Week 10 Flashcards
MSK drugs (28 cards)
Which NSAID irreversibly inhibits COX-1 and COX-2?
Aspirin
What is aspirin used for?
Pain relief
ASCVD secondary prevention
What are adverse effects of Aspirin?
Common: GI (ULCERS, UPSET STOMACH, diarrhea, dyspepsia), tinnitus, REYE SYNDROME (CHILDREN)
Chronic use: AKI, interstitial nephritis
INCREASES BLEEDING TIME BUT DOES NOT HAVE AN EFFECT ON PT OR PTT
OVERDOSE IS MIXED METABOLIC ACIDOSIS, RESPIRATORY ALKALOSIS
Which NSAID reversibly and selectively inhibits COX-2?
Celecoxib
What is Celecoxib used for?
Pain relief
What are some adverse effects of Celecoxib?
Common: GI (upset stomach, diarrhea, dyspepsia)
RARE/SERIOUS: CV (ACUTE MI, STROKE, HTN)
Chronic use: AKI, interstitial nephritis
LESS GI IRRITATION THAN OTHER NSAIDS
LESS ANTIPLATELET EFFECT
INCREASED RISK OF THROMBOSIS
Which NSAIDS reversibly inhibits COX-1 and COX-2?
Standard NSAIDs (ie: ibuprofen, naproxen, indomethacin, diclofenac, meloxicam)
What are Standard NSAIDs (ie: ibuprofen, naproxen, indomethacin, diclofenac, meloxicam) used for?
Pain relief
What are the side effects of Standard NSAIDs (ie: ibuprofen, naproxen, indomethacin, diclofenac, meloxicam)?
Common: GI (ULCERS, UPSET STOMACH, DIARRHEA, dyspepsia)
Rare/serious: CV, AKI
CONTRAINDICATED eGFR <30
Can consider PPI for GI protection
Meloxicam and diclofenac – more COX-2 selective standard NSAIDs
Which analgesic drug inhibits synthesis of prostaglandin?
Acetaminophen (Tylenol)
What does Acetaminophen (Tylenol) treat?
Pain relief
Fever
What are some side effects of Acetaminophen (Tylenol)?
Rare/serious: HEPATOTOXICITY
N-ACETYLCYSTEINE IS THE ANTIDOTE FOR OVERDOSE
Which drugs are bisphosphonate (antiresportive) that inhibit osteoclast to prevent bone resportion?
Alendronate, Ibandronate, Risedronate, and Zoledronic acid (Reclast)
What does Alendronate, Ibandronate, Risedronate, and Zoledronic acid (Reclast) treat?
Osteoporosis
Hypercalcemia
What are the side effects of Alendronate, Ibandronate, Risedronate, and Zoledronic acid (Reclast)?
Common: ESOPHAGITIS, myalgias
RARE/SERIOUS: OSTEONECROSIS OF THE JAW (ONJ), ATYPICAL FRACTURES, HYPOCALCEMIA
Zoledronic acid – IV only (injection site reactions)
For PO – take with full glass of water >30 minutes before first meal of the day, stay upright for at least 30 minutes after taking
Contraindicated with CrCL <30-35 (depends on specific agent)
Ibandronate – doesn’t have data supporting hip fracture prevention
Supplement with Vitamin D and Ca
Which drug is a RANK-L inhibitor (antiresorptive) that reduces osteoclast formation by reducing RANK-L activity?
Denosumab (Prolia)
What does Denosumab (Prolia) treat?
Osteoporosis
What are the adverse effects of Denosumab (Prolia)?
COMMON: INJECTION SITE REACTIONS
RARE/SERIOUS: ONJ, ATYPICAL FRACTURES, HYPOCALCEMIA
Contraindicated with hypocalcemia
Bone turnover rebound upon discontinuation, start another anti-resorptive therapy
Can use in CKD
Supplement with Vitamin D and Ca
Which drug is a parathyroid hormone analog that increases osteoblastic activity?
Teriparatide (Forteo)
What does Teriparatide (Forteo) treat?
Severe Osteoporosis
What are the adverse effects of Teriparatide (Forteo)?
Common: Nausea, dizziness, tachycardia, muscle spasms, hypercalcemia
RARE/SERIOUS: OSTEOSARCOMA
LIMIT DURATION OF USE TO 2 YEARS
Supplement with Vitamin D and Ca
Which drug is a selective estrogen receptor modulator (SERM) that is an agonist in bone and uterine tissues and antagonist in breast tissues?
Tamoxifen
What does Tamoxifen treat?
Breast Cancer
What are some adverse effects of Tamoxifen?
Common: hot flashes, peripheral edema, arthralgia, flu like symptoms
Serious/rare: thrombosis, increased stroke risk, higher risk of endometrial cancer
TAMOXIFEN HAS NOT BEEN STUDIED FOR OSTEOPOROSIS
