Pharmacology Ii Unit 5: Drugs Used To Treat Musculoskeletal Disorders (Quizlet)

Front 1

Muscles attached to the bones that are generally activated by voluntary control.

Back 1

Skeletal muscles

Front 2

These muscles produce movement of the body , help maintain normal body posture, and counteract opposing physical forces.

Back 2

Skeletal muscles

Front 3

These drugs are used into the treatment of acute muscle spasm associated with sprains, strains, myalgia, and other acute traumatic conditions.

Back 3

Centrally acting skeletal muscle relaxants

Front 4

The mechanisms of action of these drugs is the reduction of skeletal muscle spasm by depression of the CNS specifically in the brainstem.

Back 4

Centrally acting skeletal muscle relaxants

Front 5

carisoprodol/Soma, diazepam/Valium, metaxalone/Skelaxin, and methcarbamol/Robaxin are all examples of what drug type?

Back 5

Centrally acting skeletal muscle relaxants

Front 6

List forms of centrally acting skeletal muscle relaxants.

Back 6

PO- tablets, capsules. Parenteral- Robaxin, Norflex

Front 7

This is a centrally acting skeletal muscle relaxant that works somewhat differently from the others. It is a gamma-aminobutyric acid derivative that interrupts polysynaptic reflexes at the level of the spinal cord. Especially effective for flexor spasms, pain, and muscle rigidity associated with spasticity related to Multiple Sclerosis.

Back 7

baclofen/Lioresal

Front 8

Soma

Back 8

carisoprodol

Front 9

Valium

Back 9

diazepam

Front 10

Skelaxin

Back 10

metaxalone

Front 11

Robaxin

Back 11

methcarbamol

Front 12

Lioresal

Back 12

baclofen

Front 13

This drug is indicated primarily for treatment of spasticity caused by multiple sclerosis or spinal cord injury

Back 13

baclofen/Lioresal

Front 14

List forms of baclofen/Lioresal

Back 14

Intrathecal, PO

Front 15

Patient should never __________ baclofen. Severe hallucinations and exaggerated rebound spasticity may occur.

Back 15

abruptly discontinue

Front 16

List side effects of centrally acting skeletal muscle relaxants.

Back 16

Drowsiness, dizziness, N&V, hypotension, confusion

Front 17

What can give additive side effects to centrally acting skeletal muscle relaxants?

Back 17

Any other CNS depressant (alcohol, opioids, etc.)

Front 18

Centrally acting skeletal muscle relaxants are not __________ but cases of drug abuse and dependence have been reported.

Back 18

controlled substances

Front 19

List nursing implications/considerations for skeletal muscle relaxants.

Back 19

Drugs may cause dependence. Discontinue CNS relaxants gradually to avoid insomnia, weakness, muscle tremors, etc.Avoid prescribing to patients with history of substance abuse or depression.Diazepam is incompatible with any other drug in syringe. Administer with food to minimize GI irritation.

Front 20

This centrally acting skeletal muscle relaxant is incompatible with any other drug in the syringe.

Back 20

diazepam/Valium

Front 21

Centrally acting skeletal muscle relaxants should be discontinued ___________

Back 21

gradually

Front 22

A neurological disorder characterized by the uncontrollable urge to move the legs and affects up to 10 percent of the population

Back 22

Restless Leg Syndrome, RLS

Front 23

gabapentin/Neurontin, gabapentin enacarbil/Horizant, and ropinirole HCL/Requip are all used to treat what?

Back 23

Restless Leg Syndrome, RLS

Front 24

Besides treating RLS, what is ropinirole HCL used to treat?

Back 24

Parkinson's

Front 25

List side effects of RLS drugs

Back 25

Dizziness, somnolence, fatigue

Front 26

The state of being drowsy is known as...

Back 26

Somnolence

Front 27

This type of muscle relaxant works at the site

Back 27

Direct Acting Skeletal Muscle Relaxant

Front 28

This drug is a direct acting muscle relaxant used to control the spasticity of chronic disorders such as cerebral palsy, MS, spinal cord injury, and stroke syndrome.

Back 28

dantrolene/Dantrium

Front 29

List forms of dantrolene/Dantrium

Back 29

PO

Front 30

List side effects of dantrolene/Dantrium

Back 30

Weakness, somnolence, lightheadedness

Front 31

Progressive degeneration of bone mass with resultant loss of bone density and increased bone fragility.

Back 31

Osteoporosis

Front 32

List drugs used in the treatment of osteoporosis.

