Exam 16 - Drugs for Msk

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

Which of the following correctly describes the mechanism of action for Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)?

They selectively inhibit the production of COX-1 enzymes.

They accelerate tissue response to injury.

They slow the production of inflammatory mediators derived from arachidonic acid. (correct)

They enhance the production of inflammatory mediators.

Which of the following is a characteristic of nonselective NSAIDs?

They have fewer side effects compared to selective NSAIDs.

They are only effective for pain management.

They block both COX-1 and COX-2 enzymes. (correct)

They primarily target COX-2 enzymes.

Which of the following is NOT a recommended nursing consideration when administering NSAIDs?

Encourage patients to increase their intake of fluids.

Administer without regard to recent surgical procedures. (correct)

Administer with food or beverages to reduce GI irritation.

Assess for signs of allergic reactions to NSAIDs.

What condition is not typically treated with NSAIDs?

Tuberculosis Signup and view all the answers

Which of the following best describes a serious adverse reaction to NSAIDs?

GI bleeding, ulceration, or perforation. Signup and view all the answers

What is a primary mechanism by which corticosteroids exert their therapeutic effects?

Inhibit production of inflammatory cytokines Signup and view all the answers

Which of the following conditions is NOT commonly treated with corticosteroids?

Chronic heart failure Signup and view all the answers

What is a potential long-term side effect of corticosteroid therapy?

Cushing syndrome Signup and view all the answers

How should corticosteroids be administered to minimize gastrointestinal upset?

With food Signup and view all the answers

What should patients receiving high-dose corticosteroids be monitored for after discontinuation?

Adrenal insufficiency symptoms Signup and view all the answers

Which of the following should be avoided during corticosteroid therapy?

NSAIDs Signup and view all the answers

Which of the following correctly describes a side effect of colchicine used for acute gout attacks?

Gastrointestinal upset. Signup and view all the answers

What mechanism is primarily used by capsaicin cream to relieve pain?

Depletes substance P from nerve endings Signup and view all the answers

Which medication requires that patients avoid foods high in purines to prevent gout attacks?

Allopurinol. Signup and view all the answers

Which side effect is commonly associated with tramadol?

Dizziness Signup and view all the answers

What is a critical nursing consideration when administering acetaminophen?

Evaluate for existing liver conditions Signup and view all the answers

What is a contraindication that must be considered when administering allopurinol?

Breastfeeding. Signup and view all the answers

What is a primary mechanism of action for cyclobenzaprine?

Depresses the CNS to slow motor nerve signal transmission Signup and view all the answers

Which condition is NOT associated with the use of bisphosphonates?

Acute gout. Signup and view all the answers

Which condition should contraindicate the use of tramadol?

History of seizures Signup and view all the answers

What is an important patient education point regarding the use of antidepressants like amitriptyline?

Medication may take 1-2 weeks before pain relief is experienced Signup and view all the answers

What nursing consideration is essential for patients taking bisphosphonates?

Remain upright for at least 30 minutes post-administration. Signup and view all the answers

Which of the following chronic inflammatory disorders is NOT typically treated with DMARDs?

Asthma Signup and view all the answers

What is a common side effect of using cyclobenzaprine?

Dry mouth Signup and view all the answers

What should be monitored regularly in patients undergoing treatment with allopurinol?

Uric acid levels. Signup and view all the answers

Which substance must be avoided when taking acetaminophen?

Alcohol Signup and view all the answers

What condition is pregabalin primarily used to treat?

Neuropathic pain Signup and view all the answers

Which of the following adverse reactions is associated with the use of gold salts?

Corneal deposits Signup and view all the answers

What is a key nursing consideration for patients starting azathioprine therapy?

Verify vaccination history Signup and view all the answers

What potential complication can arise from the use of hydroxychloroquine in patients?

Retinal edema Signup and view all the answers

Study Notes

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

Mechanism of Action: NSAIDs slow prostaglandin, kinins, histamine, tumor necrosis factor, and other inflammatory mediator production from arachidonic acid. This leads to analgesic, anti-inflammatory, and antipyretic effects, preventing tissue and blood vessel response to injury. NSAIDs are categorized as selective or nonselective.
Types:
- Nonselective NSAIDs: Block both COX-1 and COX-2 enzymes, leading to more side effects. COX-1 produces protective prostaglandins, while COX-2 is associated with inflammation. Examples include aspirin, ibuprofen, naproxen, nabumetone, and indomethacin.
- Selective NSAIDs: Primarily block COX-2 enzymes. Examples include celecoxib, meloxicam, and diclofenac.
- Inhibit platelet aggregation.
Uses: Myalgia, neuralgia, arthralgia, headache, dysmenorrhea, arthritis (rheumatoid, osteoarthritis, ankylosing spondylitis, gout), pain from procedures/injuries (dislocations, herniation of intervertebral disk), and clot prevention.
Side Effects: GI irritation (heartburn, nausea, vomiting), dizziness, headache, increased risk of bleeding, fluid retention, edema, increased blood pressure, reduced effectiveness of antihypertensive drugs, and increased risk of hypoglycemia in patients taking oral antidiabetic drugs.
Adverse Reactions/Contraindications: Allergic reactions, renal failure, GI bleeding/ulceration/perforation, blood disorders, increased risk of cardiovascular events (stroke, myocardial infarction), Reye syndrome (in children), and toxicity (tinnitus, hyperventilation, diaphoresis, thirst, headache, drowsiness, skin eruptions, electrolyte imbalances, CNS depression, stupor, convulsions, coma, tachycardia, respiratory insufficiency).

