Musculoskeletal Pharm

Question 1

what is calcium in the blood good for

Answer 1

clot factors, muscle contraction, and nerve function

Question 2

osteoblasts

Answer 2

create and set the bone

Question 3

osteoclasts

Answer 3

break down the bone (reabsorb)

Question 4

where do osteoblasts and class originate

Answer 4

in the bone marrow

Question 5

what is calcium absorption increased by

Answer 5

parathyroid hormone and vitamin D

Question 6

what decreases calcium absorption

Answer 6

glucocorticoids

Question 7

what eliminates calcium (excretes)

Answer 7

calcitonin

Question 8

what happens if there is TOO much serum calcium

Answer 8

give calcitonin to get rid of it

Question 9

how are calcium levels regulated

Answer 9

PTH
Vitamin D
Calcitonin

Question 10

where is calcium absorbed

Answer 10

small intestines

Question 11

where is calcium excreted

Answer 11

kidneys

Question 12

what are the 4 drugs for disorders involving calcium

Answer 12

calcium salts
Vitamin D
Calcitonin-salmon
Bisphosphonates

Question 13

what are the 3 names of calcitonin-salmon

Answer 13

calcimar, miacalcin, fortical

Question 14

what do the bisphosphonates typically end in and what is the main one we will look at

Answer 14

“ate”; alendronate

Question 15

bisphosphonates ______ bone resorption and the main side effect is_______

Answer 15

inhibits; gastritis

Question 16

what is the proper administration of bisphosphonates (alendronate)

Answer 16

take with full glass of water
take 30 minutes before food or other meds
remain upright for at least 30 minutes

Question 17

why do you take bisphosphonates on empty stomach and why should they remain upright after admin

Answer 17

food decreases absorption; prevents esophageal irritations

Question 18

calcitonin ____ bone resorption and is secreted by the ______

Answer 18

inhibits; thyroid gland

Question 19

what is the proper administration of calcitonin

Answer 19

give IM form at night to minimize side effects
alternate nostrils when using nasal form
MUST use calcium supplement with it

Question 20

why do you have to take calcium supplement with calcitonin

Answer 20

because pt will be at high risk for secondary hyperparathyroidism

Question 21

mimics estrogen by reducing bone reabsorption without stimulating tissue or breast or uterus

Answer 21

reloxifene (SERM)

Question 22

also given to REDUCE osteoporosis, uterine cancer, treat post menopausel

Answer 22

Raloxifene

Question 23

what are the side effects of reloxifene

Answer 23

leg cramps, hot flashes, and blood clots

Question 24

what is denosumab used for

Answer 24

used in women for high risk fractures

monoclonal antibody against formation of osteoclasts (birth control for osteoclasts)

Question 25

what is given most often for people on LONG TERM corticosteroid therapy

Answer 25

denosumab

Question 26

what is one of the WORST side effects of raloxifene

Answer 26

venous thromboembolism (VTE) so can not take this med while immobilized

Question 27

what is the only drug that increases bone formation

Answer 27

teriparatide (forteo)

Question 28

what does teriparatide do

Answer 28

increases osteoblasts

Question 29

what is the greatest concern when laying down new bone

Answer 29

osteosarcoma (bone cancer)

Question 30

what are the drugs that weaken the bacterial cell wall

Answer 30

cephalosporins and vancomycin

Question 31

what are the most widely used group of antibiotics and are similar to penicillin structure

Answer 31

cephalosporins

Question 32

what do cephalosporins cause and what is important about their toxicity

Answer 32

drug causes lyses and death; toxicity is low

Question 33

cephalosporins bind to _____ binding proteins, disrupts ___ ____ synthesis, and cause cell ____

Answer 33

penicillin; cell wall; lyses

Question 34

which of the cephalosporins are active against broad spectrum antibiotics

Answer 34

beta-lactum (3rd and 4th)

Question 35

what are the ceph generations in order

Answer 35

first gen= cefazolin second gen= cefaclor third gen= cefoperazone fourth gen= cefepime

Question 36

which generations can reach the cerebral spinal fluid

Answer 36

3rd- 5th

Question 37

how should you give cephalosporins if long term

Answer 37

through PICC or Central Line

Question 38

what are first and second generation cephs typically used for

Answer 38

pre op as prophylaxis

Question 39

what generation of cephs is the only one to treat MRSA

Answer 39

5th- ceftarolene

Question 40

what is the action of vancomycin and how should it be given

Answer 40

inhibits cell wall synthesis; given iv cause not absorbed from the gut

Question 41

vancomycin treats...

Answer 41

MRSA or staph

Question 42

why would oral version vanc be used

Answer 42

for C diff if metronidazole was ineffective

Question 43

what is main adverse effects of vancomycin

Answer 43

ototoxicity red mans (if given to fast) thrombophlebitis RENAL FAILURE

Question 44

bacteriocidal inhibitors of protein synthesis

Answer 44

aminoglycosides (gentamicin, tobramycin, amikacin)

Question 45

what is the use of aminoglycosides

Answer 45

aerobic gram neg bacilli and is a narrower spectrum antibiotic

Question 46

do ahminoglycosides cross CSF

Answer 46

NO

Question 47

what are the adverse effects of aminoglycosides

Answer 47

oto and nephrotoxicity

Question 48

why should you get a peak and trough on ahminoglycosides and vancomycin

Answer 48

wanna know the trough because this is what the serum level is BEFORE you give the dose

Question 49

peak levels must be ___ enough to kill bacteria; through levels must be ___ enough to minimize toxicity

Answer 49

high; low