Back 32

Bisphosphonates, Human Monoclonal Antibody, Calcium, Conjugated Estrogens, Calcitonin, Selective Estrogen Receptor Modulator, & Parathyroid Hormone

Front 33

Group of drugs that regulate bone growth and slow the breakdown of bone by osteoclasts.

Back 33

Bisphosphonate's

Front 34

alendronate sodium/Fosamax, ibandronate sodium/Boniva, risedrontae/Actonel/Atelvia, and zoledronic acid/Zometa/Reclast are all what type of drug?

Back 34

Bisphosphonate's

Front 35

This is the prototype drug of the bisphosphonate's. PO.

Back 35

alendronate sodium/Fosamax

Front 36

Fosamax

Back 36

alendronate sodium

Front 37

Boniva

Back 37

ibandronate sodium

Front 38

Actonel, Atelvia

Back 38

risedrontae

Front 39

Zometa, Reclast

Back 39

zoledronic acid

Front 40

What are side effects of bisphosphonate's?

Back 40

Abdominal pain, dyspepsia, Nausea and diarrhea, constipation, photosensitivity. (Boniva causes leg/back/arm pain)

Front 41

What are adverse effects of bisphosphonate's?

Back 41

Femur fractures, esophageal/gastric ulcer, osteonecrosis of the jaw (generally associated with tooth extraction

Front 42

You should instruct the geriatric osteoporosis patient to take _________ of Ca daily and _________ of vitamin D daily. They should take it in the ________ with a full glass of water and remain upright for __________ after taking.

Back 42

1500 mg; 800 international units; morning, 30-60 minutes

Front 43

What are some bisphosphonate nursing interventions?

Back 43

Encourage regular exercise program. Patient should advise dentist on meds before dental work. Encourage the patient to reduce behaviors that increase risk of osteoporosis (smoking, alcohol). Advise patient to use sunscreen and protective clothing to prevent photosensitivity reactions.

Front 44

This drug is a selective estrogen receptor modulator and bone resorption inhibitor. It is used in the treatment and prevention of osteoporosis in post-menopausal women.

Back 44

raloxifene/Evista

Front 45

Evista

Back 45

raloxifene

Front 46

What form does Evista come in?

Back 46

Oral (60 mg/day)

Front 47

What are side effects of raloxifene/Evista?

Back 47

Leg cramps, hot flashes

Front 48

What are adverse effects of raloxifene/Evista?

Back 48

CVA, deep-vein thrombosis

Front 49

What are some nursing considerations for Evista?

Back 49

Calcium supplements should be added if daily intake is inadequate.Patient should quit smoking. Patient should do weight bearing exercise regularly. Instruct patient on s/s of DVT/stroke. Evista is teratogenic.

Front 50

This drug is used to treat osteoporosis for patients at extreme risk of having fractures (men and post-menopausal women). Stimulates new bone formation. Has many adverse effects.

Back 50

Teriparatide recombinant human/Forteo

Front 51

What form does Forteo come in?

Back 51

Injection

Front 52

A naturally occurring hormone involved in calcium regulation and bone metabolism. It is formulated using salmon.

Back 52

Calcitonin

Front 53

This drug form of a natural hormone has been approved for treatment of post-menopausal osteoporosis in women who are at least five years post-menopausal and acts by directly inhibiting bone reabsorption through receptors on osteoclasts.

Back 53

Calcitonin

Front 54

List 2 brand names of calcitonin drugs

Back 54

Miacalcin. Fortical.

Front 55

List forms that calcitonin is given in

Back 55

IM, subcut. Inhaled.

Front 56

List side effects of calcitonin

Back 56

Nasal spray- headache, rhinitis, nasal irritation. Parenteral- urinary frequency, injection site reactions, pain.

Front 57

List nursing implications/considerations of calcitonin

Back 57

Observe for s/s of hypersensitivity. Assess for signs of hypocalcemic tetany (nervousness, paresthesia, muscle twitching). Flushing and warmth after injection are transient and usually last about an hour. Regular exercise arrests and preserves bone loss.

Front 58

What is a common form of calcium supplementation?

Back 58

Oyster-shell calcium tablets

Front 59

This supplementation is recommended in the prevention and treatment of osteoporosis.

Back 59

Combined calcium and vitamin D supplements

Front 60

Until recently, this recommended supplement was perceived as harmless but recent studies have given evidence that they may be associated with increased cardiovascular risks.

Back 60

Calcium supplements

Front 61

Post-menopausal women should take ___________ of calcium and ___________ of vitamin D by mouth each day.

Back 61

000-1500 mg; 800 international units

Front 62

An inflammatory condition that attacks joints, tendons, and other tissues. Primarily occurs on the joint of the great toe. Pain and inflammation in affected joints.

