Pharmacology - Musculoskeletal Disorders

Front 1

What does the Musculoskeletal system consist of? Name Seven

Back 1

1. Bones
2. Muscles
3. Joints
4. Tendons
5. Ligaments
6. Cartilage
7. Bursae

Front 2

Musculoskeletal System is important because it produces what?

Back 2

blood cells in the bone marrow.

Front 3

When skeletal growth is complete what process do the bones go through?

Back 3

Osteoclasts continue remodeling of bones.

Balance of bone resorption with new bone cell placement

Front 4

When does bone resorption and bone replacement stop?

Back 4

Never, continues throughout life.

Front 5

What are the three types of muscles?

Back 5

1. Skeletal
2. Smooth
3. Cardiac

Front 6

Voluntary Muscles (biceps in arms)

Back 6

Skeletal Muscles

Front 7

Involuntary Muscles (walls of the stomach, intestine, blood vessels)

Back 7

Smooth Muscles

Front 8

Involuntary Muscles - found only in the heart

Back 8

Cardiac Muscles

Front 9

The junction between two or more bones.

Back 9

Joints

Front 10

What is Hyaline Cartilage?

Back 10

The substance that covers the surfaces of joints, which reduces friction during joint movement.

Front 11

What is the joint cavity?

Back 11

Space between joints.

Front 12

What is enclosed in the joint cavity?

Back 12

fibrous capsule lined with synovial membrane.

Front 13

What does synovial membrane produce?

Back 13

synovial fluid which acts as a lubricant

Front 14

Cord-like structures which attach muscles to the bone

Back 14

Tendons

Front 15

fibrous tissue connecting freely movable bones.

Back 15

Ligaments

Front 16

What do ligaments do?

Back 16

Help protect the joints by stabilizing their surfaces and keeping them in proper alignment.

Front 17

A firm, dense type of connective tissue that consists of cells embedded in a substance called the matrix.

Back 17

Cartilage

Front 18

Cartilage's Primary Function

Back 18

reduce friction between articular surfaces, absorb shocks and reduce stress on joint surfaces

Front 19

A small sac filled with synovial fluid which reduces friction between areas.

Back 19

Bursae

Front 20

Salicylates is also known as what?

Back 20

Aspirin (ASA)

Front 21

What is Aspirin (ASA) derived from

Back 21

Salicylic acid

Front 22

What are the 3 main effects of Aspirin (ASA)?

Back 22

1. Analgesic
2. Antipyretic
3. Anti-inflammatory

Front 23

Means to reduce pain

Back 23

Analgesic

Front 24

Means to reduce fever

Back 24

Antipyretic

Front 25

Means to reduce inflammation

Back 25

Anti-inflammation

Front 26

Salicylates 2 Mechanisms of action

Back 26

1. Reduce fever by dilating peripheral blood vessels.
2. Reduce pain and inflammation by inhibiting the production of prostaglandins.

Front 27

What are prostaglandins?

Back 27

the substance responsible for the sensitivity of pain receptors

Front 28

Salicylates Side Effects

Back 28

Aspirin prolongs bleeding time by inhibiting the aggregation of platelets.

Front 29

Salicylates Dosage and Route

Back 29

325-659 mg
orally
rectally

Front 30

Salicylates Uses List 7

Back 30

1. Relieving mild and moderate pain
2. Reduce fever
3. Treating inflammatory conditions (rheumatoid and osteoarthritis)
4. decreasing the risk of MI in patients with angina or previous MI
5. Acute Coronary Syndrome (MI)
6. Reducing the risk of Transient Ischemic Attacts or strokes in men. (not effective in women)
7. Maintaining high risk pregnancies.

Front 31

Salicylates Adverse Reactions
List 3

Back 31

1. Gastric Upset (heartburn, N&V)
2. Anorexia
3. GI Bleeding

Front 32

Salicylates Contraindications List 5

Back 32

1. Patients with allergic reations.
2. Patients with bleeding disorders
3. Patients receiving anticoagulant drugs.
4. Patients with GI bleeding
5. Children or teenagers with influenza or chickenpox, bc it can cause Reye's Syndrom

Front 33

Salicylates Precautions List 6

Back 33

1. Hepatic or Renal DZ
2. Hypothrombinemia
3. Vitamin K deficiency
4. GI irritation
5. During lactation
6. Pregnancy Category C

Front 34

S/S of Mild Toxicity with Salicylates

Back 34

Salicylism,tinnitus, hearing difficulties, dizziness, N&V, confusion

Front 35

Nonsalicylates are also known as?

