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Chap - 21
PharmacologyHSC1149
| Question | Answer |
|---|---|
| drugs used to treat disorders of the musculoskeletal system are classified as | skeletal muscle relaxants & NSAIDs |
| structural defect of the musculoskeletal system | ruptured disk |
| some disorders of the musculoskeletal system require __ intervention rather than medication | surgical |
| musculoskeletal system disorders associated w/pain, spasm, abnormal contraction, or impaired mobility do respond to | skeletal muscle relaxants |
| backaches & neck strains are treated w/combination of muscle relaxants, PT, & mild __ | analgesics |
| muscle relaxants are given on a | short-term basis |
| most muscle relaxant drugs affect the | spinal cord & brain |
| most muscle relaxant drugs have no direct effect on | skeletal muscles |
| reduces muscle spasm, causes alterations in perception of pain, & produces sedative effect, promoting rest & relaxation of affected part | resulting actions of muscle relaxant drugs |
| used to treat acute, painful musculoskeletal conditions | diazepam (Valium) & methocarbamol (Robaxin) |
| different kind of muscle relaxant causing direct effect of skeletal muscles & used in treatment of spasticity resulting from upper motor neuron disorders (MS, or cerebral palsy) | dantrolene |
| dantrolene is ineffective for amyotrophic lateral sclerosis & not indicated for treatment of muscle spasms resulting from | rheumatic disorders or musculoskeletal trauma |
| neuromuscular blocking agents (NMBAs) used during surgical, endoscopic, or orthopedics procedures | succinylcholine & tubocurarine |
| are only administered by anesthesiologists or specially trained personnel skilled in intubation & CPR | NMBAs |
| NMBAs can cause serious | CNS problems |
| neostigmine (Prostigmin) or edrophonium (Tensilon) are __ for NMBAs | antidotes |
| used in treatment of myesthenia gravis | Prostigmin |
| used in diagnosis of myesthenia gravis | Tensilon |
| used to treat disorders in which musculoskeletal system is not functioning properly due to inflammation | anti-inflammatory drugs |
| arthritis, bursitis, spondylitis, gout & muscle strains | conditions treated w/anti-inflammatory drugs |
| corticosteroids are not used for extended periods time because of | serious side effects |
| frequently given for lengthy periods of time in maintenance doses as low as possible | NSAIDs |
| substance responsible for producing much of the inflammation & pain of rheumatic conditions, sprains & menstrual cramps | prostaglandins |
| older adults are particularly susceptible to __ __ from NSAIDs | silent bleeding |
| if chronic anti-inflammatory therapy must be continued despite ulceration, the patient should be switched to __ __ NSAIDs or selective __ __ | partially selective; CO-2 inhibitor |
| etodolac, meloxicam, or nambutone are considered | partially selective NSAIDs |
| Arthrotec combines Voltaren w/ Cytotec to protect __ mucosa | gastric |
| used in strict accordance w/label directions & if needed for longer than 10 days, a physician should be consulted | OTC non-selective NSAIDs |
| NSAID; exhibits anti-inflammatory, analgesic, & antipyretic activities by selectively inhibiting COX-2 (cyclooxygenase-2) | celecoxib (Celebrex) |
| cyclooxygenase-2 (CO-2) synthesizes | prostaglandin |
| since celecoxib (Celebrex) does not inhibit COX-1, it does not inhibit | platelet aggregation (clotting) |
| Celebrex does not pose the __ __ of other non-selective NSAIDs | bleeding risk |
| celecoxib (Celebrex) has potential to cause fewer __ problems | gastric |
| selective COX-2 inhibitor; voluntarily withdrawn from market due to subjects experiencing twice the rate of MI/stroke compared w/subjects receiving placebos | rofecoxib (Vioxx) |
| selective COX-2 inhibitor; withdrawn from market due to causing severe/fatal skin reactions | Bextra |
| as far as the heart is concerned there are __ __ & __ prostaglandins | both good & bad |
| non-selective NSAIDs __ both good & bad prostaglandins | suppress |
| selective COX-2 inhibitors shut down only the __ prostaglandins, which raises BP & risk for atherosclerosis & clotting | good |
| until cardio safety studies for Celebrex are complete the __ __ __ of this drug & pain relief vs. cardio/GI safety must be weighed on individual basis | risks and benefits |
