6.1 Drugs and Body Systems (Prt 1)

What are the functions of the musculoskeletal system?

• Allows movement

• Supports body structure

• Protects organs

• Stores minerals

Musculoskeletal conditions make up a group of more than ____ diseases and conditions that affect the muscles, joints, bones, and connective tissues of the body. 

150

What are the common musculoskeletal disorders?

Arthritis & Joint Conditions:

• Osteoarthritis (OA)

• Gout: Inflammatory arthritis

Spine and Back Disorders:

• Low Back Pain

• Herniated/Ruptured Disc

• Spinal Stenosis

• Spondylolisthesis

Tendons & Muscles:

• Tendinitis/Tendonitis

• Rotator Cuff Tear

• Fibromyalgia

Bone & Soft Tissue:

• Osteoporosis

• Osteopenia

• Carpal Tunnel Syndrome

• Fractures

What are the drug classes for musculoskeletal?

• NSAIDS

• Muscle relaxants

• Corticosteroids

• Bisphosphonates

• Gout

NSAIDs (pain/anti-inflammatory)

• Used for:

• Example:

• Most at risk:

• Safety concern:

• Clue:

• Pharm tech:

• Reduce pain, fever, and inflammation by blocking COX enzymes

• aspirin (Bayer, St. Joseph’s), ibuprofen (Advil, Motrin), oxaprozin (Daypro), celecoxib (Celebrex), salate (Disalcid), tolmetin (Tolectin), ketoprofen (Orudis, Ketaprofen ER, Oruvail)

• Cautiously in OLDER ADULTS (higher risk of stomach bleeding and kidney problems)

• Stomach irritation, bleeding, kidney failure

• TAKE w/ food (to reduce stomach upset)

• Not mixed w/ other NSAIDs

Muscle Relaxants

• Used for:

• Example:

• Most at risk:

• Safety concern:

• Clue

• Pharm tech:

• To alleviate muscle spasms (cramp), pain, and spasticity (rigid muscles) by relaxing tense muscle fibers

• baclofen (Lioresal), carisoprodol (Soma), cyclobenzaprine (Flexeril/Amrix), tizanidine (Zanaflex), metaxalone (Skelaxin), orphendarine (Norflex/Banflex/Flexon)

• Can increase fall risk in OLDER ADULTS

• Drowsiness, dizziness, and sedation

• Makes you drowsy

• AVOID driving and NOT combined w/ alcohol or other CNS depressants.

“often prescribed for SHORT-TERM use only.”

Corticosteroids

• Used for:

• Example:

• Most at risk:

• Safety concern:

• Clue:

• Pharm tech:

• Reduce severe inflammation in the body and autoimmune conditions (lupus, rheumatoid arthritis).

• hydrocortisone (Cortisol), betamethasone (Betnovate), prednisolone (Deltasone), ketoconazole (Nizoral), aminoglutethimide (Cytadren)

• Long-term use can lead to bone loss (osteoporosis)

• Weakened immune system (higher infection risk) and increased blood sugar

• Don’t stop immediately

• Best TAKEN w/ food to reduce stomach irritation and should NOT BE STOPPED suddenly after long-term use (taper required)

Bisphosphonates

• Used for:

• Example:

• Most at risk:

• Safety concern:

• Clue:

• Pharm tech:

• Used to treat osteoporosis by slowing bone breakdown (resorption) and fracture prevention

• tiludronate (Skelid), etidronate(Difronel), zoledronic acid (Zometa)

• Long-term use may increase the risk of atypical fractures or jaw problems (rare)

• Must stay upright for at least 30 minutes after taking (helps prevent throat/esophagus irritation), DO NOT take w/ other meds, food, or supplements at the same time.

• Stay upright

• Taken first thing in the morning on an empty stomach, also take w/ a full glass of plain water only AND don’t lie down.

Gout Medications

Allopurinol treats ________ AND Colchicine treats _______

What is the pharmacy safety focus?

• Uric acid (prevent gout)

• Inflammation (acute gout attacks)

1. Stop taking = MILD rash

2. Increased fluid

“AVOID kidney clients and liver disease”

:NOT a pain med”

What is the function of the cardiovascular system?

• Pumps blood through the body

• Delivers oxygen and nutrients

• Removes waste products

• Helps regulate blood pressure

What are the common cardiovascular problems?

• Hypertension

• Fluid overload

• Blood clots

• Irregular heart rhythm

What are the drug classes for cardiovascular?

