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Working Decks > Lewis 68 - Musculoskeletal Problems > Flashcards

Lewis 68 - Musculoskeletal Problems Flashcards

1
Q

MOA/Class

Prednisone, methylprednisolone

A

Steroids stabilize leukocytes (WBCs) preventing the release of intracellular chemical/inflammatory mediators
Restore/increase bronchial responsiveness to beta-adrenergic receptor stimulation

Systemic glucocorticoid/corticosteroid

Tucker 36

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2
Q

Side Effects

Prednisone, methylprednisolone

A

Growth suppression, elevated blood glucose, weight gain
GI upset (tolerated best in AM with food/milk)
Osteoporosis (long-term use)

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3
Q

Nursing Considerations

Prednisone, methylprednisolone

A

Taper dose when stopping to prevent adrenal insufficiency

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4
Q

Indications

Prednisone, methylprednisolone

A

Used to gain control of inflammatory musculoskeletal conditions.

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5
Q

MOA/Class

ibuprofen, naproxen, ketorolac, indomethacin, celecoxib

A

Inhibit cyclooxygenase thus inhibiting inflammatory symptoms

NSAID

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6
Q

Side Effects

ibuprofen, naproxen, ketorolac, indomethacin, celecoxib

A

GI upset/ulcers/bleeding, risk for thrombotic events

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7
Q

Nursing Considerations

ibuprofen, naproxen, ketorolac, indomethacin, celecoxib

A

Monitor renal (and hepatic) function
Increased bleeding risk when combined with alcohol, anticoagulants, some herbals
Take with food
Misoprostol can help decrease risk for ulcers with chronic NSAID use
Stop NSAIDs several days prior to surgery/dental work
Celcoxib has less risk of GI irritation as it is a COX-2 inhibitor.

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8
Q

Indications

ibuprofen, naproxen, ketorolac, indomethacin, celecoxib

A

Pain due to inflammation

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9
Q

MOA/Class

cyclobenzaprine, tizanidine

A

Acts on the brainstem to decrease muscle spasms

Centrally-acting muscle relaxant

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10
Q

Side Effects

cyclobenzaprine, tizanidine

A

CNS depression; may have some anticholinergic effects

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11
Q

Nursing Considerations

cyclobenzaprine, tizanidine

A

Do not combine with alcohol or other CNS depressants.

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12
Q

Indications

cyclobenzaprine, tizanidine

A

Short-term/intermittent treatment of acute muscle spasms/injuries.

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13
Q

MOA/Class

duloxetine

A

Inhibits serotonin and norepinephrine reuptake in the CNS

SNRI

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14
Q

Side Effects

duloxetine

A

Serotonin syndrome, neuroleptic malignant syndrome, Stevens-Johnson syndrome
Hepatotoxicity, drowsiness, constipation, dry mouth

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15
Q

Nursing Considerations

duloxetine

A

Do not use within 14 days of MAOI medications
Taper dose to discontinue

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16
Q

Indications

duloxetine

A

Antidepressant and nerve pain management

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17
Q

MOA/Class

gabapentin

A

Unknown

Analgesic/anticonvulsant

Tucker 23

18
Q

Side effects

gabapentin

A

Confusion, drowsiness, fatigue, ataxia

Tucker 23

19
Q

Nursing Considerations

gabapentin

A

Increased risk of CNS depression when combined with alcohol

Tucker 23

20
Q

Indications

gabapentin

A

Used for neuropathic pain and mood stabilization

Tucker 23

21
Q

MOA/Class

tramadol

A

Binds to opioid and norepinphrine receptors to block pain signals.

Centrally-acting opioid serotonin/norepinephrine reuptake inhibitor

Tucker 26

22
Q

Side Effects

tramadol

A

Dizziness, headache, constipation, serotonin syndrome, seizures

Tucker 26

23
Q

Nursing Considerations

tramadol

A

Fluid and fiber to prevent constipation
(Analgesic effect is weaker than most opioids, but stronger than codeine)

Tucker 26

24
Q

Indications

tramadol

A

Moderate pain

Tucker 26

25
Q

MOA/Class

diazepam

A

Binds to GABA receptors to depress CNS activity and relax muscles.

Benzodiazepine

Tucker 20

26
Q

Side Effects

diazepam

A

Drowsiness, vertigo, “hangover effect”

Tucker 20

27
Q

Nursing Considerations

diazepam

A

Antidote: flumazenil
Avoid alcohol and other CNS depressants
Grapefruit increases effect/toxicity

Tucker 20

28
Q

Indications

diazepam

A

Anxiety, muscle spasms, seizure management / status epilepticus

Tucker 20

29
Q

MOA/Class

alendronate, zolendronate acid

A

Slows bone resorption (degeneration)

Tucker 37

30
Q

Side Effects

alendronate, zolendronate acid

A

GI and musculoskeletal pain, constipation, esophageal burns

Tucker 37

31
Q

Nursing Considerations

alendronate, zolendronate acid

A

Take on an empty stomach 30-60 minutes before food. Adminsitered with a full glass of water. Remain upright 30 minutes after administration.
Ensure adequate calcium intake during therapy.

Tucker 37

32
Q

Indications

alendronate, zolendronate acid

A

osteoporosis, Paget’s disease, multiple myeloma, hypercalcemia

Tucker 37

33
Q

MOA/Class

calcitonin

A

Mimics naturally thyroid-produced calcitonin
Inhibits osteoclasts (bone degeneration)

Calcimimetic

Tucker 37

34
Q

Side Effects

calcitonin

A

Flushing, nausea, diarrhea, decreased appetite

Tucker 37

35
Q

Nursing Considerations

calcitonin

A

Contraindicated with salmon allergy
Usually administered as a nasal spray - one spray daily; alternating nostrils.

Tucker 37

36
Q

Indications

calcitonin

A

osteoporosis, Paget’s disease, multiple myeloma, hypercalcemia

Tucker 37

37
Q

MOA/Class

raloxifene

A

Stimulates estrogen receptors in bones

Selective estrogen receptor modifier

Tucker 40

38
Q

Side Effects

raloxifene

A

Hot flashes, leg cramps, increased risk for VTE, teratogenic

Tucker 40

39
Q

Nursing Considerations

raloxifene

A

Contraindicated in pregnancy, during menopause, or with history of thrombotic disorder

Tucker 40

40
Q

Indications

raloxifene

A

osteoporosis, reduction of breast cancer in post-menopausal patients

Tucker 40

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