Treatments

Muscle Strain

- Nsaids

- tylenol

- ice 20 mins

- bed rest (no more than 2 days)

- PT (back to school)

Herniated Disc

- Nsaids

- Narcotics (no more than 7 days)

- Epidural Steroid injection (3 in 6 months allowed)

- decreased activity (1-2 days)

Cauda Equina

- Immediate surgical referral

Scoliosis

- braces (night only/ day)

- Surgery (ORIF) when skeletally mature

Osteoarthritis

- Nsaids

- Tylenol

- Intra-articular injections (triamcinolone)

- Surgery (Joint Arthroplasty)

Meniscus Injury

- Rice

- Surgical: Arthroscopic debridement or repair

ACL Injury

- Rice

- aspiration of hemarthrosis

- knee immobilizer

- surgical: ACL Reconstruction

Osteoporosis

- Bisphosphonates

- Vitamin D and Calcium

- Calcitonin

- Selective Estrogen Receptor Modulators (SERMs)

- Estrogen/ Progestin therapy

Bisphosphonates are:

- First line of therapy for OP

- indicated for DXA

Bisphosphonate medications

- Alendronate (Fosamax) 70 mg once weekly

- Risedronate (Actonel) 35 mg po once weekly

- Ibandronate Sodium (Boniva) 150 mg once monthly

Vitamine D and Calcium are used for:

- Vitamin D needed for absorption of calcium into GI tract

- Calcium is supplementation for those whose dietary intake is low

Calcitonin is

- antiresorptive medication to reduce risk of vertebral fracture

- administered via nasal spray

Selective Estrogen Receptor Modulators (SERMs) help to:

- increase bone density by 1% over 2 years

- reduce LDL cholesterol

- reduce risk of breast cancer by 76% after 3 years

-TERATOGEN to fetus (contradicted in pre-menopausal)

SERMs Medications

Evista (Raloxifene)

Estrogen/ Progestin Therapy was ______ and outdated risks include:

- recently approved as a treatment for OP and Menopause

outdated risks include:

- breast cancer

- heart attack

- stroke

Rheumatoid Arthritus goal of treatment

reduce inflammation, pain, preserve function, and prevent deformity

Rheumatoid Arthritis Medications

- low dose corticosteroids

DMARDS:

- Sulfasalazine

- Methotrexate

- Biological Response Modifyers

low-dose corticosteroid medication:

prednisone

Sulfasalazine is:

DMARD

- similar to methotrexate

- NOT teratogenic (for premenopausal women)

Methotrexate is:

DMARD

- increases adenosine levels in body

Methotrexate medication

Methotrexate - once a week PO or IM

Biological Response Modifiers (biologicals) are:

- newest class of DMARDs

- act like a protein in pts immune system

- tumor necrosis factor blocker

- can lead to tuberculosis, Herpes zoster, and fungal infections

Biologicals medications

Etanercept (Enbrel) - IM

Adalimumab (Humira) - IM

Infliximab (Remicade) - IM

What is a tumor necrosis factor? Blocker?

- TNF is a protein in the immune system that contributes to inflammation and joint damage

- TNF blockers (biologicals) block the action of TNF that leads to damage from abnormal inflammation