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MSK Pharmacology - Coggle Diagram
MSK Pharmacology
Related Diseases and Pharmacological Control
Hypoparathyroidism
what does this lead to
hypocalcemia
description
low blood Ca2+ levels
treatment (2)
Ca++ supplementation
Vitamin D
Hyperparathyroidism
what does this lead to
excessive bone resorption and hypercalcemia
why does it lead to excessive bone reabsorption
bc this cause excessive PTH levels, which increase osteoclast activity to cause bone breakdown to release Ca2+ from bone
what else can this cause
arrythmias
treatment
Surgical resection of parathyroid gland
Osteoporosis
leads to what
bone demineralization
what can this lead to
increase chance of fxs
what population is at more risk
Postmenopausal women
treatment (6)
calcium supplements
vitamin D
estrogen
what does this do
maintain bone minerlization
what adverse effect can occur
can increase certain forms of cancer when combined with what
progestin
select estrogen receptor modulators (SERMs)
what can this do
decrease certain forms of cancer
but id does not do what
decrease post-menopausal symptoms
biphophonates
what does it do (2)
appear to absorb calsim directly into bone and decrease osteoclast activity
calcitonin supplements
Rickets
what causes this
vitamin D deficiency
treatment (2)
Vita. D and calcium supplements
what is the adult form of rickets called
osteomalacia
treatment (2)
Vita. D and calcium supplements
Pagets disease
description
Excessive bone formation
2 ways this can occur
Ineffective remodeling
Structural abnormalities
treatment (2)
calcitonin and biphosphonates
Renal osteodystrophy
description
excessive bone resorption from chronic renal failure
treatment (2)
Vita. D and calcium supplements
how to avoid overstress of affected system (2)
Gradually increase loading
Emphasize axial loading
Skeletal Muscle Relaxants
what is the primary goal of usage
reduce dysfunctional SkM activity
Type of med used depends upon what 2 things
type of dysfunction
what are 2 conditions that cause increase skeletal m. excitabilty
m. spasm
description
increase of involuntary m. tension that is linked to injury and inflammation
2 agents used to treat m. spasms
diazapam
trade name
Valium
aka
benzodiazepine
MOA
Facilitates action of gamma-aminobutyric acid (GABA)
by binding to receptors at GABA-ergic synapse (inhibitory effect)
AEs (2)
sedation
Tolerance and physical dependence
Polysynaptic Agents
what does it cause (3)
3 more items...
can it be combined w other analgesics
yes, like ASA
AEs (5)
5 more items...
common ones
Carisoprodol
2 more items...
Chlorzoxazone
2 more items...
Cyclobenzaprine
2 more items...
Orphenadrine Citrate
2 more items...
spasticity
when does it occur
when higher CNS control is disrupted
seen clinically in what 4 diagnoses
CVA
Cerebral palsy
MS
Traumatic lesions to brain or SC
agents used to treat m. spasticity
baclofen
trade name
Lioresal
MOA
Binds to GABA receptors which Inhibits α-motor units within SC
what is it known as
Drug of choice for spasticity of SC lesions
not as effective w what lesions
1 more item...
Primary AEs
for SC lesions
1 more item...
for cerebral lesions
1 more item...
what occurs if someone OD
1 more item...
what can occur if one abruptly stops this medication (4 things)
1 more item...
how is it administered
in the intrathecal-subarachnoid space (spinal canal)
type of MOA
Rehab concerns
benefits are maximized with skillful complement of what 4 things
Thermal agents
Manual therapy
Therapeutic exercise
Patient education
does the drug therapy increase or decrease the effectiveness of total therapy
increase
what do PTs do to help pts on these drugs (3)
help Patients adapt to often sudden changes in muscle excitability
Identify suitable candidates for certain anti- spasticity drugs
Evaluate effectiveness of these drug therapies
Management of Pain and Inflammation
4 broad categories commonly used :red_cross:
Opioid (narcotic) analgesics
Non-opioid analgesics
what do these properties have the ability to do (4)
Ability to ↓ inflammation
Ability to ↓ pain
inability to feel pain is called
(analgesia)
Ability to ↓ temp associated with fever
what is this called
(antipyresis)
Ability to ↓ blood clotting
what is this called
(anti-coagulation)
Important ones in PT practice (4)
NSAIDs
what is the full name
Non-steroidal anti-inflammatory drugs
what signaling molecules start the inflammatory response
Eicosanoids
what are the 3 different ones
3 more items...
