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Pharmacology
Chapter 6
| Question | Answer |
|---|---|
| System provides framework for body | Skeletal System |
| System allows for movement | Muscular System |
| Study of the body’s structure | Anatomy |
| Study of the body’s function | Physiology |
| Loss of muscle coordination | Ataxia |
| Wasting due to lack of use | Atrophy |
| Muscle pain | Myalgia |
| Disorder | Pato |
| How many bones does a person have? | 206 bones |
| How many muscles does a person have? | 650 muscles |
| How many percent does your muscle contribute to your weight? | 30%-40% |
| What are the main components of the Skeletal System? | Bones, Cartilage, Ligaments and Tendons |
| The place of union or junction between two or more bones | Joint |
| Noncontractile connective tissue that ties one bone to another | Ligament |
| An organ that produces movement by contracting | Muscle |
| Tough, cordlike tissue that connects muscle to bone | Tendon |
| Formed by compact and cancellous (spongy tissue) | Bones |
| Helps to protect your bones | Cartilage |
| Contraction used for locomotion and maintaining posture. It is striated and voluntary. | Skeletal Muscle |
| Found in the lining of organs such as the stomach, esophagus, uterus, and bladder. It is Nonstriated and Involuntary | Smooth Muscle |
| Found only in the heart and pumps blood. It is Striated and Involuntary. | Cardiac Muscle |
| Production of Blood Cells | Hematopoiesis |
| Functions of Skeletal System | Framework Protection Movement Production of Blood Cells Storage of calcium and phosphorus |
| The formation of bone | Ossification |
| Bone cell | Osteocytes |
| Moves Calcium from the blood to build bone. It forms the bone. | Osteoblasts |
| Cells that break down bone and moves Calcium into the bloodstream | Osteoclasts |
| Osteoclast and osteoblasts break down, build up, and repair bone, a continual process is called? | Bone Remodeling |
| Joint inflammation | Arthritis |
| A degenerative joint disease in which cartilage in joints becomes thinner and less elastic eventually causing bone to wear and become deformed | Osteoarthritis (OA) |
| The followings are the joints affected in____ –Sternoclavicular joint –Spine, hips, knees, fingers, big toes | Osteoarthritis (OA) |
| The following are_______ – Stiffness in the morning or after inactivity – Progressive pain – Limitation of motion – Deformed joints | Symptoms of OA |
| Simple analgesic; Antipyretic | acetaminophen (Tylenol) |
| Caution in alcoholic liver disease or > 3 alcoholic drinks/day | Cautions and Considerations of Tylenol |
| The only antidote for acetaminophen overdose | acetylcysteine (Acetadote, Mucomyst) |
| Works by detoxifying the active metabolite of acetaminophen | acetylcysteine (Acetadote, Mucomyst) |
| Reduces pain and fever by decreasing the production of prostaglandins, may elevate the pain threshold | MOA of Tylenol |
| Inhibit prostaglandin synthesis in tissues | MOA of Conventional NSAIDs |
| -Selectively inhibits Cycloxygenase-2 (COX-2) -Reduces pain and inflammation without increasing the risk of GI side effects | Cox-2 Inhibitor |
| It is not for pregnant because it makes the uterus to contract | diclofenac or misoprostol (Arthrotec) |
| An autoimmune disorder in which the immune system destroys the synovial membrane of the joint, producing inflammation | Rheumatoid Arthritis (RA) |
| – Small joints of the hands affected first – Joints of the feet, ankles, knees, wrists, elbows, shoulders, jaw (temporomandibular), vertebral column affected later | Joints affected in RA |
| – Morning pain and stiffness • Symmetrical • Last longer than an hour • Not relieved by activity – Aggravated by cold temperatures and barometric pressure | Symptoms in RA |
| Disease-modifying antirheumatic drugs | DMARDs |
| Agents that can potentially modify the disease progression of rheumatoid arthritis. | DMARDs |
| Target the part of the immune system responsible for inflammation and joint damage. | DMARDs |
| Change the way the immune system responds | Immunomodulators / Immunosuppressants |
| – Have the drug stem au- (elemental symbol for gold) ie. auranofin (Ridaura) | Gold Compounds |
| Used to treat Lupus (SLE – Systemic lupus erythematosus) – an autoimmune disease | hydroxychloroquine (Plaquenil) |
| Eye exam when starting medication and every 12 months | hydroxychloroquine (Plaquenil) |
| Also classified as an Antimalarial drug – used to treat Malaria | hydroxychloroquine (Plaquenil) |
| It is hazardous drug/chemo drug and not for pregnants. | methotrexate (Rheumatrex, Trexall) |
