Exam 3 Drugs

Exam 3 Drugs - Joint Disorders DRUGS OA RA methotrexate JRA...

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Joint Disorders DRUGS INDICATED FOR MOA ADVERSE EFFECTS ADMINISTRATION IMPLICATIONS methotrexate OA RA Folate antimetabolite that inhibits DNA synthesis In RA MOA unknown (immune modulator and anti- inflammatory) Pharyngitis Arachnoiditis Reddened skin Renal dysfunction Immunosuppression Adequate hydration important Monitor kidney function Pregnancy category X PO, IV, IM etanercept JRA RA Binds tumor necrosis factor (TNF) HA Injection site Irritation Upper respiratory infection Rhinitis Infection SubQ admin (refrigerate powder/ solution) Rotate signs of injection Pregnancy category B colchicine Prophylaxis Acute gouty attacks Decreases phagocytosis in joints & lactic acid production reducing deposition of urate crystals Nausea Vomiting Diarrhea Abdominal pain Reversible alopecia Blood dyscrasias Pregnancy category C (PO) ; D (IV) allopurinol Recurrent gouty attacks Inhibits xanthine oxidase Drowsiness Nausea Vomiting Diarrhea HA Active metabolite long metabolife Pregnancy category C
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Osteoarthritis: excessive wear & tear of articular cartilage of weight-bearing joints - S& S: Localized pain & stiffness Joint & bone enlargement Limitations in movement - Rh e u m at oid Arthritis: disfigure m e nt & inflam m ation of multiple joints – a utoimmune - Rhematoid factors (autoantibodies) activate complement & draw leukocytes into area, where attack normal cells → persistent injury & formation of - May produce systemic manifestations o Infections o Pulmonary disease o Pericarditis o Abnormal #s of blood cells o Fatigue o Anorexia o Weakness - Same analgesics and anti-inflammatories - Glucocorticoids (short-term) - Progression can be modified with DMARDs (disease-modifying antirheumatic drugs) Gout: actue arthritis caused by accu mulation of uric acid crystals → ↑ m e t abolism of nucleic acids or reduced excretion of uric acid by kidneys - Primary: genetic errors in uric acid metabolism - Secondary: disease or drugs that ↑ metabolic turnover of nucleic acids, or that interfere with uric acid excretion o Diabetic ketoacidosis o Kidney failure o Leukemia o Hemolytic anemia o Polycythemia
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DRUGS INDICATED FOR MOA ADVERSE  DAILY ADULT DOSE  LIMITS ADMINISTRATION  IMPLICATIONS calcium gluconate  Hypocalcemia  Osteoporosis  Paget’s disease Return serum levels of calcium  to normal  Hypercalcemia  Drowsiness  Lethargy  Weakness  HA  Anorexia  N/V  Increased   Thirst cardiac arrest PO: 1-2 g bid-tid  Give oral calcium  supplements with meals  or within 1 hour following   Administer IV slowly to  avoid hypotension,   Pregnancy category B etidronate disodium  Osteoporosis  Paget’s disease
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Exam 3 Drugs - Joint Disorders DRUGS OA RA methotrexate JRA...

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