• Antihypertensives (ACE inhibitors)

• Beta Blockers

• Calcium Channel Blockers

• Diuretics

• Anticoagulants

Antihypertensives (ACE Inhibitors)

• Used for:

• Example:

• Most at risk:

• Safety concern:

• Clue

• Pharm tech:

• Main side effect:

• To lower blood pressure and reduce strain on the heart by inhibiting the enzyme that produces angiotensin II, a substance that narrows blood vessels, and to improve circulation.

• benazepril (Lotensin), fosinopril (Monopril) “all ending in pril.”

• Kidney issues

• Risk of hypotension and MAY cause dizziness or lightheadedness

• Dry cough

• Monitor blood pressure

• Cough

“Patients should CHANGE positions slowly: orthostatic precautions help prevent falls.”

Beta Blockers

• Used for:

• Example:

• Most at risk:

• Safety concern:

• Clue

• Pharm tech:

• Main side effect:

• Used for hypertension, arrhythmias, and heart disease by blocking the effects of adrenaline and noradrenaline

• metoprolol (Lopressor) “all ending in olol”

• Heart patients and asthma

• Risk of bradycardia, which may cause fatigue or dizziness

• Lowers heart rate

• Monitor heart rate AND do not STOP suddenly

• Bradycardia

Calcium Channel Blockers

• Used for:

• Example:

• Most at risk:

• Safety concern:

• Clue

• Pharm tech:

• Manage high blood pressure by preventing calcium from entering heart and blood vessel muscle cells, leading to relaxed, widened vessels. Also used for angina and certain arrhythmias

• amlodipine (Norvasc) “all ending in ine” diltiazem (Cardizem), verapamil (Calan)

• Heart patients

• May cause ankle swelling

• Edema

• Avoid grapefruit juice w/ some meds/ hrt rate and bp should be monitored

“Patients may feel lightheaded

Diuretics

• Used for:

• Example:

• Most at risk:

• Safety concern:

• Clue

• Pharm tech:

• Main side effect

• Increase urine output and decrease fluid overload by reducing electrolyte reabsorption, drawing water into the nephron. The purpose is to remove excess fluid, reduce edema, and lower bp

• mannitol (Osmitrol), glycerol (Fleet), acetazolamide (Diamox), furosemide (Lasix), ethacrynic acid (Edecrin), metolazone (Zaroxolyn and Mykrox), spironolactone (Aldactone)

• Risk of dehydration

• Frequent urination

• Pee more

• Monitor daily weight and fluid intake

• Ototoxicity (damage your hearing)

“daily weight check for fluid status”

Anticoagulants

• Used for:

• Example:

• Most at risk:

• Safety concern:

• Clue

• Pharm tech:

• Known as blood thinners, these meds prevent or reduce the coagulation of blood (prevent blood clots and reduce risk of stroke or pulmonary embolism “pe→blood clot in the lung”)

• warfarin (Coumadin), dalteparin (Fragmin), dabigatran (Pradaxa), rivaroxaban (Xarelto), edoxaban (Savaysa), fondaparinux (Arixtra)

• High bleeding risk patients

• Bleeding and small dosing errors can cause serious harm

• Bruise easily

• Monitor for bruising or bleeding gums/ AVOID injury-prone activities: reduce fall risk

“DO NOT dissolve existing clots; they help prevent clot growth and new clot formation.”

“This is considered “HIGH-ALERT medications.”

What are the functions of the respiratory system?

• Brings oxygen into the body to support energy production in cells

• Removes carbon dioxide

• Allows gas exchange in the lungs

• Supports cellular respiration by maintaining adequate oxygen levels for tissues

What are the common respiratory conditions?

Asthma, COPD, Pneumonia, bronchitis, lung cancer, sleep apnea, cystic fibrosis, pe, sinusitis

What are the drug classes for respiratory?

• Bronchodilators

• Inhaled corticosteroid

• Antihistamine

• Decongestants

Bronchodilator

• Used for:

• Example:

• Most at risk:

• Safety concern:

• Clue

• Pharm tech:

• Relax airway muscles and open the airways. Used for asthma, bronchospasm, and shortness of breath.

