Musculoskeletal

Pregunta	Respuesta
Non-opioid analgesic	Acetaminophen (Tylenol)
Mechanism of Action	Inhibits COX- 1 which blocks prostaglandin production. Actual MOA unkown.
Adverse Effects	Hepatoxicity
Nursing Actions	3g/day max No alcohol Med can be crushed Acetylcysteine is antidote Monitor LFT
First Gen NSAIDs	Aspirin, Ibuprofen (Advil, Motrin)
Mechanism of Action	Blocks COX -1 and COX-2 activity to block synthesis of prostaglandins.
Prostaglandin	Make mucosal layer in stomach and play a role in platelet aggregation.
Side Effects	Bleeding tendencies Renal dysfuntion
Nursing Actions	Monitor for signs of bleeds Monitor for BUN and creatinine Don't crush DC 1 week before surgery Take with food or milk
Second Gen NSAIDs	Celecoxib (Celebrex)
Mechanism of Action	Blocks COX-2 activity. Has no effect on prostaglandins
Side effects	Renal dysfunction Cardiovascular events
Nursing actions	Teratogenic Monitor BUN and creatinine Take with food or drink.
Centrally acting non-opioid	Tramadol (Ultram)
Mechanism of Action	Binds to opioid receptors and blocks reuptake of norepinephrine and serotonin in CNS
Side effects	Sedation respiratory depression constipation
Nursing actions	metabolized into codeine monitor RR and vitals administer with food or water recommend lowest dose first
Opioid Pain Medication	Morphine Sulfate
Mechanism of Action	Mimics naturally occurring opioid. Depresses CNS and alters response to painful stimuli
Side effects	Respiratory depression abuse, tolerance constipation possible urinary retention
Nursing actions	Monitor RR and vitals Assess pain Risk for orthostatic hypotension Monitor bowel function
Opioid antagonist	Naloxone (Narcan)
Mechanism of Action	Blocks opioid action
Side effects	Arrythmias
Nursing Action	Monitor vitals Administer slowly
Selective estrogen reuptake modulators (SERMs)	Roloxifene (Evista)
Mechanism of action	Produces estrogen like effects on bone Reduces bone resorption
Side effects	Fractures VTE risk
Nursing actions	teratogenic Monitor bone scans Monitor for VTE
Bisphosphonates	Alendronate (Fossamax)
Mechanism of action	Decrease bone reabsorption by stopping osteoclast activity
Side effects	photosensitivity esophagitis N/V
Nursing actions	Sit upright for 30 mins after med admin Take on empty stomach Give with full glass of water
Hormone	Calcitonin (Miacalcin, Calcimar)
Mechanism of action	Inhibits osteoclast action and increases calcium excretion. decreases serum calcium
Side effects	allergic reactions hypocalcemia rhinitis
Nursing actions	Ask about fish allergies Monitor nares for patency Check for hypocalcemia
Calcium replacements	Calcium carbonate (Tums)
Mechanism of action	Non-dietary access to calcium
Side effects	hypercalcemia Kidney stones
Nursing actions	Check calcium levels Give 1 hr before or 2 hrs after other meds Monitor for s/s of hypercalcemia
Anti-Rheumatic Drugs (Nonbiological)	Methotrexate (Rheumatrex)
Mechanism of action	lower body's immune system
Side effects	Hair loss Low WBC, RBC Photosensitivity Immunosupressant
Nursing actions	Teratogenic No live vaccines Increase fluid
Anti-Rheumatic Drug (Non-Biological)	Hydroxychloroquine (Plaquenil)
Mechanism of action	Reduces inflammation
Side effects	Immunosupression
Nursing actions	Monitor labs and vitals

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	Creado por Yean Ji Jung hace más de 4 años