Back 62

Gout

Front 63

Accumulation of uric acid in the blood.

Back 63

Hyperuricemia

Front 64

This condition is characterized by a uric acid metabolism disorder and a defect in purine. This results in an increase in uric acid salts and hyperuricemia.

Back 64

Gout

Front 65

An accumulation of uric acid that crystallize and form in joint areas.

Back 65

Tophi

Front 66

List drugs used in the treatment of gout.

Back 66

Anti-inflammatory - colchicine/Colcrys. NSAID's. Uricosuric agents. Corticosteroids (glucocorticoids).

Front 67

Anti-inflammatory drug that is effective in alleviating acute symptoms of gout by decreasing pain and inflammation. It is used to treat gout attack and prophylaxis.

Back 67

colchicine/Colcrys

Front 68

What forms do colchicine come in?

Back 68

PO

Front 69

List side effects of colchicine

Back 69

NVD, abdominal pain

Front 70

List adverse effects of colchicine

Back 70

Agranulocytosis. Aplastic anemia (blood dyscrasias-leukopenia, thrombocytopenia). Toxicity.

Front 71

List nursing implications/considerations for colchicine.

Back 71

Encourage fluid intake, at least 2 L/day. Assess for toxicity (muscle pain, weakness, tingling or numbness in fingers/toes). Educate patient about these symptoms. Instruct patient in reduction of purine-rich food.

Front 72

This is the most common agent used to reduce the inflammation (and pain) caused by deposits of uric acid crystals (tophi), but have no effect on the elevated uric acid levels in the body.

Back 72

NSAIDs

Front 73

Give examples of NSAIDs

Back 73

ibuprofen, indomethacin, Naproxen, Sunlindac.

Front 74

List side effects of NSAIDs

Back 74

GI nausea, dyspepsia, cramps, diarrhea, flatulence

Front 75

List adverse effects of NSAIDs

Back 75

Skin reactions (ibuprofen). GI bleeding. Nephrotoxicity (long-term use). Cardiovascular events (MI, CVA, thrombus formation)(FDA Black-box warning for these adverse effects)

Front 76

List two examples of Xanthine Oxidase Inhibitors.

Back 76

allopurinol/Zyloprim. febuxostat/Uloric (newest)

Front 77

Zyloprim

Back 77

allopurinol

Front 78

Uloric

Back 78

febuxostat

Front 79

These drugs inhibit the production of uric acid by inhibiting an enzyme needed to make uric acid. Treats primary hyperuricemia in patients with gout or gout secondary to antineoplastic therapy. Does not treat acute attacks of gout.

Back 79

Xanthine Oxidase Inhibitors

Front 80

What forms do xanthine oxidase inhibitors come in?

Back 80

Uloric - PO. allopurinol - PO, IV

Front 81

What patients are contraindicated for xanthine oxidase inhibitors?

Back 81

Patients with liver disease

Front 82

List side effects of xanthine oxidase inhibitors.

Back 82

NVD, anorexia, headache

Front 83

List adverse effects of xanthine oxidase inhibitors.

Back 83

Cataracts. Retinopathy. Bone Marrow Suppression (leading to aplastic anemia, thrombocytopenia, agranulocytosis, leukopenia).

Front 84

List nursing implications/considerations for xanthine oxidase inhibitors.

Back 84

Patients should have sufficient fluid intake (2 L per day) to prevent urine acid stones from forming. Monitor for Maculopapular rash. Avoid caffeine and excessive alcohol (diminish drug effects). May be taken without regards to meals.

Front 85

These drugs increase urinary excretion of uric acid thereby lowering serum levels of uric acid.

Back 85

Uric Acid Inhibitors (Uricosurics)

Front 86

List two uric acid inhibitor drugs.

Back 86

Probenecid. suflinpyrazne.

Front 87

List adverse effects of uricosurics.

Back 87

Anaphylaxis. Aplastic anemia. Hepatic necrosis.

Front 88

List side effects of uricosurics.

Back 88

Headache, N&V, Skin rash

Front 89

List nursing implications/considerations of uric acid inhibitor drugs.

Back 89

To prevent kidney stones, patient should drink 6-8 glasses of water.Assess involved joints noting pain inflammation.

Front 90

This is a series of events triggered as part of the normal reaction of living tissue to injury.

Back 90

Inflammation

Front 91

These are important mediators of the inflammatory process.

Back 91

Prostaglandins

Front 92

Drugs used to treat inflammation may be classified on the basis of whether they are ___________ or __________ agents.

Back 92

steroidal (hormones); nonsteroidal

Front 93

Most common agent prescribed or used to reduce inflammation

Back 93

NSAIDs

Front 94

These drugs are used in the treatment of rheumatoid arthritis and related inflammatory disorders that include osteoarthritis.

