emptying or renal impairment, and in people with hormone replacement therapy
Standard drug treatment of osteoporosis
5 years of biophosphonate administrations
Denosumab is associated with
Hypokalemia, osteonecrosis of the jaw (ONJ), infection, skin reactions, and atypical femoral fractures
Biophosphonates interactions
Calcium supplements, or antacids containing magnesium and aluminum decrease effectiveness of biophosphonates, aspirin increases risk of GI belleding, increased risk of theophylline toxicity
Allopurinol MOA
Reduces the production of uric acid, decreasing serum uric acid levels, and the deposit of rusted crystals in joints
Febuxostat MOA
Reduce serum uric acid levels, preventing gout attacks
Colchicine MOA
Reduces the inflammation associated with the deposit of urate crystals in the joints, and has no effect of uric acid metabolism
What to use in an acute gout attack
Pegloticase IV infusion, to decrease the amount of uric acid in the body
How to treat frequent, recurrent, gout attacks
With probenecid, which can also be given with colchicine
Uric acid inhibitors use
Manage acute attacks of gout or in preventing acute attack of gout
Uric acid inhibitors snide effects
Nausea, vomiting, diarrhea, abdominal pain, headache, urinary frequency
Allopurinol side effects
Skin rash, which in some cases can also be followed by exfoliative dermatitis and SJS
Colchicine side effects
Severe nausea, vomiting, and bone marrow depression, so it’s only used when other drugs fail
Colchicine contraindications
Serious GI, renal, hepatic, or cardiac disorders, and blood dyscrasias,
Probenecid contraindications
Blood dyscrasias, uric acid kidney stones, and in kids under 2
Febuxostat contraindications
Theophylline, mercaptopurine, azathioprine
Uric acid inhibitors precautions
Renal impairment, pregnancy (cat B or C)
Allopurinol precautions
Liver impairment
Probenecid precautions
Sulfa allergy, peptic ulcer disease,
Colchicine precautions
Elderly
What should be used to premeditate patients before pegloticase infusions
Antihistamines and corticosteroids because anaphylactic reactions have been seen
Allopurinol interactions
Ampicillin increases risk of rash, increased risk of theophylline toxicity, and aluminum antacids decrease effectiveness of allopurinol
Febuxostat interactions
Ampicillin increases risk of rash, increased risk of theophylline toxicity
Probenecid interactions
Penicillins, cephalosporins, acyclovir, rifampin, and sulfonamides increase serum levels of anti-infective, increased serum levels of barbiturates and benzodiazepines, and salicylates decrease effectiveness of probenecid
bone resorption inhibitors : Biophosphonates ex
Alendronate, etidronate, ibandronate, pamidronate, risedronate, zoledronic acid
Bone resorption inhibitors: non biophosphonates
Denosumab, raloxifene, teriparatide,
Uric acid inhibitors ex
Allopurinol, colchicine, febuxostat, pegloticase, probenecid
Biological drugs used to treat multiple sclerosis
Natalizumab