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Published byNelson Craig Modified over 9 years ago
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Musculoskeletal Medications Osteoporosis Rheumatoid Arthritis Gout Muscle Spasms
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Osteoporosis Medications Calcium Supplements –Calcium, Vitamin D, combination of both
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Symptoms Hypocalcemia –Nerve and muscle excitability –Muscle twitching, tremors, cramping –Numbness, tingling, convulsions Symptoms Hypercalcemia –Nausea/vomiting, anorexia –Increased thirst, increased urination –Muscle pain/weakness Osteoporosis Medications
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Bisphosphonates (Bone Resorption Inhibitors) –Action draws calcium from blood to bone increasing bone mineralization –Example alendronate (Fosamax) –Uses osteoporosis, Paget’s disease, hypercalcemia 2 o malignancy –Adverse Reactions GI discomfort and esophageal irritation
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Osteoporosis Medications Bisphosphonates –Nursing Considerations Given once weekly Give on an empty stomach (poorly absorbed) Remain upright for 30 minutes after (esophageal irritation)
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NSAID’s –Analgesic effect –Anti-inflammatory effect –GI Distress Corticosteroids –Anti-inflammatory effect –GI Distress –Long term effects Rheumatoid Arthritis Medications
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Disease-Modifying Antirheumatic Drugs (DMARD’s) –Cytotoxic Drugs –Gold Salts –Antimalarial Agents –Sulfasalazine Rheumatoid Arthritis Medications
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Disease-Modifying Antirheumatic Drugs (DMARD’s) –Common Side Effects GI discomfort/ulceration Hepatic dysfunction Myelosuppression Rheumatoid Arthritis Medications
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Disease-Modifying Antirheumatic Drugs (DMARD’s) –Cytotoxic Drugs methotrexate (Rheumatrex) Nausea, stomatitis, alopecia, myelosuppression Rheumatoid Arthritis Medications
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Disease-Modifying Antirheumatic Drugs (DMARD’s) –Antimalarial Agents hydrochloroquine (Plaquenil) Relatively few side effects except for retinal damage causing blindness Rheumatoid Arthritis Medications
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Disease-Modifying Antirheumatic Drugs (DMARD’s) –Sulfasalazine sulfasalazine (Azulfidine) GI discomfort (n/v, diarrhea, cramping) Hepatotoxicity Myelosuppression Rheumatoid Arthritis Medications
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Disease-Modifying Antirheumatic Drugs (DMARD’s) –Evaluation Therapeutic Effect Relief of pain Decreased inflammation, swelling Increased joint function Rheumatoid Arthritis Medications
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Disease-Modifying Antirheumatic Drugs (DMARD’s) –Evaluation Adverse Reactions GI discomfort, ulceration, bleeding Liver function tests CBC, platelet count Rheumatoid Arthritis Medications
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Acute Gout –NSAID’s Decrease pain / inflammation –colchicine Decrease inflammation GI Distress, diarrhea 0.5 mg q 1-2 h until pain relieved or adverse reactions (max = 4 mg) Anti-Gout Medications
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Chronic Gout –allopurinol (Zyloprim) Decrease uric acid production –probenecid (Benemid) Increases uric acid excretion in kidneys Avoid ASA products May be used to potentiate action of penicillin and cephalosporins
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Anti-Gout Medications Nursing Considerations –Decrease foods high in purine (animal fats) –Increase fluid intake (2-3 L / day) Evaluation –Decreased pain / inflammation –Decreased number acute attacks –Decreased uric acid levels
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Muscle Relaxants Common Uses –Muscle spasm –Back pain Example –baclofen (Lioresal) Side Effects / Nursing Considerations –Drowsiness, lethargy, confusion –Avoid concurrent use with other CNS depressants
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Review –Osteoporosis Calcium supplements replenish calcium levels Bone resorption inhibitors move calcium from blood to bone Musculoskeltal Medications
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Review –Rheumatoid Arthritis NSAID’s provide short term immediate pain relief Corticosteroids provide intermediate use for decreasing inflammation DMARD’s provide long term use for slowing progression of disease Musculoskeletal Medications
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Review –Gout colchicine used to treat acute gout allopurinol (Zyloprim) used daily to prevent chronic gout episodes probenecid (Benemid) chronic gout and antiobiotic (penicillin and cephalosporins) potentiator Musculoskeletal Medications
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Review –Muscle relaxants Used to treat back pain and/or muscle spasms CNS depressants Musculoskeletal Medications
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