Pharmacology Clear and Simple – CH 12 – Musculoskeletal System Medicaions

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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

nervous system provides:
signals that make the muscles contract or relax and allow body to perform tasks such as picking up a spoon and bringing it to the mouth

a muscle that is not healthy:
cannot perform its functions

skeleton not only gives body structure, it:
also stores minerals that help muscles move

endocrine system must be ____ to control deposit of these minerals
healthy

thyroid gland produces:
calcitonin, which allows calcium to control deposit of these minerals

parathyroid glands secrete:
parathyroid hormone, which increases amount of calcium in blood and leads to loss of calcium in bones

if thyroid and parathyroid do not function correctly,
abnormal calcium levels may lead to bone abnormalities

calcium also assists in:
muscle contraction and nerve impulses, so abnormalities can lead to altered muscle functioning

other minerals stored in the bones also affect
musculoskeletal functioning (magnesium and potassium)

muscle disorders that originate in the brain:
cerebral palsy, stroke, MS

psychotropic drugs can cause:
muscle spasms

dystonia:
abnormal tension in one area of the body, such as limbs, neck, face, eyes or spine

Flexeril
muscle relaxant, cyclobenzaprine

antispasmodics:
like Skelaxin, metaxalone; muscle relaxants; relax muscles and relieve muscle spasms

muscle relaxants and anispasmodics work with the:
CNS to inhibit neurological activity that causes spasms or rigidity

benzodiazepines
Valium, diazepam

Cymbalts
duloxetine, used for chronic low back pain, is an antidepressant

Botulinum toxic type A
Botox and Botox Cosmetic, onabolulinumtoxin A, toxic substance derived from bacterium Clostridium botulinum, which in high doses causes good poisoning

botulism
food poisoning

Botox works by:
in low doses, acts as an effective muscle relaxant by blocking acetylcholine release and paralyzing muscle

Botox is used to treat:
chronic migraines, limb spasticity, abnormal head position and neck pain, severe underarm sweating, and certain eye muscle problems

cervical dystonia
neck pain

Botox lasts:
max effectiveness from 6 weeks and repeated every 3-6 months

botulinum toxin causes pain and is admin’d with:
local anasthetic

myasthenia gravis
autoimmune disease of skeletal muscle fatigue and weakness that is causes by loss of acetylcholine receptors, a breakdown in communication between nerves and muscles

neostigmine
a cholinesterase inhibitor, which blocks cholinesterase and can facilitate acetylcholine accumulation

fibromyalgia:
disorder of chronic pain in muscles and soft tissues surrounding joints; rheumatological illness, difficult to manage

treat fibromyalgia with:
PT, antidepressants, anti-inflammatory agens, trigger point injections, and narcotic analgesics

skeletal system has ___ bones
206

human skeleton is a repository for minerals such as ____
calcium

calcium is needed for:
nerves, bones and muscles to function properly

not enough calcium:
bones can break

too much calcium:
not enough is available for blood stream to deliver to muscles

parathyroid and thyroid glands ensure :
proper amounts of calcium in circulated and stored

parathyroid glands secrete
parathyroid hormone, which pulls calcium from bones into bloodstream

thyroid gland secretes
calcitonic, which deposits calcium into bones

if either thyroid or parathyroid gland fails
musculoskeletal disorders can result

hypocalcemia
low blood calcium

Lyrica
pregabalin; oral antileptic drug, used for fibromyalgia, shingles pain, & diabetic neuropathy pain

Vitamin D assists in :
absorption of calcium from stomach and helps to keep serume calcium levels for proper bone development

risk factors for hypocalcemia
smoking, lack of exercise, high alcohol consumption, anorexia, estrogen or testosterone deficienct, poor nutrition, obesity

Miacalcin
calcitonin, available as a nasal spray or injectable form

osteomalacia
lack of calcium and bones become soft, brittle and deformed

rickets
soft bones in children

osteoporosis
common bone disease that also results from lack of calcium in body; disease creates holes in bones, bones break easily

some meds inhibit bone resorption of calcium and can reduce extent of osteoporosis
estrogen replacement therapy (ERT); but has side effects, such as breast and uterine cancer and blood clots

bisphosphonate
such as Fosamax, to help with bone density

Paget’s Disease
enlarges the bone; resorbs bone excessively, but new bone is weak and fragile; bowing in lower limbs, pain, fractures

treatment for Paget’s disease:
calcitonin and bisphosphonates, to encourage strong bone formation, supplemental calcium and Vitamin D may also be taken

arthritis two types:
1. osteoarthritis
2. rheumatoid arthritis

osteoarthritis:
erosion of bone occurs where bones meet at joint

rheumatoid arthritis:
autoimmune condition, in which joints are affected by inflammation caused by a negative reaction from immune system