• albuterol (Proair), salbutamol (Ventolin), bambuterol (Bambec), terbutaline (Brethine/Bricanyl), doxophyline (Doxolin), ipratropium Br. (Atrovent)

• Asthma pts

• Tachycardia, tremors(jittery), and nervousness

• Quick relief inhaler

• OVERUSE may indicate poor asthma control and need for reassessment/ TEACH correct inhaler technique/ MONITOR heart rate, especially in pts w/ cardiac history

“open everywhere, NOT just airway.”

Inhaled Corticosteroids

• Used for:

• Example:

• Most at risk:

• Safety concern:

• Clue

• Pharm tech:

• Reduce inflammation in the airways. Used for ASTHMA MAINTENANCE (long-term control) and chronic airway inflammation

• budesonide (Pulmicort), fluticasone (Flovent) “suffix- onide or -asone”

• Asthma pts

• Oral thrush (fungal infection in the mouth), hoarseness/voice changes

• Rinse mouth

• Pts should RINSE mouth after use/ monitor adherence: these work best when taken consistently

“USED daily for prevention and control, not for IMMEDIATE rescue.”

Antihistamines

• Used for:

• Example:

• Most at risk:

• Safety concern:

• Clue

• Pharm tech:

• Main side effects:

• Block histamine to reduce allergy symptoms. Used for allergic rhinitis, seasonal allergies, and itching or sneezing

• diphenhydramine (Benadryl), fexofenadine (Allerga), doxylamine (Unisom), dimenhydrinate (Dramamine)

• Older adults→ increased risk of falls and confusion w/ sedating agents

• Drowsiness and dry mouth

• makes sleepy

• AVOID driving and combining w/ alcohol

• Headaches, drowsiness, dry cough, and reduced coordination

Decongestant

• Used for:

• Example:

• Most at risk:

• Safety concern:

• Clue

• Pharm tech:

• Reduce nasal swelling by causing vasoconstriction (muscles around your blood vessels tighten). Used for nasal congestion and sinus pressure

• afrin (Oxymetazoline), Benzedrex, NeilMed SinuFrin

• High bp pts or w/ cardiovascular disease

• increased BP, insomnia, nervousness

• Keeps you awake

• AVOID late evening dosing to reduce insomnia

“SHORT-TERM USE is recommended to reduce side effects and rebound issues, product-dependent”

What is the function of the urinary system?

• Filters blood

• Removes waste products as urine

• Maintains fluid balance by adjusting how much water is excreted

• Helps regulate electrolytes

What are the common urology problems?

• UTIs, kidney stones, BPH, prostatitis

What are the drug classes for urinary?

• Bladder Antispasmodics

• Prostate drugs (Alpha Blockers/BPH medications)

Bladder Antispasmodics

• Used for:

• Example:

• Most at risk:

• Safety concern:

• Clue

• Pharm tech:

• Relax bladder muscles to reduce spasms and urgency. Used for overactive bladder, urinary urgency, and incontinence

• SOFT blaDAR

Solifenacin, Oxybutynin, Fesoterodine, Tolterodine, DARifenacin

• Use caution in older adults→ may cause dizziness and blurred vision; caution w/ driving

• Dry mouth, constipation, and blurred vision

• Encourage hydration

• Monitor urinary retention (trouble starting urine stream, feeling unable to empty bladder)

Prostate Drugs (Alpha Blockers/BPH medications)

• Used for:

• Example:

• Most at risk:

• Safety concern:

• Pharm tech:

• Relax prostate and bladder neck muscles to improve urine flow. Used for benign prostatic hyperplasia, difficulty urinating, and a weak urine stream

• terazosin (Hytrin), doxazosin (Cardura), tadalafil (Cialis), dutasteride (Avodart)

• Dizziness, low bp, and fall risk

• Monitor blood pressure/ Patients should not consuming w/ alcohol

What are the functions of the nervous system?

• Controls thoughts and emotions

• Coordinates movement

• Process sensory information = pain, temperature, touch, vision, and sound

• Regulates body functions = breathing, hrt rate, sleep, digestion, and stress response

What are the common neurological and psychiatric problems?

• Multiple sclerosis, epilepsy, migraine, restless leg syndrome, depression, bipolar mood disorder, anxiety

What are the drug classes for the nervous system?

• Antidepressants

• Antipsychotics

• Anticonvulsants

Antidepressant

• Used for:

• Example:

• Most at risk:

• Safety concern:

• Pharm tech:

• To help regulate brain chemicals that affect mood commonly serotonin, norepinephrine, and dopamine pathways. Used for depression, anxiety disorders, and mood disorders.

