Pharmacology Chapter 9 Musculoskeletal Drugs

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Also known as degenerative joint disease.

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Osteoarthritis

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Occurs when cumulative damage causes degeneration of the cartilage pad and erosion of the bone ends inside a joint.

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Osteoarthritis

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Weightbearing Joints:

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hips, knees and lower back

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Preferred first treatment for osteoarthritis because it relieves mild-to-moderate pain and does not cause stomach irritation.

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Acetaminophen

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Medicine: Acetaminophen for Osteoarthritis

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Tylenol

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Drugs used to treat osteoarthritis include aspirin

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Salicylate

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Medicine: Salicylate For Osteoarthritis

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Aspirin

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Oldest drug known to man:

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Aspirin

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Manufactured as an enteric-coated tablet that does not dissolve in the stomach

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Ecotrin

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Inhibit the production of prostaglandins to produce both an analgesic effect and an anti-inflammatory effect.

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NSAIDS

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Have less of a tendancy than an aspirin to cause gastric irritation or ulcers.

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NSAIDS

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Medicine: NSAIDS

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Advil & Motrin

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Given to newborn infants intravenously to close a persistent patent ductus arteriosus, a part of the fetal circulation that normally closes after birth.

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Indocin

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Drugs also used to treat animals:

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NSAIDS

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Cats and dogs with osteoarthritis are given:

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Rimadyl

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Commonly used in race horses to reduce inflammation, slang name is bute.

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Butazolidin

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Drugs that selectively inhibit COX-2, an enzyme that normally plays a role in the production of prostaglandins that cause the pain and inflammation of osterarthritis

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COX-2 Inhibitor Drugs

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Medicine: COX-2 Inhibitor Drug for Osterarthritis

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Celebrex

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COX-2 drugs that were taken off the market because they greatly increased the risk of heart attacks and strokes.

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Vioxx & Bextra

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Only COX-2 inhibitor drug that remains on the market.

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Celebrex

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Secreted by the cortex of the adrenal gland, has a powerful anti-inflammatory action; has same inflammatory effect and are given orally to treat flare-ups; only prescribed to treat acute symptoms for limited time

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Corticosteroid Drugs

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Medicine: Corticosteroid drug for Osteoarthritis

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Celestone,Solu-Medrol, prednisone, & Kenalog-10

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Secreted by the synovial membrane of a joint and helps to maintain the slippery, thick quality of synovial fluid; is injected into the joint of a patient with osteoarthritis to improve those lubricating qualities of the synovial fluid.

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Hyaluronic Acid

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Medicine: Other Drugs for Osteoarthritis

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hyaluronic acid

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Where is hyaluronic acid deprived from?

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Combs of Chickens

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Prescription drug that is categorized as a medical food product; contains concentrated plant antioxidants and the mineral zinc.

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Limbrel

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Substance used to produce cartilage:

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Glucosamine

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Medicine: Glucosamine

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Osteo Bi-Flex

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Used to treat the pain of osteoarthritis.

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OTC Topical Drugs

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Menthol is an ___________ drug.

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analgesic

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A natural substance derived from chili pepper plants; makes the skin and joint less sensitive to pain by decreasing the nerve signals from the sensory nerves.

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Capsaicin

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Medicine: Topical drugs for Osteoarthritis

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Aspercreme, Icy Hot, & Bengay

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What do the oral combination drugs contain for osteoarthritis?

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salicylate drug, NSAIDS, antacid, and a prostaglandin

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Medicine: Combination drug for Osteoarthritis

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Arthrotec & Bufferin Extra Strength

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Produces symptoms of pain, inflammation, swelling, joint deformity, and loss of joint function; is caused by an autoimmune response in which the body's own immune system targets and destroys cartilage, connective tissue, and joints.

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Rheumatoid Arthritis

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Contain actual gold from __% to __% of the total drug.

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29-50%

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Used to treat active rheumatoid arthritis; inhibits macrophages in the immune system from the attacking joints, but they cannot reverse joint damage that has already occured.

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Gold Compound Drugs

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Medicine: Gold Compound Drugs

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Ridaura & Aurolate

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These drugs prevents lymphocytes from making antibodies against joint tissues and they inhibit tumor necrosis factor; a substance that causes inflammation

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Monoclonal AntiBody Drugs

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Medicine: Monoclonal Antibody for RA

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Humira & Remicade

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An enzyme within the cell that triggers cytokines

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Janus Kinase (JAK)

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Substances that are released by white blood cells during an autoimmune response and they produce inflammation

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Cytokines

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Medicine: JAK Inhibitor Drugs for RA

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Xeljanz

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Suppress the overactivity of the immune systems autoimmune response in patients with RA.

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Immunosuppressant Drugs

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Blocks interleukin-1 from binding to receptors on cartilage cells and destroying cartilage

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Anakinra

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Blocks tumor necrosis factor and suppresses the immune response

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Etanercept

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Medicine: Immunosuppressant Drugs for RA

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Orencia, Kineret, & Enbrel

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Metabolite of a naturally occurring fungus

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Cyclosporine

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Immuno. drugs given to patients following organ transplants.