| Stevens-Johnson syndrome is the most known side effect of this drug. | sulfasalazine (Azulfidine, Azulfidine EN- tabs) |
| The caution and considerations of this drug includes: - Potential for cross-reactivity in SULFA allergy, or in allergy to aspirin or other salicylates; - potential for blood diseases and severe skin reactions | sulfasalazine (Azulfidine, Azulfidine EN- tabs) |
| What is the drug stem for Monoclonal Antibody? | mab |
| What is the drug stem for a TNF Inhibitor? | cept |
| What is the drug stem for JAK Inhibitor? | citinib |
| – A form of arthritis resulting from the body’s improper excretion of uric acid – Patients may either overproduce or insufficiently excrete uric acid. – Often referred to as GOUT | Gouty Arthritis |
| Deposit of sodium urate that forms around joints | Tophus |
| The following are Symptoms of? - Painful, swollen, and red joints – Big toe affected first | Gouty Arthritis |
| increases levels of ________ (increased liver or kidney impairment) • Grapefruit juice, clarithromycin, erythromycin, cyclosporine – Statin drugs – increased risk of neutropenia | Interaction of colchicine (Colcrys) |
| Anti-inflammatory, may decrease uric acid accumulation | MOA of colchicine (Colcrys) |
| Chronic management of high uric acid levels / Preventive gout treatment | febuxostat (Uloric) |
| Living tissue that is constantly replaced | Bone |
| – Condition of reduced bone mineral density, disrupted microarchitecture of bone structure, and increased likelihood of fracture – Occurs as a result of deficiency of estrogen, calcium, and vitamin D – Can cause fractures in the hips, spine, and wrists | Osteoporosis |
| – Used to assess the risk for osteoporosis – Combines x-ray and ultrasound technology to measure bone density | Bone Mineral Density (BMD) Machine |
| – Result reported from a BMD screening – Provides an estimate of risk | T-score |
| Prevent bone breakdown by inhibiting osteoclasts from removing calcium from bone tissue. | Bisphosphonates |
| Indications of this drug are Osteoporosis, Paget’s Disease | Bisphosphonates |
| Works as estrogen receptors by mimicking the beneficial effects of estrogen on bone mineral density | SERMs (Selective Estrogen Response Modifiers) |
| This means dead jaw | Osteonecrosis |
| The oral formulation of _____ it is important for the patients to drink a full glass of water at least 30 mins before any food or beverage of the day, they also need to sit upright, and they can't lay down for 30-60 mins because esophagitis might occur. | alendronate (Fosamax, Binostro) |
| What is the drug stem for SERM? | oxifen |
| Patients who have failed other osteoporosis therapy take this drug | denosumab (Prolia, Xgeva) |
| You can only take this is you are under Prolia REMS program. | denosumab (Prolia, Xgeva) |
| A sudden and involuntary contraction of one or more muscles, also called a CRAMP | Muscle spasm |
| Range from an annoyance to severe pain is symptoms of? | Muscle spasm |
| Arises from muscle injury or overuse | Acute muscle spasm |
| Arises from prolonged injury or underlying medical conditions | Chronic Muscle Spasm |
| A drug that reduces or prevents a skeletal muscle contraction and spasms, as well as providing pain relief | Muscle relaxant |
| The following are? - Block release of acetylcholine (ACh) – Prevent destruction of ACh – Prevent ACh from reaching specific receptors | MOA of Skeletal Muscle Relaxant |
| - Take with food or milk. – Avoid alcohol consumption while taking this medication. | baclofen (Lioresal, Gablofen) |
| – Use only for short durations (two to three weeks). – Avoid alcohol consumption. – Do not operate heavy machinery or engage in tasks that require mental alertness. – C-IV controlled substanct | carisoprodol (Soma) |
| It is a controlled substance. The potential for dependence and abuse exists. (C-IV) | diazepam (Valium) |
| It is very fragile tablet because of its design | Valium |
| These are side effects of what drug? – Dizziness, drowsiness, skin rash or yellowish discoloration of the skin or eyes (Jaundice) | metaxalone (Skelaxin, Metaxall) |
| These are side effects of what drug? – Drowsiness, vertigo, skin rash, jaundice, blurred vision, nasal congestion, and discoloration of urine (blue, black, or green) | methocarbamol (Robaxin) |
| Capsules may be opened and contents sprinkled on food. | tizanidine (Zanaflex) |
| – The body’s response to tissue injury or infection – Results from vasodilation and increased vascular permeability | Inflammation |
