21. Musculoskeletal & Anti-Inflammatory Drugs

Unit 3
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Terms in this set (...)

Musculoskeletal Drugs (2 categories)
1. Skeletal Muscle Relaxants
2. Nonsteroidal anti-inflammatory drugs (NSAIDs)
Skeletal Muscle Relaxants
-classification of drugs that are associated with pain, spasm, abnormal contraction, impaired mobility
-short term basis
-affect the spinal cord and brain with no direct effect on the skeletal muscle
-causes alterations in perception of pain & produces a sedative effect
Dantrolene
-type of muscle relaxant that causes a direct effect on the skeletal muscles
-manages spasticity (MS or cerebral palsy)
-Not for muscle spasms from rheumatic disorders
neuromuscular blocking agents (NMBAs)
-used during surgical, endoscopic, or orthopedic procedures
-can result in respiratory arrest because of the potential to paralyze major muscle of ventilation, the diaphragm
-only administered by anethesiologists
Neopstigmine (Prostigmin)
-used as an antidote for NMBAs
-used in diagnosis & tx of myasthenia gravis
Skeletal Muscle Relaxants (Side Effects)
-Drowsiness, dizziness, dry mouth, weakness, tremor, ataxia, headache, confusion, nervousness, slurred speech, blurred vision, hypotention, GI symptoms, frequency of urination, liver toxicity, respiratory depression
Skeletal Muscle Relaxants (Contraindications)
Hypersensitivity to the muscle relaxant, pregnancy, lactation
Skeletal Muscle Relaxants (Caution)
Hx of drug abuse, impaired kidney function, liver disorders, blood dyscrasias, COPD, cardiac disorders, older adults, abrupt discontinuation, closed-angled glaucoma
Skeletal Muscle Relaxants (Interactions)
Alcohol, Analgesics, Psychotropic drugs, antihistamines
Anti-Inflammatory drugs
-drugs used to treat disorders in which the musculoskeletal system is not functioning properly due to inflammation
NSAIDs
-Nonsteroidal Anti-inflammatory Drugs
-Inhibit synthesis of prostaglandins
prostaglandins
substance responsible for production much of the inflammation and pain of rheumatic conditions, sprains, and menstrual cramps
COX-2 Inhibitor
-shuts down the "good" prostaglandin, raising the risk of high blood pressure, artherosclerosis, and clotting
Celecoxib (Celebrex)
-NSAID that exhibits anti-inflammatory, analgesic, and antipyretic activities by selecting cyclooxygenase-2 prostaglandin synthesis
-does not inhibit clotting or the production of mucosal-protective prostaglandins
-causes fewer gastic problems
NSAIDs (Side Effects)
GI ulceration & bleeding, GERD, myocardial infarction, stroke, fluid retention, constipation, tinntus, headache, visual disturbances, liver toxicity
NSAIDs (Contraindications or extreme caution)
Asthma, Cardiovascular disorders, kidney dz, liver dysfunction, hx of GI ulcer or IBD, children with viral infections, GERD, older adults, aspirin/NSAID hypersensitivity or sulfonaminde hypersensitiviy
NSAIDs (Interactions)
Alcohol, Anticoagulants, Corticosteroids, Aspirin + NSAIDs, Antihypertensives, Lithium, Methotrexate, Uricosurics
Gout
-metabolic disorder
-accumulation of uric acid crystals in various joints (big toe)
Colchicine
-specific drug used to relieve inflammation in acute gouty arthritis
-used in the chronic management of gout
Gout Medications (Side Effects)
Rash, GI upset, diarrhea, blood disorders
Osteoporosis
-Disease characterized by low bone mass and deterioration of bone tissue, leading to bone fragility
Osteoporosis Therapy
-Includes calcium and vitamin D supplementation
Hormone Replacement Therapy (HRT)
Estrogen without progestin used for osteoporosis prevention & treatment
Raloxifene (Evista)
-Selective Estrogen Receptor Modifiers (SERMs)
-estrogen agonist activity on bone & lipids
-increased bone mineral density and reduced fracture risk without promoting breast or endometrial cancer
-can cause hot flashes and muscle cramps in legs
Calcitonin-Salmon
-increases spinal bone density and provides analgesic effect in acute vertebral fractures
-for women who can't tolerate HRT
-nasal spray
Teriparatide (Forteo)
-Injectable form of parathyroid hormone approved for postmenopausal women and men with osteoporosis who are at high risk for a fracture
-increases GI calcium absorption
Bisphosphonates
-nonhormonal agents that act directly to inhibit bone reabsorption
-increases bone density at the spine & hip
Bisphosphonates (Side Effects)
-GI distress
-Abdominal & chest pain
Bisphosphonates (Caution)
Upper GI problems (GERD, dysphagia, gastritis, ulcers
Bisphosphonates (Contraindications & Cautions)
-Hypocalcemia
-Renal Failure
-Inability to sit upright for 30-60 minutes after taking drug