RA affects:
mostly women 30-50 years old

most common meds to treat OA and RA:
NSAIDS, such as Advil, Aleve, Motrin

Gout is a form of
arthritis characterized by sudden, severe attack of pain, redness, and joint tenderness, most commonly at joint of big toe and foot

gout affects:
men in middle age, and women after menopause

risk factors of gout:
excessive alcohol use, hypertension, diabetes, hyperlipidemia, and arteriosclerosis

gout is caused by:
uric acid buildup in joints. too much is produced or not enough is excreted by kidneys

meds for gout are:
often not admin’d until acute attack is over; uric acid may migrate to additional joints

gout attack symptoms are treated with:
NSAIDS

colcrys
colchicine, used to relieve gout pain

when acute gout attack is done, treat with:
antigout meds such as Zyloprim (allopurinol) or Uloric (febuxostat) to lower uric acid level in body

NSAIDS reduce
inflammation

side effects of NSAIDS:
GI bleeding, renal & cardiac damage from long-term use

topical meds for RA OA and gout:
menthol, salicylate, trolamine, creams and gels rubbed into muscles and joints; Absorbine, Bengay, IcyHot, and capsaicin

COX-2
cyclooxygenase-2 (COX-2) inhibitors (Celebrex) decrease production of prostaglandins that cause pain and inflammation; can’t be used by patients allergic to sulfa drugs

DMARDS
disease modifying antirheumatic drugs

DMARDS are used:
in patients with RA where the NSAIDS aren’t working to reduce inflammation enough

DMARDS suppress
autoimmune response, and suppress immunity systematically

DMARDS don’t cure disease they:
slow down the continual joint destruction; goal is continued joint mobility

Solganal
a DMARD, gold aurothioglucose, given by injection or oral, prevents joint damage and disability; works best in early stages of RA

Rheumatrex
methotrexate, an DMARD

Neoral
cyclosporine, a DMARD

Azulfidine
sulfasakazine, a DMARD

glucocorticosteroids are meds:
made to mimic cortisol, a hormone produced in adrenal gland

Decadron
dexamethasone, a glucocorticosteroid

Medrol
methylprednisolone, a glucocorticosteroid

corticosteroids reduce:
inflammation by suppressing the production of materials that trigger allergic and inflammatory responses, but don’t cure inflammatory diseases like arthritis and gout

corticosteroids reduce body’s
ability to fight infection, so used for short term therapy during acute symptomatic episodes

phantom limb pain:
amputated limbs, as a result of surgery or trauma, ache as if limb were still intact

phantom limb pain treated with:
tricyclic antidepressants such as Elavil (amitriptyline) and Pamelor (nortriptyline); tricyclic antidepressants, anticonvulsants, narcotics (Roxanol (morphine))

True or False: Gout is a disease caused by buildup of calcium in joints
False. It’s uric acid

True or False: Myasthenia gravis is a progressive autoimmune disease affecting muscles
True

True or False: Capsaicin is a drug made from hot peppers
True

True or False: NSAIDS are used for phantom limb pain
False

True or False: Osteoporosis can lead to increased risk of fractures
True

True or False: Fibromyalgia is an acute disorder of bones
False

True or False: Lyrica is a drug used to treat osteoarthritis
False

True or False: The endocrine system is important to keep proper levels of calcium in bones
True

True or False: Side effects of ERT can include breast and uterine cancer
True

True or False:Examples topical NSAIDS for gout, OA and RA include IcyHot, BenJay, capsaicin & Absorbine.
False

Osteomalacia is a:
Calcium disorder

What is a buildup of uric acid in the joints?
Gout

What is an example of DMARDS?
Gold salts and Cyclosporine

Which is used to treat dystonia?
Muscle relaxant and Antispasmodic

Which disorder is characterized by chronic pain in muscles and soft tissue surrounding joints?
Fibromyalgia

Examples of corticosteroids include:
Decadron

Examples of DMARDS include:
Rheumatrex

Examples of narcotics include:
Morphine

Examples of COX-2 inhibitors include
Celebrex

Which endocrine gland produces calcitonin?
Thyroid

An example of a muscular disorder that originates in the muscle itself:
(A)Cerebral palsy
(B)Muscular dystrophy
(C)Multiple sclerosis
(D)Stroke
(B)Muscular dystrophy

The endocrine gland that is responsible for keeping calcium in the bones is:
(A)Adrenal
(B)Thyroid
(C)Parathyroid
(D)Pancreas
B. Thyroid gland produces calcitonin which is responsible for keeping the calcium in the bones

What vitamin assists in the absorption of calcium?
(A)Vitamin A
(B)Vitamin B
(C)Vitamin C
(D)Vitamin D
D. Vitamin D assists in absorption of calcium and maintenance of adequate levels in blood for proper bone development.

All of the following are types of arthritis EXCEPT:
(A)Osteoarthritis
(B)Rheumatoid arthritis
(C)Fibromyalgia
(D)Gout
(C)Fibromyalgia

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