| Heat, redness, swelling, pain are symptoms of? | Inflammation |
| Indications of this drugs are the ff: • Pain • Muscle pain • Inflammation • Osteoarthritis (OA) • RA • Fever | NSAIDs |
| It is the STRONGEST or POTENT anti-inflammatory drugs, and it STOP IMMMUNE RESPONSE. | Steroids (Glucocorticoids) |
| Analgesia means? | Pain |
| Antipyretic means? | Fever |
| Indications of this drug are the ff: – Pain (analgesia), Fever (antipyretic), Inflammation (anti- inflammatory) • OA & RA • Menstrual cramps • Muscle aches and pains • Headache (HA) | Aspirin ASA (Durlaza, Vazalore, Ecotrin, Bayer) |
| – Tinnitus – Dizziness – Headache – Mental confusion | Salicylism or Mild salicylate intoxication |
| Life-threatening – Nausea / Vomiting – Hyperpnea – Acid-Base disturbances – Petechial hemorrhages – Hyperthermia – Delirium – Convulsions – Coma | Salicylate Toxicity |
| – Involves penetrating the skin with thin needles in specific areas – Used for acute and chronic pain | Acupuncture |
| – Involves the physical manipulation of the spine based on the theory that proper alignment of the body’s musculoskeletal structure will enable the body to heal – Used to relieve pain associated with muscles, joints, bones, and connective tissue | Chiropractic Care |
| – Used with glucosamine for hip and knee OA – Thought to work by inhibiting an enzyme that promotes inflammation – Effectiveness of combination unclear – Side effects include nausea, heartburn, diarrhea, constipation. | Chondroitin |
| – Used to improve pain and stiffness from OA – Thought to slow joint degeneration – Side effects include nausea, heartburn, diarrhea, constipation. – Avoid if patient has shellfish allergy | Glucosamine |
| – Contains salicin – Has been used to treat many different kinds of pain – Comparative studies with conventional agents warranted | Willow bark (Salix alba) |
| What is the nonsteroidal anti-inflammatory drugs are available in topical formulations except? | nabumetone |
| What drugs should only be used for a short term (less than five days)? | ketorolac |
| What muscle relaxant has a topical cream dosage form? | baclofen |
| Celecoxib has the potential for cross-reactivity in patients who are allergic to which of the following drug classes? | sulfonamides |
| Poisoning by what drugs has become the most common cause of acute liver failure in the United States? | acetaminophen (Tylenol) |
| What drug is least likely to produce GI irritation at analgesic doses? | celecoxib |
| When injected, a 30 mg dose of which NSAIDs is as effective as 12 mg of morphine in relieving pain? | ketoralac |
| The enteric-coated (EC) form of a medication means? | should not be halved or crushed. |
| If you saw a line in the middle of the drug it means you can cut it in half, what do you call the line in the middle of that drug? | score |
| Acetaminophen is a good first-line medication for mild to moderate pain, but not for which of the following patients? | alcoholic patients |
| In women ____ is a hormone that is important for the absorption of calcium and phosphorus. | estrogen |
| How many minutes a day out in the sun to get enough vitamin D | 10 mins |
| What side effect of bisphosphonate is to be concerned with? | esophagitis |
| This bisphosphonate is only to be injected once a year | Reclast |
| PPI means? | Proton Pump Inhibitor |
| It is a type of a drug that when you drop in the water it bubbles up | Effervescent Tablet |
| What is the drug stems for Bisphosphonates? | dronic or dronate |
| What is the serious side effect of SERMs that is related to increased risk of blood cloth? | deep-vein thrombosis |
| The benefit of using a Cox-2 Inhibitor over a Salicylate of Convention NSAID is that Cox-2 Inhibitors are less likely to cause bleeding. True or False | True |
| Aspirin cannot be used in treating what? | Tinnitus |
| A potentially lethal dose of ASA (aspirin) is? | 10,000 mg |
| What is the maximum dose of aspirin and acetaminophen? | 4,000 mg a day |
| Using aspirin with _______________ can increase the risk of a gout attack. | probenecid |
| Aspirin should not be used in ______________ due to the risk of Reye's Syndrome. | children |
| A patient with an allergy to shellfish should not use: | Glucosamine |
| What patient should not take misoprostol (Cytotec), a drug sometimes used to counter the gastric irritating effects of NSAIDs? | pregnant women |
| Which of the following drugs may cause a skin rash or yellowish discoloration of skin, eyes, or both? | methaxolone |
