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Unit 1 Meds

Muscle Spasms, Calcium, Osteoperosis/arthritis, Corticosteroids, DMARD, RA, Gout

Flexeril Dry mouth, urinary retention, constipation. (Tx: muscle spasms)
Robaxin Changes urine to harmless brown, black, dark green (Tx: muscle spasms)
Centrally acting muscles relaxants Adverse Effects: sedation, drowsiness, avoid alcohol or other depressants
Name the types of Muscle Spasm meds Flexeril, Robaxin
Parathyroid Hormone Promotes calcium absorption from bone and promotes calcium re-absorption from glomerulus in kidneys, activates Vitamin D
Vitamin D Same action as parathyroid hormone, comes from the sun
Calcitonin Inhibits osteoclasts
Name the Biophosphonates Fosamax, Actonel, Boniva
Fosamax, Actonel, Boniva Esophagitis. s/s painful/difficulty swallowing and heartburn is worsening or new
Biophosphonates Take 1x week w/ full glass of water on empty stomach, sit up for 30 minutes after taking, avoid antacids for 30 minutes
Selective Estrogen Receptor Modulators Raloxifene
Raloxifene Preserves bone mineral density, mimics natural estrogen. Contraindicated if history of clots or breast cancer/endometrial cancer. Category X
Medications for Osteoarthritis Ibuprofen, Naproxen, capsaicin, diclofenac, celebrex
COX-1 Ibuprofen, Naproxen, capsaicin, diclofenac
COXC-2 Celebrex
NSAIDs (COX-1) increase bleeding, upset stomach, renal/liver toxic, decreases platelet aggregation putting you more at for bleeding
Celebrex renal impairment, increased risk of MI/stroke. Anti-inflammatory properties. Does not inhibit platelet aggregation
Corticosteroids Solumedrol, Depomedrol, prednisone
Solumedrol, prednisone Decrease in bone density, muscle mass, protein synthesis (buffalo hump, moon face), inflammation & immune response and thinning skin. SE: hyperglycemia, poor wound healing, increase infection risk, adrenal insufficiency. Do not stop abruptly taper off
RA autoimmune, body attacking joint tissue resulting in disruption and fusion of joints
NSAIDS Goal: provide rapid relief symptoms, treats pain but NOT underlying cause
Glucocorticoids Provide rapid relief of symptoms and DO slow progression of disease
Non-biological DMARDS (Disease Modifying Antirheumatic drugs) Methotrexate, Sulfasalazine, Plaquenil
Methotrexate Don't see therapeutic result for 3-6 weeks, immune suppression, hepatic & nephro toxic (watch BUN, creatinine, AST, ALT). Drug of 1st choice. Category X
Sulfasalazine Won't see effects for weeks to months. GI disturbances, skin reactions (rashes). Avoid with sulfa allergy
Plaquenil 3-6 months for therapeutic effect. Retinal damage (blindness), get eye exam q6 mos. Usually combined with methotrexate
Biologic DMARDS Enbrel, Remicade, Humira
Enbrel Given Subcut, redness, tenderness at site, risk for heart failure
Remicade IV infusion, risk for heart failure and liver damage
Humira Given Subcut, injection site reactions
Destruction of B-Lymphocytes Rituxan
Rituxan IV infusion, high risk for hypersensitivity reaction. Pre-medicate with Benadryl
Inhibition of T-Lymphocytes Cannot use with tumor necrosis factor antagonists (Enbrel, Remicade, Humira)
DMARD III Ridaura, Imuran
Ridaura Used when nothing else is working. Reduces pain and stiffness
Imuran Immunosuppressant and anti-inflammatory, slows progresison of disease. Category X, Risk for hepatitis (liver damage), blood dyscrasias (drop in blood counts)
Gout NSAIDS (naproxen, diclofenac), Colchicine, allopurinol, probenicid
Naproxen, diclofenac used for pain relief
Colchicine Anti-inflammatory, interupts inflammation process in gout. SE: GI upset, toxic to proliferating cells. Do not use if pregnant
Allopurinol Inhibits uric acid formation. Prolonged use (years) causes increase risk for cataracts. Interferes with coumadin levels.
Probenicid Increases uric acid excretion
Allopurinol & Probenicid Reduces uric acid levels. Not an anti-inflammatory or pain reliever
Category X Raloxifene, Methotrexate, Imuran
Doxycycline Bacterial Infection
Created by: kristyd02