Back 94

NSAIDs

Front 95

List forms of NSAIDs

Back 95

Oral

Front 96

NSAIDs should be taken with meals to minimize what?

Back 96

GI irritation

Front 97

ibuprofen, indomethacin, Naproxen, and sulindac are examples of what?

Back 97

NSAIDs

Front 98

Celebrex

Back 98

celecoxib

Front 99

Name a Cox-2 inhibitor used in treatment of arthritic conditions.

Back 99

celecoxib/Celebrex

Front 100

Toradol

Back 100

ketorolac

Front 101

In 2007, the FDA notified health care officials about the potential drug interaction between these two drugs when taken concurrently.

Back 101

aspirin and ibuprofen (NSAID's interfere with cardio-protective effects of ASA)

Front 102

Anti-inflammatory effects of NSAID's may take up to ___________ after initiation of therapy.

Back 102

2 weeks

Front 103

Congenital abnormalities may occur when women in early pregnancy take this type of drug. Pregnant women are not advised to take this drug type.

Back 103

NSAIDs

Front 104

prednisone, prednisolone, dexamethasone are examples of what?

Back 104

Corticosteroids/Glucocorticoids (hormone)

Front 105

This drug type is frequently used as anti-inflammatory agents in the treatment of acute injury or acute arthritic flare-up. Not widely prescribed for arthritic conditions due to numerous side effects.

Back 105

Corticosteroids/Glucocorticoids

Front 106

A chronic disease that causes pain, stiffness, swelling and loss of function to joints. Occurs when your immune system mistakenly starts attacking healthy tissue.

Back 106

Rheumatoid Arthritis, RA

Front 107

If not managed properly over time, this disease can cause joint damage and even permanent joint destruction.

Back 107

Rheumatoid Arthritis, RA

Front 108

This type of therapy uses gold to arrest the progression of rheumatoid arthritis and prevent deformities caused by the disease.

Back 108

Chrysotherapy

Front 109

Solganal and auranofin/Ridaura are examples of what?

Back 109

Gold (chrysotherapy drugs)

Front 110

What is the usual route for gold (chrysotherapy) drugs?

Back 110

Parenteral

Front 111

List side effects of gold (chrysotherapy) drugs.

Back 111

Dermatitis, urticaria, alopecia

Front 112

List adverse effects of gold (chrysotherapy) drugs.

Back 112

Blood dyscrasias, nephrotoxicity

Front 113

DMARDs

Back 113

Disease-Modifying Anti-Rheumatic Drugs

Front 114

DMARD's are classified as ___________ and ___________ forms.

Back 114

Nonbiologic; Biologic

Front 115

List nonbiologic forms of DMARD's.

Back 115

methotrexate, hydroxychloroquine, cyclosporine, sulfasalazine

Front 116

This nonbiologic DMARD has mild immunosuppressant effects used in the treatment of RA that is unresponsive to conventional therapies. PO 7.5 mg/week.

Back 116

methotrexate/Folex

Front 117

List side effects of methotrexate/Folex.

Back 117

N&V, Stomatitis, Alopecia, Photosensitivity

Front 118

List adverse effects of methotrexate/Folex.

Back 118

Aplastic anemia (monitor CBC), Nephrotoxicity

Front 119

List nursing implications for methotrexate.

Back 119

Monitor for symptoms of bone marrow depression (bleeding, petechiae, guaiac). Avoid IM injectionsInstruct patient to report symptoms of infection, bleeding. Teratogenic.

Front 120

This nonbiologic DMARD is prescribed in the treatment of RA patients that are unresponsive or intolerant to NSAIDS/salicylates. PO.

Back 120

sulfasalazine/Azulfidine

Front 121

List side effects of sulfasalazine.

Back 121

Headache. N&V. Photosensitivity

Front 122

List adverse effects of sulfasalazine.

Back 122

Blood dyscrasias (agranulocytosis, aplastic anemia, thrombocytopenia)

Front 123

List nursing implications for sulfasalazine.

Back 123

Assess patient for allergy to sulfonamides and salicylates. Monitor kidney and liver function. Encourage liberal fluid intake (1.5 L/day). Avoid direct sunlight.Assess for skin rashes

Front 124

Stephens-Johnson syndrome may be caused by the use of this drug.

Back 124

sulfasalazine

Front 125

This nonbiologic DMARD is used in treatment of severe rheumatoid arthritis and lupus. PO. It is an antimalarial and anti-rheumatic.