| includes: GI ulceration/bleeding, epigastric pain, nausea, heartburn, GERD, rash, allergic reactions, bronchospasm, blood dyscrasias, >prolonged bleeding time, liver toxicity | non-selective NSAID side effects |
| contraindication/extreme caution of NSAIDs for those w/asthma can manifest __ __ as bronchospasm | aspirin sensitivity |
| medications should be taken w/meals/milk to reduce GI side effects; enteric-coated, timed-release caps/buffered aspirin also recommended to reduce gastric irritation | non-selective NSAIDs |
| NSAIDs potentiate possibility of GI bleeding is considered an interaction with | alcohol |
| NSAIDs potentiate possibility of bleeding when taken with | anticoagulants or vitamin E |
| NSAIDs potentiate hyperglycemia when taken with | sulfonylureas |
| NSAIDs increase GI effects when taken with __ for prolonged administration of NSAIDs | corticosteroids |
| __ + NSAIDs = increased GI effects | aspirin |
| when aspirin is taken w/NSAIDs it will __ GI risk reducing effects of COX-2 | diminish |
| NSAIDs cause attenuated (lessens) response when taken with | antihypertensives |
| NSAIDs decrease clearance when taken taken with | lithium |
| NSAIDs potentiate & increase risk of toxicity from, when taken with | methotrexate |
| __ action is antagonized by salicylates, NSAID interaction | uricosurics (Benemid/Anturane) |
| non-selective (traditional NSAID) diclofenac brand name(s) | Voltaren & Voltaren XR |
| non-selective (traditional NSAID) ibuprofen brand name(s) | Motrin & Advil |
| non-selective (traditional NSAID) indomethacin brand name(s) | Indocin & Indocin SR |
| non-selective (traditional NSAID) ketorolac brand name(s) | Toradol |
| non-selective (traditional NSAID) naproxen brand name(s) | Naprosyn, Anaprox, Aleve |
| non-selective (traditional NSAID) oxaprozin brand name(s) | Daypro |
| non-selective (traditional NSAID) sulindac brand name(s) | Clinoril |
| partially-selective NSAID etodolac brand name(s) | Lodine & Lodine XL |
| partially-selective NSAID meloxicam brand name(s) | Mobic |
| partially-selective NSAID nambutone brand name(s) | Relafen |
| combination anti-inflammatory diclofenac/misoprostol band name(s) | Arthrotec |
| combination anti-inflammatory lansoprazole/naproxen band name(s) | Prevacid NapraPAC |
| non-steroidal anti-inflammatory specifically used to relieve inflammation in acute gouty arthritis; can also be used as prophylaxis | colchicine |
| __ or __ __ of NSAIDs for those w/cardio disorders, such as hypertension or CHF | contraindication or extreme caution |
| contraindication/extreme caution of __ __ for those w/kidney/thyroid disease, liver dysfunction, GERD, & history of GI bleed/IBD | NSAID use |
| contraindication/extreme caution of NSAID use for those w/blood dyscrasias, especially __ __ or __ | clotting disorders; anemia |
| NSAIDs pose a danger to children w/viral infections, due to possibility of Reye's syndrome with | salicylates |
| contraindication/extreme caution for those with __ hypersensitivity; they should not taken Celebrex | sulfonamide |
| metabolic disorder characterized by accumulation of uric acid crystals in various joints, especially big toe, knee, & elbow w/resultant pain/swelling | gout |
| rash, GI upset, diarrhea, and blood disorders are __ __of gout medications | side effects |
| encouraging large fluid intake, for those on gout meds, facilitates __ of uric acid crystals | excretion |
| patients should be instructed to DC NSAIDs 10-14 days __ of any kind, to reduce risk of __ __ | surgery; serious bleeding |
| disease characterizes by low bone mass & deterioration of bone tissues; leads to bone fragility & > susceptibility to fracture | osteoporosis |
| osteoporosis means | porous bone |
| includes several prescription meds | treatment of osteoporosis |
| recommended for post-menopausal __ __ | osteoporosis prevention |
| estrogen w/without progestin, only when unable to take other agents, & benefits outweigh risks | hormone replacement therapy (HRT) |
| if started soon after menopause, HRT estrogen prevents accelerated phase of __ __ occurring in 1st 5yrs of onset | bone loss |
| selective estrogen receptor modifier (SERMs) w/estrogen antagonist activity on bone & lipids & estrogen antagonist activity of breast & uterine tissues | Evista |
