Term
baclofen
carisoprodol
chlorzoxazone
cyclobenzaprine
dantolene
diazpam
metazalone
methocarbamol
orphenadrine
tizanidine |
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Definition
Skeletal muscle relaxants |
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Term
alendronate
etidronate
ibandronate
pamidronate
risedronate
tiludronate
zoledronic acid |
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Definition
Biophosphate Bone Resorption Inhibitors
Fosamax is alendronate
Boniva is ibandronate
Actonerl is risedronate |
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Term
adalimumab
anakinra
etanercept
hydroxychloroquine
infliximab
leflunomide
methotrexate (MTX)
sulfasalazine |
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Definition
All treat RA
Can be used for other condisiton as well (some)
Are DISEASE MODIFYING ANTIRHEUMATIC DRUGS |
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Term
allopurinol
colchicine
probenecid
sulfinpyrazone |
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Definition
URIC ACID INHIBITORS
All are used for gout
probenecid is used as an adjuvant to antibiotics |
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Term
Actions of skeletal muscle relaxants |
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Definition
not clearly understood; may be from sedative properties |
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Term
Adverse reactions to skeletal muscle relaxants |
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Definition
Most common is drowsiness and dizziness |
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Term
Contraindications of skeletal muscle relaxants |
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Definition
- No baclofen with rheumatisms
- No cyclobenzaprine in recent MI pts and hyperthyroidism, nor with MAOIs
- Carisoprodol contra in those hypersensitive to meprobamate
- Oral dantrolene contra during lactation, active hepatic disease and muscle spasms from rheumatic disorders
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Term
Precautionary use of skeletal muscle relaxants |
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Definition
i. Preg Cat C (cyclobenz. Is B)
ii. Carisprodol caution with severe liver/kidney |
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Term
Interactions skeletal muscle relaxants |
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Definition
- Cyclobenzaprine and MAOIs can lead to high fever and convulsions
- orphenadrin and haloperidol can increase psychosis
- tizanidine and antihypertensives and increase hypotension
- CNS depressants with skeletal muscle relaxants can increase the CNS depressant effect
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Term
Actions of biophosphate bone resorption inhibitors |
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Definition
a. inhibit bone (normal and abnormal) resorption, increasing mineral density, reversing progression of osteoporosis |
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Term
Uses biophosphate bone resorption inhibitors |
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Definition
a. mainly osteoporosis in postmenopausal women; also hypercalcemia of malignancies and Paget’s disease (abnormal bone remodeling making bones very susceptible to breaking) |
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Term
Adverse reactions biophosphate bone resorption inhibitors |
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Definition
i. N/V
ii. More or recurrent bone pain
iii. Headache
iv. Dyspepsia, acid regurgitation and dysphagia |
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Term
Contraindications/precautions biophosphate bone resorption inhibitors |
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Definition
i. Fosamax and Actonel contraindicated in hypocalcemia
ii. Alendronate in preg cat C
iii. All contraindicated in delayed esophageal emptying or renal impairment
iv. Not recommended to use with concurrent hormonal replacement therapy
v. Use cautiously in GI disorders or renal impairment |
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Term
Interactions of biophosphate bone resorption inhibitors |
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Definition
i. Effectiveness reduced if taken with calcium suppls or antacids with magnesium and aluminum
ii. If taken with aspirin will increases risk of bleeding
iii. Can make theophyline toxic |
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Term
What types of drugs are used for RA? |
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Definition
NSAIDs
corticosteroids
DMARDs |
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Term
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Definition
Disease Modifying Antirheumatic Drugs |
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Term
Actions and uses of DMARDs |
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Definition
a. Actions and Uses – used in RA after NSAIDS and pain relievers don’t work to treat the inflammation in joints;
i. are immunosupressants usually for RA and some other autoimmune disorders
ii. Can also be used for cancer |
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Term
Adverse reactions of DMARDs |
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Definition
i. N/V
ii. Stomatitis
iii. Alopecia |
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Term
Contraindications of DMARDs |
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Definition
i. Hypersensitivity
ii. Renal impairment, liver disease, alcohol abuse
iii. Enbrel, Humira Remicade not used in cong heart failure or a demyelinating disease (MS)
iv. Pregnancy |
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Term
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Definition
- obese
- diabetic
- hepatitis B or C
- must take precautions not to become pregnant
- With some must screen for TB b/c of immunosupression
- Also monitor for any other infections
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Term
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Definition
i. Sulfa antibiotics can risk toxicity
ii. Aspirin and NSAIDs can also risk toxicity |
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Term
Actions of uric acid inhibitors |
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Definition
a. some reduce production of uric acid, cochicine unknown, some increases uric acid excretion by kidneys |
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Term
uses of uric acid inhibitors |
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Definition
used for gout (flare-ups or as a prophylactic) where uric acid accumulates in blood then deposited in joints causing pain, redness, swelling, deformity |
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Term
Adverse reactions of uric acid inhibitors |
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Definition
- N/V diarrhea and abdominal pain
- Headache and urinary frequency
- Allopurinol can cause a severe skin rash and serious hypersensitivity
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Term
Contraindications of uric acid inhibitors |
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Definition
Some contraindicated with GI inflammation or ulcers |
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Term
Precautions uric acid inhibitors |
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Definition
renal impaired; pregnancy caty B or C, liver impaired, peptic ulcers |
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Term
Interactions of allopurinol (uric acid inhibitor) |
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Definition
- with alum. Based antacids can decrease effectiveness of allopurinol
- with theophylline increases risk of theophyline toxicity
- with ampicillin increases risk of rash
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Term
Interactions of probenecid (uric acid inhibitor) |
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Definition
- with NSAIDS can increase serum level of NSAID
- with salicylates can decrease effectiveness of probenecid
- with certain anti-infectives increases the level of the anti-infective
- with barbituates and bezodiazepines increase serum level of sedative
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Term
Interactions of sulfinpyrazone (uric acid inhibitor) |
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Definition
with oral anticoagulants increases bleeding risk
with tolbutamide for diabetes increases risk of hypoglycemia
with verapamil for heart condition increases effect of verapamil |
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Term
hydroxychloroquine
what kind of drug
seroius adverse reactions |
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Definition
- DMARD
- is especially monitored closely for skin rash, fever, cough and easy bruising. Also tinnitus, hearing loss and visual changes; immediately report. Visual disturbances can be permanent retinal damage.