Back 35

Acetaminophen (APAP)

Front 36

Nonsalicylates Mechanism of Action

Back 36

1. Antipyretic
2. Analgesic

Front 37

True or False? Nonsalicylates have no anti-inflammatory or anti-platelet action.

Back 37

True

Front 38

Acetaminophen - Uses

Back 38

1. treating mild to moderate pain
2. reduce fever
3. managing pain from arthritic disorders
4. an alternative to Asppirin in patients who are allergic of have bleeding disorders

Front 39

Acetaminophen - Dosage

Back 39

325-650 mg q 3-4 hr po

Front 40

When can toxicity occur with Acetaminophen?

Back 40

10-15 g.

Front 41

Implementation with Aspirin and Tylenol

Back 41

1. No ASA 7 days before or after surgery.
2. Give with full glass of wate
3. Educate Patient and family

Front 42

Evaluation with Aspirin and Tylenol

Back 42

Document administration
Document follow-up assessment of patient

Front 43

Nonsteroidal Anti-Inflammatory Drugs (NSAID's) and their Actions

Back 43

Antipyretic
Analgesic
Anti-inflammatory

Front 44

True or False? Anti-inflammatory Drugs have the same side effects of steroids.

Back 44

False

Front 45

NSAID's: Mechanism of Action

Back 45

Exact mechanism is unknown.
Are thought to inhibit prostaglandin synthesis by inhibiting the action of the enzyme cyclooxygenase.

Front 46

Two related enzymes of cyclooxygenase.

Back 46

cox-1 & cox- 2

Front 47

Enzyme which helps to maintain stomach lining.

Back 47

Cox-1

Front 48

Enzyme that triggers pain and inflammation.

Back 48

Cox-2

Front 49

List two examples of Traditional NSAID's

Back 49

Ibuprofen and Naproxen

Front 50

Traditional NSAID's do what?

Back 50

block both COX-1 and COX-2 which explains why they relieve pain and inflammation but also can cause GI irritation and ulcers.

Front 51

Newer NSAIDS do what?

Back 51

work specifically on COX-2

Front 52

NSAID's are used for what? List 4

Back 52

1. Pain from rheumatoid and osteoarthritis and other musculoskeletal disorders
2. menstrual cramps
3. fever
4. mild to moderate pain

Front 53

What is Ibuprofen? Example? Dosage?

Back 53

NSAID, Advil or Motrin, 400 mg po q 4-6 hr

Front 54

What is Ketorola? Example? Dosage?

Back 54

NSAID, Toradol.
Single Dose: 60 mg IM or 30 mg IV
Multiple Dose: 10 mg q 4-6 hrs.

Front 55

What is Naproxen?Example?Dosage?

Back 55

NSAID, Alleve or Naprosyn, 250-500 mg po q 4-6 hrs

Front 56

What is celecoxib? Example?Dosage?

Back 56

NSAID, Celebrex, 100-200 mg po BID

Front 57

NSAID's GI symptoms

Back 57

N&V, anorexia, diarrhea, constipation, abdominal pain

Front 58

NSAID's CNS symptoms

Back 58

dizziness & head ache

Front 59

NSAID's CV symptoms

Back 59

Cardiac Heart Failure, Acute Coronary Syndome (MI)

Front 60

NSAID's Hematologic symptoms

Back 60

Pancytopenia

Front 61

NSAID's Skin symptoms

Back 61

rash, ecchymosis (subcutaneous hemorrhage)

Front 62

What are the 5 types of adverse reactions?

Back 62

1. GI symptoms
2. CNS
3. CV
4. Hematologic
5. Skin

Front 63

NSAID's Contraindication

Back 63

1. Hypersensitivity to NSAID's or aspirin
2. 3rd trimester of pregnancy
3. PUD peptic ulcer disease or GI bleeding
4. 7 days before surgery

Front 64

An abnormal loss of bone density which occurs in older adults, more often in women than in men

Back 64

Osteoporosis

Front 65

When bone resorption exceeds bone formation means you have what disorder?

Back 65

Osteoporosis

Front 66

When you have decreased levels of calcitonin, estrogen and parathyroid can cause what disorder?

Back 66

Osteoporosis

Front 67

What can osteoporosis lead to?

Back 67

fractures