| SERM properties resulted in >__ __ __ & reduced fracture risk w/out promoting breast/endometrial cancer | bone mineral density |
| incidence of vaginal bleeding & breast tenderness is< w/Evista than with | HRT |
| Evista can cause __ __ & muscle cramps in the legs | hot flashes |
| Evista contraindicated in pregnancy & women w/history of __ disorders | thromboembolic |
| synthetic form of hormone; available in nasal spray for treatment of post-menopausal osteoporosis in women >5 yrs past menopause onset | calcitonin-salmon (Miacalcin) |
| Miacalcin increases spinal bone density & provides __ __ in acute vertebral fractures | analgesic effect |
| reserves for women who refuse/cannot tolerate HRT, or in whom HRT is contraindicated | calcitonin-salmon |
| local nasal effects including: irritation, redness, rhinitis, & epistaxis are the most common __ __ from Miacalcin | adverse effects |
| Miacalcin should be stores in the refrigerator | prior to opening |
| once Miacalcin pump has been activated it should be stored | at room temperature |
| all __ bottle of Miacalcin should be discarded after 30 days | unrefrigerated |
| non-hormonal agents that act directly to inhibit bone resorption, thereby > bone mineral density at spine/hip, as well as <incidence of 1st & future fractures | bisphosphonates |
| Fosamax & Actonel are both approved for prevention & treatment of osteoporosis & considered __ __ | first-line therapy |
| bisphosphonates are indicated for management of __ __ of the bone, chronic disorder characterized by fractures, skeletal abnormalities, & significant bone pain | Paget's disease |
| includes: GI distress (nausea, dyspepsia, esophagitis) & abdominal/chest pain | side effects of bisphosphonates |
| bisphosphonates carry a caution for those with active __ __ problems | upper GI |
| bisphosphonates are contraindicated for those with renal insufficiency and __ | hypocalcemia |
| bisphosphonates are contraindicated for those unable to __ __ for 30 minutes after taking drug | sit upright |
| patients should be advised of importance of taking w/full glass of water, at least 30 min before first food, beverage, or medication of the day | Fosamax or Actonel |
| when taking Fosamax or Actonel, not lying down for at least 30 min will __ __ to the stomach & avoid esophageal irritation | speed delivery |
| those taking Fosamax or Actonel should take __ calcium & vitamin D | supplemental |
| those taking Fosamax or Actonel should be instructed about __ exercise | weight-bearing |
| modification of __ & __ should be advised for those taking Fosamax or Actonel | smoking; alcohol |
| bisphosphonate; ibandronate brand name | Boniva |
| patients taking skeletal muscle relaxants should be instructed to move slowly & have support available because __ is a common side effect | hypotension |
| skeletal muscle relaxants should only be taken as long as absolutely necessary because prolonged use can lead to | physical or psychological dependence |
| abrupt withdrawal of muscle relaxants, such as Valium, after prolonged use can cause | seizures |
| represents appropriate care for musculoskeletal injuries to extremities | rest, ice, compression, elevation |
| oldest non-steroidal anti-inflammatory drug w/analgesic & antipyretic effects is | aspirin |
| aspirin is contraindication for patients with asthma because it can cause | bronchospasm |
| partially selective NSAID; nambutone brand name | Relafen |
| skeletal muscle relaxant; carisoprodol brand name | Soma |
| skeletal muscle relaxant; cyclobenzaprine brand name | Flexeril |
| skeletal muscle relaxant; diazepam brand name | Valium |
| skeletal muscle relaxant; methocarbamol brand name | Robaxin |
| skeletal muscle relaxant; dantrolene brand name | Dantrium |
| skeletal muscle relaxant; baclofen brand name | Lioresal |
| skeletal muscle relaxant; tizanidine brand name | Zanaflex |
| bisphosphonate; alendronate brand name | Fosamax |
| bisphosphonate; risedronate brand name | Actonel |
| SERM; raloxifene brand name | Evista |
| patients who use NSAIDs, particularly on long-term basis, can develop | silent bleeding |
| NMBAs must be used with caution because they can produce | respiratory arrest |
Created by:
lfrancois
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