ATI Pharmacology Made Easy: Musculoskeletal System

stenosis
the abnormal narrowing of a passage in the body.

hemoglobin
a red protein responsible for transporting oxygen in the blood of vertebrates. Its molecule comprises four subunits, each containing an iron atom bound to a heme group.

lapratomy
a surgical incision into the abdominal cavity, for diagnosis or in preparation for surgery.

Primary Prevention
The U.S. Preventative Services Task Force (USPSTF) describes primary prevention as the measures taken to provide individuals with knowledge to prevent the onset of a targeted condition. In this type of prevention, nurses play the part of educators that offer information and counseling to communities and populations that encourage positive health behaviors. From providing immunizations to reinforcing the use of seat belts, programs are designed to avoid suffering and illness in patients, as well as avoid any type of cost supplementary to disease treatment. Primary prevention is typically the most economical method of health care

Secondary Prevention
Secondary prevention, a form of early disease detection, identifies individuals with high risk factors or preclinical diseases through screenings and regular care to prevent the onset of disease. Once identified, nurses work with these patients to reduce and manage controllable risks, modifying the individuals’ lifestyle choices and using early detection methods to catch diseases in their beginning stages when treatment may be more effective. Regular screenings, conducted by a preventative health care nurse, are the most common method of secondary prevention and can dramatically diminish the development of certain illnesses.

Tertiary Prevention
The third tier of prevention, tertiary prevention, is slightly different. This method involves the treatment of existing diseases in patients. At this point of care, nurses are tasked with helping individuals execute a care plan and make any additional behavior modifications necessary to improve conditions. As the primary and secondary methods have been unsuccessful, this stage encompasses methods of minimizing negative effects and preventing future complications.

murmur
A sound due to vibrations from the flow of blood through the heart or great vessels.

pericardial friction rub
creaking sound heard over the heart in some cases of pericarditis, due to rubbing of the inflamed pericardial surfaces as the heart contracts and relaxes; during normal sinus rhythm it is usually triphasic; during any rhythm it may be biphasic or uniphasic.

percussion
the act or technique of tapping the surface of a body part to learn the condition of the parts beneath by the resulting sound

palpataion
Examination with the hands, feeling for organs, masses, or infiltration of a part of the body, feeling the heart or pulse beat, or vibrations in the chest.

Two common muscloskeletal disoders
Rheumatoid arthritis
osteoporosis

Rheumatoid Arthritis
inflammatory disease of joints, surrounding structures, and other parts of the body.

Rheumatoid Arthritis S/S
Joint Stiffness
Pain
Swelling
Deformity

Goal of Drug Therapy for RA
Decrease pain and inflammation
prevent disabling deformities

Osteoporosis
Loss of calcium from bones that makes them porous and fragile.

What are some common causes of osteoporosis?
Menopause; aging
Long term glucocticoid therapy
poor calcium intake
chronic alcohol abuse
paget’s disease

Paget’s Disease
A disease that disrupts the replacement of old bone tissue with new bone tissue.

What changes in bone cause osteoporosis?
Decrease in bone density
greater osteoclast activity

Goal of Drug Therapy for Osteoporosis
Prevent excessive loss of calcium
Prevent fractures

What are the most common sites of fractures due to osteoporosis?
Hip
wrist
Spinal Vertebra

Muscular Disorders
Occurs as a result of dysfunction of central or peripheral nervous systems.

Myasthenia Gravis (MG)
A disease of the motor division of the peripheral nervous system, Auto immune disease that destroys actylcholine receptor sites on muscle fibers

Goal of Treatment for MG
Increase the amount of acetylcholine for muscle contraction.

What three types of drugs are used for RA?
Non steroidal anti-inflammatory drugs (NSAIDS)
Glucocorticoids
Disease-modifying anti rheumatic drugs (DMARDs)

What are DMARDs?
Drug theraphy for RA; decreases joint inflammation and joint damage.

-initially given with NSAIDs
-slow onset of therapeutic effects (weeks)
-May discontinue when therapeutic effects are reached.

Categories of DMARDs
DMARDs I- Major non-biologic
DMARDs II- Major biologic
DMARDs III- Minor non-biologic and biologic

DMARDs I
antimetabolite drugs that interfere with a normal metabolic process. (lymphocytes and antibodies)

Methotrexate
DMARD 1 Prototype drug

lefunomide (Arava)
DMARD 1 drug (non-prototype)

Expected pharmacological action of DMARDs 1
Immunosuppression
Can slow stop progression of RA
Treat cancer in large doses

DMARDs 1 Adverse Effects
Liver damage
Bone marrow suppression
increased risk of infection
gastrointestinal ulceration
pulmonary fibrosis

How is methotrexate administered?
Given once a week.
– oral
-subcutaneous
-intramuscular

Also given with a weekly folic acid supplement.

Rheumatoid Arthritis (RA) Inflammatory disease of joints the joints, their surrounding structures, and other parts of the body. Typically develops in older adults but children can also have. Rheumatoid Arthritis can result in Joint stiffness, pain, swelling, deformities WE WILL …

A health care professional is caring for a patient who is taking a calcium supplement and reports flank pain. The health care professional should suspect the patient has which of the following? Renal Calculi; Calcium supplements can cause renal calculi. …

A health care professional is caring for a patient who is taking a calcium supplement and reports flank pain. The health care professional should suspect the patient has which of the following? Renal calculi A health care professional is caring …

muscoskeletal system consists of: muscles, tendons, and ligaments that attach to bones and joints and rely on nervous and endocrine systems to function properly coordinated and strong movement require: healthy nerve signals, healthy muscle tissue, and adequate endocrine function WE …

etanercept (Enbrel) Disease-Modifying Antirheumatic Drugs (DMARDs) II Therapeutic Use • DMARDs are drugs that decrease joint inflammation, and subsequently, joint damage • DMARD II drugs are tumor necrosis factor antagonists – drugs that bind with naturally occurring tumor necrosis factor, …

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