• sertraline (Zoloft), duloxetine (Cymbalta), escitalopram (Lexapro), bupropion (Wellbutrin), propranolol (Inderal)

• Delayed onset of many antidepressants takes SEVERAL WEEKS for full symptom improvement

• DO NOT STOP suddenly, as it can cause withdrawal-like symptoms and symptom rebound

• Monitor mood changes

“ADHERENCE matters, consistent dosing supports stable brain levels and better outcomes”

Antipsychotics

• Used for:

• Example:

• Most at risk:

• Safety concern:

• Pharm tech:

• To help control SYMPTOMS of severe mental illness by altering brain signaling, often targeting dopamine and sometimes serotonin receptors. Used for schizophrenia, bipolar disorder, and severe psychosis.

• haloperidol (Haldol), fluphenazine (Fluanxol), risperidone (Risperdal), aripiprazole (Abilify), zuclopenthixol (Clopixol)

• Heat sensitivity possible some patients may have impaired temperature regulation ENCOURAGE hydration and caution in heat

• Sedation, weight gain, movement disorders

• Monitor for excessive drowsiness increased fall risk and impaired driving or decison-making/ watch for tremors or stiffness that need to reporting

“ENCOURAGE ADHERENCE missed doses CAN CAUSE symptom relapse and hospitalization risk.”

Anticonvulsant

• Used for:

• Example:

• Most at risk:

• Safety concern:

• Pharm tech:

• Prevent or control seizures by stabilizing electrical activity in the brain. Used for epilepsy, seizure disorders, and sometimes nerve pain

• ethosuximide (Zarontin), clonazepam (Klonopin), phenobarbitone (Luminal), carbamazepine (Tegretol)

• Seizure risk if doses are missed (seizure thres-hold), dizziness, and fatigue

• Therapeutic levels may be MONITORED/ Must be taken CONSISTENTLY/ AVOID abrupt discontinuation can trigger seizures

“Driving precautions may be NEEDED”

1. Why might taking two medications for pain and inflammation at the same time be dangerous?

2. Explain why dizziness after starting a new blood pressure medication could increase fall risk.

1. Can cause too many side effects, such as gastrointestinal bleeding, stomach ulcers, and kidney damage

2. Dizziness can make you fall more easily

1. A patient says their rescue inhaler “doesn’t last very long.” What might this suggest about their condition?

2. Why is it important for some medications to be taken at the same time every day?

3. Describe how excess fluid in the body could affect breathing or heart function.

1. It may mean their condition is getting worse or not controlled

2. It keeps the drug level steady in the body

3. Extra fluid can make it harder to breathe and strain the heart

1. Why might daily weight changes be an important sign for some patients taking medication?

2. Explain why some medications require very accurate dosing and careful double checking.

3. Why might a medication that relaxes muscles also affect coordination or alertness?

1. Sudden weight change can mean fluid buildup

2. It can cause serious harm or overdose

3. It can make you sleepy and less alert

1. How could certain allergy medications affect a person’s ability to drive or operate machinery?

2. Why might a patient need to rinse their mouth after using a medication delivered through an inhaler?

3. Explain how swelling in the ankles could be related to a medication rather than an injury.

1. They can cause drowsiness and slow reaction time

2. To prevent oral thrush

3. Some meds cause fluid buildup (swelling)

1. Why might a medication that opens airways also cause nervousness or a fast heartbeat?

2. Describe why some medications should not be stopped suddenly after long-term use.

3. Why might taking a medication late in the evening interfere with sleep?

1. It can stimulate the body, causing a fast heart rate

2. The body may not adjust fast enough, causing illness

3. Some meds keep you awake

1. How could preventing blood clots help reduce the risk of stroke or heart attack?

2. Explain why some medications require patients to stay upright after taking them.

3. Why might older adults be more sensitive to side effects like dizziness or sedation?

1. It helps stop clots that cause stroke or heart attack

2. To prevent throat irritation or damage

3. Because their body processes drugs more slowly

1. How could misunderstanding when to use a medication lead to poor symptom control?

2. Why is it important for pharmacy staff to ask patients about other medications they are already taking?

3. Describe one way medication side effects could be mistaken for a new health problem. 

1. It may not work properly, so their symptoms don’t get better

2. To prevent drug interactions

3. A side effect like dizziness from a medication could be mistaken for a new illness, such as an inner ear problem.