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azathioprine & cyclosporine

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Used to treat malaria:

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Hydroxychloroquine

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Chemotherapy drug used to treat many different types of cancer:

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Methotrexate

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Has very long half-life; traces of this drug can still be found in the body six months after the last dose.

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Arava

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Most people think of a bone as _____, ________ _______.

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hard, unchanging substance

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Two types of bone cells are constantly at work:

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osteoblasts and osteoclasts

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deposit new bone

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osteoblasts

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break down and remove areas of old or damaged bone

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osteoclasts

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A thinning of the bone at a cellular level:

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Osteoporosis

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Inhibitor drugs that inhibit osteoclasts, and this decreases the rate at which bone is resorbed; AKA bisphosphonate drugs

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Bone Resorption

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Medicine: Bone Resorption for Osteoporosis

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Fosamax & Boniva

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What well known actress had an active lifestyle bu just prior to her 60th birthday discovered she had osteoporosis?

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Sally Fields

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Tablets that are taken orally every morning, 30 minutes before eating:

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Actonel, Atelvia

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Advertised as the osteoporosis drug that is the easiest to remember how to take:

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Boniva

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Given as a single dose just once a year, but that dose must be given intravenously, which means a visit to the doctor's office or clinic:

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Reclast, Zometa

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Drugs that bind to estradiol receptors on cells and stimulate the receptors in the same way that estradiol does:

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Selective Estrogen Receptor Modulator Drugs for Osteoporosis (SERM)

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Medicine: SERM drugs for Osteoporosis

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Evista

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What selective SERM drug was used to treat breast cancer:

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Tamoxifen

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It was discovered that in patients who took ________ for breast cancer, there was a positive effect on the patient's bones.

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Tamoxifen

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The female hormone secreted by the ovaries, inhibits the action of osteoclasts that break down the bone:

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Estradiol

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Medicine: Estrogen Drugs for Osteoporosis

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Premarin

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In the past hormone replacement therapy was commonly used for extended periods of time to treat the symptoms of ________ in postmenopausal women, with the secondary effect of preventing osteporosis

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Menopause

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Is a parathyroid hormone drug that is used to stimulate new bone formation in patients who are at high risk for a fracture:

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Teriparatide

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Medicine: Other Drugs for Osteoporosis

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Miacalcin

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Derived from a salmon fish, can be injected or given as a nasal spray:

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Calcitonin Salmon (Miacalcin)

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Medicine: Calcium Supplements for Osteoporosis

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Os-Cal & Tums Calcium for Life Bone Health

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Medicine: Combination drugs for Osteoporosis

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Prempro

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Conditions such as strains, sprains, and "pulled muscles," are treated with analgesic drugs and NSAIDS.

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Acute Muscular

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Medicine: Skeletal Muscle Relaxant Drugs

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Soma, Flexeril, Valium, & Skelakin

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Medicine: Drugs used to treat severe muscle spasticity in patients with multiple sclerosis, cerebral palsy, stroke, or spinal cord injury

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Zanaflex

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A skeletal muscle relaxant drug, but it is best known as the drug used to treat malignant hyperthermia:

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Dantrium

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A Schedule IV drug, is an antianxiety drug, not a skeletal muscle relaxant drug

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Valium

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A disease in which specific, hyperirritable trigger points along the neck, back, or hips are firm and very tender to the touch.

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Fibromyalgia

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Medicine: Fibromyalgia

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Aerofreeze, ethyl chloride, lidocaine, & procaine

(Lyrica)

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T/F: Osteoporosis is the thinning of bone at a cellular level and is most common among young african american women.

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false

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T/F: In older people, the rate of bone resorption (breakdown) exceeds that of bone deposition (new bone)

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True

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T/F: Many drugs used to treat osteoarthritis are also used to treat RA

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True

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T/F: Because of the limited side effects of corticosteroid drugs, they are considered safe for the long-term treatment of osteoarthritis

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False

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T/F: Gold compound drugs are effective in the treatment of osteoarthritis

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False

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T/F: Gout is caused by the excessive production of uric acid, and it crystallizes within the joints, causing pain and inflammation

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True

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T/F: Celecoxib is one of three different trade name COX-2 inhibitor drugs that are currently on the market

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True

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T/F: Fosamax is an effective drug for treating RA

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False

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T/F: When the generic version of a drug is available, it is less expensive than the trade name drug

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True

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Which of the following is a bone resorption inhibitor drug?

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Fosamax, Boniva, Actonel, Reclast

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Hormone replacement therapy in postmenopausal women has a secondary therapeutic effect of preventing osteoporosis, but may also increase the risk of ________.

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Breast cancer

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Which of the following drugs has no anti-inflammatory properties?

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acetaminophen

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Which of the following COX-2 inhibitor drugs is still on the market today for treating osteoarthritis?

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Celebrex

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Which of the following muscle relaxant drugs is also classified as a benzodiazepine antianxiety drug for treating anxiety disorders?

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Valium

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Which of the following drugs effectively treats osteoarthritis in cats and dogs, yet has not been approved for human use?

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Rimadyl