| Which of the following muscle relaxants is contraindicated if used with or within 14 days of an MAOI or if the patient has hyperthyroidism, history of heart failure, heart blockage, and/or used during the acute recovery phase of heart attacks? | cyclobenzaprine |
| _____ are a class of drugs that have analgesic, antipyretic, and anti-inflammatory effects. | NSAIDs |
| Healthcare workers who are pregnant should avoid or wear gloves when handling | misoprostol |
| What drug may turn urine brown, black, or green? | methacarbamol |
| What should be avoided when taking muscle relaxants? | alcohol |
| What type of salicylates can be taken daily to reduce the risk of heart attacks and strokes in patients who have a prior history of cardiovascular disease? | low dose of aspirin |
| Patients taking probenecid should not take _____ because they can prevent the excretion of uric acid and can precipitate an attack of gout. | salicylates |
| Salicylate toxicity is characterized by all the following except | hypothermia |
| Which disorder or disease requires muscle relaxants? a. hypertension b. insomnia c. rheumatoid arthritis d. multiple sclerosis | d. multiple sclerosis |
| What clinical effect or side effect of aspirin is also produced by acetaminophen (Tylenol)? | fever reduction |
| Which of the following drugs may enhance adverse reactions to corticosteroids? a. Trilisate b. Robaxin c. Zanaflex d. Skelaxin | a. Trilisate |
| What supplement derived from the exoskeleton of shellfish that is used to improve pain and stiffness from OA? | Glucosamine |
| What warning label should appear on prescriptions for muscle relaxants? | may cause drowsiness |
| In addition to providing primary drug therapy for arthritis, NSAIDs are commonly used to treat | menstrual cramps |
| It is a component within hundreds of medications and should be monitored to reduce chances of overdose | acetaminophen (Tylenol) |
| The number 1 choice for treating Osteoarthritis | NSAIDs |
| Which of the following is true about skeletal muscles? a. found in the heart b. voluntarily controlled c. involuntarily controlled d. found in the stomach | B. voluntarily controlled |
| Glucosamine and Chondroitin are most often used for | Osteoarthritis (OA) |
| All of the following are risks for osteoporosis except: a. heavy caffeine intake b. smoking c. female d. adequate calcium intake | D. adequate calcium intake |
| The test used to identify the risk of osteoporosis is known as __________ screening. | BMD |
| Which of the following is a risk associated with the use of raloxifene? a. increased in risk infection b. risk of esophagitis c. risk of osteonecrosis d. increased of blood cloths | D. increased of blood cloths |
| colchicine should not be given with _____________ due to an increased risk of neutropenia. | Statin drugs |
| Rheumatoid arthritis is usually symmetric, which means that the a. same joints on both sides of the body are affected. b. joints on one side of the body are affected. c. big toes are affected first. d. only one system is affected at a time. | A. same joints on both sides of the body are affected. |
| Patients who take _____ should be evaluated for latent TB prior to therapy and avoid live vaccines. | MAB |
| All of the following are risk factors for osteoporosis except: a. heavy caffeine intake b. participates in weight bearing exercise c. women (cis- or transgender) d. smoking | B. participates in weight bearing exercise |
| What drug is approved for Crohn’s disease, RA, ankylosing spondylitis, plaque psoriasis, psoriatic arthritis, and ulcerative colitis? | Humira |
| Which of the following is used for the treatment of both acute and chronic gout? | colchicine |
| Which of the following is not an example of a disease-modifying antirheumatic drug (DMARD)? a. methotrexate b. azathioprine c. tramadol d. anakinra | C. tramadol |
| Which of the following drugs used to treat RA is a cytotoxic agent that requires special handling as a hazardous drug? | methotrexate |
| What drug would come with patient education to drink 6-8 glasses of water a day to prevent kidney stones? | febuxostat |
| A patient allergic to sulfa drugs or ___________ should avoid taking sulfasalazine. | aspirin |
| Oral bisphosphonates should be administered | empty stomach |
| Which of the following is a narrow therapeutic index drug? a. hydroxychloroquine b. sulfasalazine c. etanercept d. methotrexate | D. methotrexate |
| Salicylate toxicity is characterized by all the following except a. hypothermia b. tinnitus c. acid-base disturbances d. mental confusion | A. hypothermia |
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