Back 125

hydroxcychloroquine/Plaquenil

Front 126

List side effects of hydroxychloroquine

Back 126

Anxiety. Apathy. Abdominal cramps. NVD

Front 127

List adverse effects of hydroxychloroquine.

Back 127

Seizures. Blood dyscrasias. Peripheral neuritis. Neuromyopathy. Hepatotoxicity.

Front 128

What is a nursing administration/implication of hydroxychloroquine?

Back 128

Administer with food/milk to reduce GI distress

Front 129

This nonbiologic DMARD is used in treatment of severe active RA. Immunosuppressant and anti-rheumatic.

Back 129

cyclosporine/Neoral

Front 130

List side effects of cyclosporine.

Back 130

Confusion. Flushing. Hypertension. Anorexia. Hirsutism. Acne. Gingival hyperplasia.

Front 131

List adverse effects of cyclosporine.

Back 131

Hepatotoxicity. Seizures. Nephrotoxicity. Blood dyscrasias. Infections. Hyperuricemia.

Front 132

List nursing implications/interventions for cyclosporine.

Back 132

Do not administer with grapefruit/grapefruit juice. Some herbs interfere with immunosuppressant effects. Assess pain and limitation of movement prior to and during administration. May cause hepatotoxicityInstruct patient on proper oral hygiene.

Front 133

What should cyclosporine not be administered with?

Back 133

Grapefruit or grapefruit juice

Front 134

What herbs may interfere with the immunosuppressant effects of cyclosporine?

Back 134

St. John's wart. Echinacea. Melatonin.

Front 135

This complication of cyclosporine use can be prevented with proper oral hygiene.

Back 135

Gingival hyperplasia

Front 136

This type of DMARD acts by inhibiting steps of the inflammatory process associated with RA. Most forms are parenteral IV or subcut.

Back 136

Biologic DMARD's (Biologic response modifiers/Immunomodulators)

Front 137

Which biologic DMARD is taken orally?

Back 137

leflunomid/Arava

Front 138

etanercept/Enbrel, infliximabe/Remicade, adalimumab/Humira, anakinra/Kineret, golimumab/Simponi, lefluniomid/Arava are all examples of what?

Back 138

Biologic DMARD's

Front 139

What are side/adverse effects of biologic DMARD's.

Back 139

Infections. Anaphylaxis. Hepatotoxicity (Arava). Injection site reaction. Headache. Flu-like symptoms.

Front 140

What are the primary adverse effects of biologic DMARD's?

Back 140

Infections. Anaphylaxis. Hepatotoxicity (Arava)

Front 141

What are nursing considerations/interventions for biologic DMARD's?

Back 141

Expensive ($14,000 to $37,000 per year). Reconstitute as directed. Patient should contact healthcare provider if any s/s of infection occur. Do not administer concurrently with immunizations.

Front 142

Biologic DMARD's should not be administered concurrently with ______________.

Back 142

immunizations

Front 143

This drug exerts a direct muscle relaxing effect on skeletal muscles. Used in treatment of skeletal muscle spasms associated with MS, cerebral palsy, spinal cord injury, and stroke.

Back 143

dantrolene/Dantrium

Front 144

List side/adverse effects of dantrolene/Dantrium.

Back 144

Drowsiness. Malaise. NVD. Photosensitivity. Hepatotoxicity.

Front 145

List forms for dantrolene/Dantrium.

Back 145

Oral (most common). IV (for treatment of malignant hypothermia)

Front 146

A condition in which movement of the extremities is marked with an combination of the the following: exaggerated reflexes, abnormal posture, involuntary movement, and walking difficulties. Caused by an injury or birth defect.

Back 146

Cerebral palsy

Front 147

An autoimmune disease that affects the brain and spinal cord. Symptoms may be mild, such as numbness to the limbs, or severe, such as paralysis or loss of vision.

Back 147

Multiple sclerosis

Front 148

Defined as an upper motor neuron disorder, possibly caused by a conduction interruption in the nerve pathway. Characterized by muscle hypertonicity and involuntary jerks, which produce stiff, awkward movements. Often a complication in patients with MS or cerebral palsy.

Back 148

Spasticity

Front 149

Sudden alternating contraction and relaxations or sustained contractions of muscle. Often associated with musculoskeletal trauma or inflammation.

Back 149

Muscle spasms

Front 150

Dantrium

Back 150

dantrolene

Front 151

Neoral

Back 151

cyclosporine

Front 152

Plaquenil

Back 152

hydroxcychloroquine

Front 153

Azulfidine

Back 153

sulfasalazine

Front 154

Zyloprim

Back 154

allopurinol

Front 155

Uloric

Back 155

febuxostat