68Q Pharm 104: Musculoskeletal System Disease States and Pharmacotherapy pg.77-88 latest version with accurate questions and answers (PASS GUARANTEED)

Strain

pain and inflammation of muscles due to overstretching

Muscle Cramps

painful, spastic contractions

Fibromyalgia

chronic, idiopathic muscle pain syndrome described as burning, soreness at rest or after mild exertion and stiffness of muscles that can last all day

Bursitis

Inflammation of bursa caused by infection, trauma, overuse, rheumatoid arthritis, and gout. Symptoms include increase in synovial fluid and severe pain

Sprain

Ligament tear that gradually heals causing inflammation, localized pain, swelling, loss of function, and decrease in ligament elasticity

Tendonitis

Inflammation of tendons caused by injury, overuse, or aging. Symptoms include aches, pains, localized stiffness, burning around the joint, and pain worsens after activity

Arthritis

inflammation of a joint as body's response to reduce further injury causing swelling, warmth/redness of overlying skin, pain, and restriction of motion

Osteoarthritis

Affects weight bearing joints like hips/knees caused by deterioration of cartilage and overgrowth of bone due to wear/tear. Causes stiffness that lasts less than 15 min, boney swollen joints, loss of mobility, aching pain

Rheumatoid Arthritis

a chronic autoimmune disorder in which the body sees joint as foreign and makes antibodies to destroy it. Symptoms include joint stiffness, soft spongy joints, swelling, warmth, loss of mobility, pain, deformities requiring lifelong treatment

What drug class can treat Rheumatoid Arthritis?

Antirheumatics

What patient education would you give to someone taking an antirheumatoid?

Avoid prolonged exposure to sunlight

What is a contraindication of a antirheumatoid?

Hepatoxic and Nephrotoxic, liver and kidney function tests are required

Enbrel

Entercept

Remecade

Infliximab

Arava

Leflunomide

Rheumatrex

Methotrexate

Prostaglandins

A group of bioactive, hormone-like chemicals derived from fatty acids are responsible for pain response

What drug classes can be used to treat pain and inflammation?

Non-Steroidal Anti-Inflammatory Drugs (NSAIDS), COX2 inhibitor, Non-Opioid Agonists, Salicylic Acid Derivates (Salicylates), Opioid Agonists

Motrin, Advil

Ibuprofen

Indocin

Indomethacin

Toradol

Ketorolac

What should you know about Ketorolac?

Short term use only 3-5 days

Mobic

Meloxicam

Naprosyn, Aleve

Naproxen

Patient Education for NSAIDS

Take with food or milk and avoid concurrent use with aspirin

How do NSAIDS work?

inhibit prostaglandin synthesis

Celebrex

Celecoxib

Patient Education for COX2 Inhibitor

Use caution in patients with sulfa allergies and take with food or milk

Ultram

Tramadol

What schedule is Tramadol?

Schedule IV

How does Ultram/Tramadol work?

Binds to opiate receptors in CNS, inhibiting pain sensation

Ecotrin, Empirin

Aspirin

Disalcid

Salsalate

Contraindication of Salicylates

Avoid concurrent use with warfarin and NSAIDS (which thins out your blood) due to anti-platelet effects

What should a patient know about morphine?

Be cautious of oral liquid concentrations or morphine; 1 tsp. of oral solution may be lethal

Sublimaze, Duragesic

Fentanyl

Demerol

Meperidine

Dolophine

Methadone

Dilaudid

Hydromorphone

Roxanol, Duramorph, MS Contin 12HR, Oxycontin 12HR

Oxycodone

Lortab, Vicodin

Hydrocodone & Acetaminophen

Percocet, Roxicet

Oxycodone & Acetaminophen

Percodan

Oxycodone & Aspirin

Tylenol #3

Codeine & Acetaminophen

Butorphanol

Stadol

Which Opioid Agonist is Schedule 3?

Tylenol 3

Which Opioid Agonist is Schedule 4?

Butorphanol

MOA of Centrally Acting Skeletal Muscle Relaxants

Reduce spasticity by binding to GABA or a2 adrenergic receptor sites that control motor movements in CNS

Adverse Reaction of Centrally Acting Skeletal Muscle Relaxants

hypotension

Valium

Diazepam

Lioresal

Baclofen

Flexeril

cyclobenzaprine

Robaxin

methocarbamol

norflex

orphenadrine

Dantrium

Dantrolene

An Injectable Form of Dantrium can treat what?

Malignant Hyperthermia

How does Dantrium work?

Reduces spasticity by weakening hyper-excited muscles

What is an adverse reaction of Dantrium?

Fatigue

Gout

disease in response to urate crystals in joints, bones, and soft tissues

Triggers of Gout

Red meat, excess alcohol

Zyloprim

Allopurinol

Colcrys

Colchicine

Benemid

Probenecid

How do Anti Gouts work?

Reduces production of and increases urinary excretion of uric acid

Most Common Type of Bone Disease

osteoporosis

What is osteoporosis?

a medical condition in which the bones become brittle and fragile from loss of tissue, typically as a result of hormonal changes, or deficiency of calcium or vitamin D.

Osteomalacia

softening of the bone caused by calcium and vitamin D deficiency - symptoms: waddling gait, chronic fatigue

Rickets

osteomalacia in children that is reversible

Symptoms of Rickets

Delayed growth, muscle weakness, bowed legs, dental deformities

Osteomyelitis

inflammation of bone, bone marrow, periosterum caused by infection that can lead to destruction of a bone requiring amputation

Treatment for Osteomyelitis

Amputation, Antibiotics for 4-6 weeks or more

What drug class treats Osteoporosis?

Biphosphonates, Selective Estrogen Receptor Modulators (SERM), Calcitonin (Hormone), Anabolic Agent (Parathyroid Hormone Analog)

Fosamax

alendronate

Boniva

ibandronate

Actonel

risedronate

How do biphosphonates work?

Inhibits osteoclast acitvity

Adverse Reactions of Biphosphonates

NVD, Painful Swallowing, GI Upset

Patient Education for Biphosphonates

Do not lie down within 30-60 min after taking and take with plenty of water

Evista

Raloxifene

How does Evista work?

Binds to estrogen receptors producing an agonist in bone and lipid metabolism

Adverse Reactions of Evista?

Hot flashes, leg cramps, Deep Vein Thrombrosis

Fortical, Miacalcin

calcitonin

What does Calcitonin treat?

Osteoporosis in women postmenopausal after 5 years

How does Calcitonin work?

inhibits osteoclastic bone resorption

Adverse Reaction of Calcitonin

Rhinits

Patient Education for Calcitonin

Alternate daily use in each nostril

Forteo

Teriparatide

How does Forteo work?

Increases rate of bone remodeling and thickens bone structure

Adverse Reactions of Forteo

Hypercalcemia

Patient Education for Forteo

Refrigerate

Cause of Migraine Headaches

swollen blood vessels in meninges reducing blood flow to brain triggering inflammation/stimulating noicereceptors that cause throbbing head pain

What triggers a migraine headache?

stress, certain foods, exposure to bright lights

What drug classes treat migraine headaches?

MISC Antimigraine Drugs, 5-HT Agonists, Ergot Alkaloids

Fiorinal

butalbital/aspirin/caffeine

Floricet

butalbital/acetaminophen/caffeine

What schedule is Florinal?

Schedule 3

Imitrex

Sumatriptan

Maxalt

rizatriptan

Zomig

zolmitriptan

How do 5-HT Agonists work?

Works primarily on serotonin receptor causing cerebral vasoconstriction