Corticosteroids

Types: Examples include prednisone, methylprednisolone, dexamethasone, and hydrocortisone.
Mechanism of Action: Decrease production of inflammatory cytokines (including COX-1 and COX-2) and white blood cells. Mimic natural cortisol hormones.
Uses: Reducing inflammatory, allergic, or immunologic responses in acute adrenal emergencies, allergic states, acute brain injury, severe asthma, herniation of intervertebral disk, carpal tunnel syndrome, arthritis (rheumatoid, osteoarthritis, ankylosing spondylitis, gout), inflammatory bowel diseases, systemic lupus erythematosus, fat embolism, and local injections for joint, soft tissue, bursae, or skin issues. Topical use for integumentary, rectal, ophthalmic, or otic problems is possible, inhaled corticosteroids are also common in asthma.
Side Effects (Short-term): Sodium and fluid retention, potassium depletion, increased blood pressure, acne, insomnia, nervousness, mood changes, and hyperglycemia.
Side Effects (Long-Term/Cushing Syndrome): Weight gain, fat redistribution (moon face, buffalo hump), loss of muscle mass/strength, thinning hair, hirsutism, stretch marks, immunosuppression, increased risk of bleeding, and GI ulcers/bleeding.
Adverse Reactions/Contraindications: Adrenal gland suppression (symptoms include anorexia, nausea, vomiting, lethargy, headache, fever, joint pain, skin peeling, myalgia, weight loss, hypotension), Immunosuppression (decreased WBCs, reduced infection signs), osteoporosis, cataracts, corneal fungal infections (blurred vision, discoloration, tearing), hypertension, and ocular hemorrhage.
Other Considerations: Corticosteroids should be tapered off rather than stopped abruptly. Monitor for infection signs (fever, cough, pain, drainage) and adrenal insufficiency (malaise, weakness, hypotension, anorexia, nausea, vomiting, aching, headache, elevated temperature) which can be fatal when abrupt tapering occurs.

Disease-Modifying Antirheumatic Drugs (DMARDs)

Types: Examples include etanercept, adalimumab, infliximab, and rituximab.
Mechanism of Action: DMARDs prevent chronic inflammatory diseases by inhibiting tumor necrosis factor (TNF), preventing TNF from binding to inflammatory cells; thereby reducing pain, improving physical function, and reducing tissue damage.
Uses: Chronic inflammatory disorders with severe tissue destruction caused by excessive TNF, including rheumatoid arthritis, ankylosing spondylitis, psoriasis, psoriatic arthritis, Crohn's disease, and ulcerative colitis.
Side Effects: Injection site reactions (pain, swelling, itching, redness), headache, nausea, and bone marrow suppression (anemia, increased risk of bleeding).
Adverse Reactions/Contraindications: Immunosuppression (increased risk of infection), heart failure, and anaphylaxis.

Other Musculoskeletal Medications

Further specifics regarding various classes including: antimalarials (Hydroxychloroquine, visual examination is needed), gold salts (renal/hepatic damage, corneal deposits, dermatitis, stomatitis, hematologic changes), antineoplastics (methotrexate, GI irritation), immunosuppressants (azathioprine, cyclophosphamide, GI irritation, rash), topical analgesics (capsaicin, rash, burning), nonopioid centrally acting analgesics (tramadol, sedation, dizziness, dry mouth, constipation, seizures), acetaminophen (mild to moderate pain, fever, potential hepatotoxicity at high doses), skeletal muscle relaxants (cyclobenzaprine, tizanidine, dizziness, headache, dry mouth, blurred vision, urinary retention, cardiac dysrhythmias), antidepressants (amitriptyline, duloxetine, chronic/cancer pain, neuropathic pain), anticonvulsants (pregabalin, fibromyalgia, neuropathic pain), other unspecified analgesics (for fractures, hip/knee replacements, compartment syndrome, strains, whiplash), colchicine (acute gout attacks), uricosurics (probenecid, gout, avoid aspirin), uric acid synthesis inhibitors (allopurinol, febuxostat, prevent/shorten gout), Bisphosphonates, estrogen receptor modulators, parathyroid hormone, calcitonin-salmon, calcium and Vitamin D supplements, indirect thrombin inhibitors (heparin and LMWH), vitamin K antagonists (warfarin).
Additional crucial information concerning all drugs: Careful assessment for contraindications, administration guidelines, monitoring for side effects, and patient education about adverse reactions (including specific guidelines concerning food, interactions, patient follow up, etc) are crucial aspects of drug use.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Description

This quiz covers the mechanisms, types, and uses of nonsteroidal anti-inflammatory drugs (NSAIDs). It provides details on nonselective and selective NSAIDs, their actions, and indications for use in various pain conditions. Test your knowledge on how these medications function and their therapeutic applications.