Drugs for the Musculoskeletal System
Drugs for the Musculoskeletal System
-Drug treatment of musculoskeletal disorders
-Osteomyelitis- infection inside the bone. It is treated with antibiotics.
-Osteoporosis- is a decrease in total bone mass. Treatment consists of estrogen, calcium supplements, and a diet rich in calcium. Fosamax and actonel are used in prevention
-Bursitis, myositis, and synovitis
-Bursitis- inflammation of the bursae.
-Myositis- inflammation of the muscle.
-Synovitis- inflammation of the cavity surrounding a joint.
-Treatment consists of anti-inflammatory agents such as indocin and naprosyn. Sometimes hydrocortisone may be injected.
-Gout- inflammation of the joints that starts when there is an excess of uric acid in the bloodstream. Patients can be treated multiple ways.
-First is with the use of uricosuric drugs, which promote the excretion of uric acid. An example is sulfinpyrazone.
-Another option would be the use of antihyperuricemic drugs, which decrease the amount of uric acid the body produces. An example would be zyloprim.
-Treatments for acute attacks are colchicines, anti-inflammatory, corticosteroids.
-Osteoarthritis- also known as degenerative joint disease. A treatment consists of relieving the pain, protecting the joints from additional injury, and restoring joint function.
-Antiarthritic drugs
-Aspirin
-Nonsteroidal anti-inflammatory drugs, for patients who cannot tolerate aspirin.
-Rheumatoid arthritis- chronic inflammatory disease that affects the mobile joints.
-In the past high doses of aspirin and nonsteroidal anti-inflammatory drugs were used
-The most common disease-modifying drug is plaquenil
-Corticosteroids may be given either alone or in conjunction with plaquenil.
-The drug of choice for moderate to severe rheumatoid arthritis is methotrexate. Aspirin and nonsteroidal anti-inflammatory drugs may still be used with this drug therapy.
-Gold therapy is reserved for those who do not respond to methotrexate. Examples of this drug are imuran and depen. Aspirin and nonsteroidal anti-inflammatory drugs may still be used with this drug therapy.
-Newer classes of nonsteroidal anti-inflammatory drugs are COX-2 inhibitors. Examples are celebrex and vioxx. This drug treatment is under FDA review.
-Muscle pain- muscle relaxants are prescribed for these patients. The most common is antispasmotics; examples are lioresal, valium, and dantrium. Other muscle relaxants are robaxin, soma, paraflex, and cyclobenzaprine hydrochloride.
-Bone marrow disorders
-Aplastic anemia- failure of the bone marrow to produce enough of all three components of the blood
-Leukemia- over production of white blood cells
-Treatments can consist of blood transfusions, discontinue the offending drug, providing antibiotics until the white blood cell count is restored, treating non-drug induced cases, and considering erythropoietin to increase the red blood cell count.
-Care of patients with musculoskeletal disorders
-Administer pain medication on time.
-Handle patients with care.
-After moving the patient position patient in a position of comfort.
-Attend to psychological needs.
-Let your actions show you are aware of the patient’s fears.
-Refer to page 335-336 for representative drugs for the musculoskeletal system.
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