Musculoskeletal Considerations Flashcards
(50 cards)
What are the main topics covered in the musculoskeletal considerations lecture?
Medications, corticosteroids, anabolic steroids, psychotropic meds, rheumatological meds, muscle relaxants, neuropathic medications, post-op joint replacement and fracture management, patient case examples, education on medications.
What are the considerations for chronic pain management?
Long-term use of medications, managing side effects, appropriate medication combinations, and monitoring for adverse events.
What are common pain medications used post-operatively?
- opioids
- acetaminophen
- anticoagulants
- muscle relaxants
- antibiotics
- stool softeners
What are the main goals of drug therapy for rheumatoid arthritis (RA)?
- decrease joint inflammation
- stop disease progression
What are the three main categories of drugs used for RA?
NSAIDs, glucocorticoids, disease-modifying antirheumatic drugs (DMARDs).
How do NSAIDs work in RA management?
Inhibit the COX enzyme, added pain relief, inhibition of prostaglandin synthesis.
What are the adverse effects of chronic NSAID use?
Stomach irritation, gastric ulceration, hemorrhage.
What is the controversy around intra-articular glucocorticoids for RA?
They may produce harmful catabolic effects in joints weakened by arthritic changes.
How do glucocorticoids reduce joint inflammation?
- Inhibiting the production of pro-inflammatory substances
- Increasing anti-inflammatory proteins
What are the adverse effects of glucocorticoids?
Muscle wasting, osteoporosis, hypertension, aggravation of diabetes, glaucoma, cataracts, increased infection risk.
What is the primary focus of DMARDs in RA treatment?
Delay disease progression, promote remission, control synovitis and erosive changes.
What are some common DMARDs used for RA?
- Antimalarials (Chloroquine, Hydroxychloroquine)
- Gold compounds (Auranofin)
- Non-biological (Methotrexate)
- Biological (Adalimumab, Infliximab)
What is Methotrexate commonly used for?
RA and cancer, slows RA effects, decreases synovitis and bone erosion, reduces joint space narrowing.
What are the adverse effects of Methotrexate?
GI issues, nausea, headache, long-term users may experience pulmonary problems, liver dysfunction, and hair loss.
How can diet affect RA symptoms?
Diets high in fatty acids and antioxidants can control inflammation, while meat and protein may exacerbate RA.
What is osteoarthritis (OA)?
A common joint disease caused by intrinsic defects in joint cartilage and subchondral bone remodeling.
How is OA commonly managed?
Pain management, maintaining an active lifestyle, using acetaminophen and NSAIDs, and topical treatments.
What are disease-modifying osteoarthritis drugs (DMOADs)?
Viscosupplementation with hyaluronan, glucosamine, and chondroitin sulfate supplements.
What are the rehab considerations for patients with RA and OA?
Medications should facilitate exercise and functional activity, be aware of adverse effects, and use ROM and strengthening exercises to avoid further injuries.
What are skeletal muscle relaxants used for?
Treat spasticity and muscle spasms, decrease muscle excitability and contraction.
What is the difference between spasticity and spasms?
- Spasticity is related to spinal cord or brain injuries
- Spasms are involuntary muscle contractions often after MSK injuries
What are anti-spasm drugs?
Diazepam, centrally acting drugs like Metaxalone, Cyclobenzaprine, and Methocarbamol.
What are the adverse effects of anti-spasm drugs?
Sedation, dizziness, nausea, light-headedness, ataxia, and headache.
What is Baclofen used for?
Reducing muscle spasticity, especially in conditions like MS, with fewer generalized weakness effects.