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Term
allopurinol serious reaction |
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Definition
may cause skin rash; monitor closely bc may proceed more serious reaction like Steves-Johnson Syndrome Immediately report rash.
Inform PCP immediately of rash |
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Term
methotrexate serious reactions |
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Definition
- potentially toxic
- watch closely for adverse reactions
- liver, kindney and blood are monitored q 1-3 months
- report abnormal labs immediately
- pregnancy categry X, do not become pregnant while on and 8 weeks after therapy
- Notify PCP if following occur:
sore mouth or sores in mouth
diarrhea
fever
sore throat
easy bruising
rash, itching
N/V |
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Term
Importance of fluid with gout |
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Definition
a. For uric acid inhibitors
b. encourage lots of water
c. measure I&O – should put out 2 liters
d. Needed to excrete urates and prevent more uric acid stones
e. If pt fails to increase water, tellPCP; may be necessary to give IV fluids
f. Pt needs to drink about 3L a day. |
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Term
“Impaired Comfort: Gastric Distress rt irritation of gastric lining from admin of biophosphate bone reabsorption inhibitor" |
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Definition
- For best absorption and reduced GI distress, instruct to take when wake up with 6-8oz water while upright. Remain upright for at least 30 min
- etitronate not admined within 2 hours of food, supplements or antacids and usually given once a day
- Many biphosphonates available 1Xweek or 1Xmonth formulas
- ibandronate, zoledronic acid and pamidronate all come in parenteral form for less frequent dosing; pt must go to clinic for IV admin
- DMARDs, uric acid inhibitors and skeletal muscle relaxers given with or immediately after food to minimize GI distress
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Term
"Risk for Injury rt med-induced drowsiness and associated risk for imbalance and falls”
Re admin of drugs for skeletal disorders |
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Definition
- Many drugs for skeletal disorders cause drowsiness
- Pain and deformity may also hamper mobility
- Assist pt as needed
- If severe drowsiness, notify PCP before next dose
- Some pts may require assistance with ADLs
- Some may require position changes q 2 hours
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Term
Pt edu re: drugs for osteoporosis |
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Definition
i. take with 6-8 oz water first thing AM
ii. do not lie down for at least 30 minutes after
iii. Wait at least 30 min before any more food or drink
iv. May need calcium and D if not enough in diet
v. May take a while for full effect
vi. Do not take OTC unless approved byPCP |
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Term
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Definition
i. do not become pregnant with methotrexate, or 8 weeks after therapy
ii. Some are self-admin subQ, must teach re this, including rotation of sites and return demonstration
iii. Pt must report inflam and pain at injection sites
iv. May take a while for full effect
v. Do not take OTC unless approved byPCP
vi. NotifyPCP if while taking methotrexate the following occur:
1. sore mouth or sores in mouth
2. diarrhea
3. fever
4. sore throat
5. easy bruising
6. rash, itching
7. N/V |
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Term
Pt edu re: drugs for gout |
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Definition
i. Drink at least 10 glasses of water a day until acute attach subsides
ii. Take with food to minimize GI upset
iii. If drowsy, avoitd hazards
iv. NotifyPCP if pain not relieved in a few days or skin rash
v. Do not take OTC unless approved byPCP |
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Term
Pt edu re drugs for muscle spasm and cramping |
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Definition
i. May cause drowsiness – hazardous tasks
ii. Is for short-term use, do not take longer than 2-3 weeks
iii. Avoid alcohol or otherCNS depressants
iv. Do not take OTC unless approved byPCP |
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Term
Cyclobenzaprine and MAOIs |
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Definition
can cause high fever and convulsions |
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Term
CNS depressants and skeltetal muscle relaxants |
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Definition
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Term
Methotrexate
Type of drug
Adverse reactions
Pregnancy category |
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Definition
DMARD
Can be toxic
Pregnancy category X |
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Term
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Definition
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Term
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Definition
Not good, must not become pregnant (only methotrexate? Not sure) |
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Term
biophosphates common adverse reaction |
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Definition
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