Question | Answer |
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 |