MSK Flashcards
(19 cards)
Calcium citrate: calcium supp
-MOA: maintenance of msk, neuro, cardiac
-use: reduce risk of osteoporosis and fractures
-complications: hypercalcemia (monitor), furosemide and calcium chelators to reverse hypercalcemia
-contraindicated: currently hypercalcemic, renal calculi, hypophosphatemia, digoxin toxicity, Vfib, kidney disease, GI function
-interacts with meds and food so wait about 1-4 hrs in between, take with water or IV solution warm to body temp (watch for extravasation and precipitation)
Raloxifene (Evista): Selective Estrogen Receptor Modulator (SERMs)
-MOA: decreases bone resorption, slows bone loss, preserves mineral bone density
-Uses: Prevent and treat postmenopausal osteoporosis
-Complications: Increased risk for DVT/PE, hot flashes
-contraindication: previous DVT/PE, stop 72hrs prior to prolonged immobility (travel or surgery)
-Take w/ or w/out food once daily, monitor bone density, monitor calcium and liver function tests, perform weight bearing exercises (walking is safe)
Alendronate (Fosamax): Bisphosphonates
-MOA: decrease number and action of osteoclasts, inhibits bone resorption
-use: Postmenopausal osteoporosis (others), paget’s disease
-complications: esophagitis and ulceration= stay upright for 30 mins after admin, drink lots of water, stop if heartburn or difficulty swallowing (call provider)
-GI disturbances, msk pain, visual disturbances, osteonecrosis of the jaw, kidney toxicity if IV admin, atypical femoral fractures
-interactions: mg supp, Ca, iron, antacids, OJ, caffiene
-prefer to take on empty stomach with water or wait 2 hrs after antacids/other supps
Calcitonin-Salmon
-MOA: decreases bone resorption by inhibiting the activity of osteoclasts in osteoporosis, increases renal calcium excretion
-use: treats but no prevention of postmenopausal osteoporosis, paget’s disease, hypercalcemia from hyperparathyroidism and cancer
-complications: nausea, nasal dryness (nasal route)
-contraindications: salmon allergy/sensitivity to fish
-interacts with lithium
-give IM, SubQ, or intranasal (only for postmeno osteo), switch nostrils daily with nasal route to prevent irritation
DMARDs 1
-major nonbiologic DMARD
-immunomodulator meds: methotrexate, leflunomide
-antimalarial agent: hydroxychloroquine
-anti-inflam: sulfasalazine
DMARDs 2
-major biologic DMARD
-tumor necrosis factor (TNF) antagonists: Etanercept, Infliximab, Adalimumab, Certolizumab pegol, Golimumab
-B-lymphocyte-depleting agent: Rituximab
T-Cell Activation Inhibitor: Abatacept
DMARDs 3
-minor nonbiologic and nonbiologic DMARD
-Gold salts: Auranofin
-Penicillamine
-immunosupp meds for severe RA that does not respond to other meds: Azathioprine, Cyclosporine
Glucocorticoids for msk
-Prednisone
-Prednisolone
-long term use can cause immunosuppression
-Glucocorticoids relieve inflammation and pain as well as delay disease progression
NSAIDs
-ASA, ibuprofen, diclofenac, indomethacin, methotrexate, Naproxen sodium, celecoxib
-NSAIDs provide rapid relief of inflammation, no delay of disease progression
DMARD: MOA and use
-MOA: slow joint degen and progression
-uses: analgesia (NSAIDs) , maintain joint function, delay worsening (DMARDS and glucocorticoids), prevent organ rejection (glucocorticoids and immunosupp)
-effects can take 3-6 wks, full effect in several mths
-keep record of injections, sharps containers, check for clarity of solution with no particles
Methotrexate complications
-cytotoxic, report if having fever or sore throat, hepatotoxicity (give with folic acid), bone marrow supp, mouth/GI ulcers, fetal death/congenital abnormalities (use BC)
Cyclosporine complications
-infection risk, nephrotoxicity, hepatotoxicity, hirsutism (hair growth in women), gingival hyperplasia
-IV infuse over 2-6 hrs, monitor for reactions and stay with patient for 30 mins
-Oral form: mix w/ milk or OJ due to bad taste
Penicillamine complications
-bone marrow supp, itching, rash
Etanercept/Infliximab (Anti-TNF) complications
-SubQ site irritation, IV reactions (flu-like, hypotension, anaphylaxis=stop infusing), opportunistic infections, Stevens-Johnson syndrome, HF, blood dyscrasias
Hydroxychloroquine complications
-blindness from retinal damage (eye exam q 6mths)
Sulfasalazine complications
-GI discomfort, hepatic dysfunction, bone marrow supp, rash
Gold salts (Auranofin) complications
-toxicity (itching, rash, stomatitis/inflam mouth), renal toxicity, blood dyscrasias, hepatitis
Colchicine: antigout
-anit-inflam
-only effective for inflam from gout
-use: stop gout attack, treat acute attacks
-complications: mild GI distress (take w/ food, antidiarrheal meds, stop if severe), thrombocytopenia, Rhabdomyolysis
Allopurinol: anitgout
-for hyperuricemia, inhibits uric acid production
-use: hyperuricemia due to chronic gout/ secondary to cancer chemo
-complications: hypersensitivity, fever, rash, kidney and liver issues, GI distress, increase in gout attacks (take with colchicine or an NSAID to prevent)