derived from what
1 more item...
what is the mechanism of action
Inhibit prostaglandin (PG) and thromboxane (TX) synthesis w/in cell
how does this occur
1 more item...
Specifc NSAIDs
what is the "classic" NSAID
aspirin
Over the Counter (OTC) (4)
aspirin
2 more items...
ibuprofen
2 more items...
naproxen
2 more items...
ketoprofen
1 more item...
Prescription (Rx)
common ones (2)
2 more items...
Applications (6)
Mild to moderate pain
inflammatory diseases (2 of them)
OA and RA
post-surgical pain
what does this decrease the need for
1 more item...
common NSAIDs given post surgery
1 more item...
fever
what NSAID should kids not take if they have a fever
1 more item...
Cardiovascular disorders
what events can it specifically prevent (3)
1 more item...
why is this
1 more item...
GI cancer prevention
why is this
1 more item...
Adverse Effects (AE) (5)
GI ulceration and hemorrhage
what is a GI ulcer
1 more item...
what is a hemmorrhage
1 more item...
High dose hepatotoxicity and renal toxicity
concern in what particular pts (2)
1 more item...
ASA overdose
what can this cause (5)
2 more items...
Reyes syndrome
risk for what population
1 more item...
associated with what
1 more item...
symptoms that can result (6)
1 more item...
NSAID hypersensitivity
what kind of rxns can this cause
1 more item...
what is the most problematic concern of NSAIDs used in rehabilitation
GI AE
are most NSAIDs selective or non selective
non selective MOA
COX2 Inhibitors (2 common ones)
Celecoxib
trade name
Celebrex
2 facts to know
COX2 specific MOA
Less, but still some, GI AE
Rofecoxib
trade name
Vioxx
2 facts to know
COX2 specific MOA
Less, but still some, GI AE
Acetaminophen
relationship to NSAIDs
similarities (2)
has analgesia and antipyretic effects
1 more item...
differences (4)
acetaminophen has no anti-inflammatory or anticoagulant properties
High doses of acetaminophen can damage liver
acetaminophen MOA not as well understood
SAID
what is the actually name
corticosteroids
description
any steroids produced by adrenal cortex
excluding what
1 more item...
description of steroids
1 more item...
3 main groups
Glucocorticoids
2 more items...
Mineralocorticoids
C19 androgens
clinical uses (5)
Endocrine replacement therapy
Diagnosis of endocrine disorders
Rx of ↑ endocrine function
Exploitation of beneficial hormone effects
Alter normal endocrine function
Management of RA and OA
Patient-controlled analgesia
Bone-Mineral Homeostasis
what 5 things are used to regulate bone-mineral homeostasis
Parathyroid Hormone
function (4)
is released from parathyroid gland when the plasma Ca2+ levels are low, which causes Ca2+ to be taken out of the bone into the bloodstream
stimulates ↑ Ca++ resorption in kidneys
stimulates ↑ Ca++ absorption in gut
Causes conversion of Vitamin D to calcitriol
what does this cause
further stimulates absorption
what is calcitrol
the hormone version of Vitamin D
abbreviation
PTH
alters metabolism in what 3 primary tissues
Bone
Kidneys
GI tract
Levels
what occurs when PTH levels increase
this increases the activity of the osteoclasts, which causes Ca2+ to be released in the bloodstream from the bone tissue
what does this lead to
bone breakdown since they take Ca2+ from the bone into the bloodstream
what occurs when PTH levels decrease or normal
this balances the activity of osteoblasts
what does this lead to
bone formation
Vitamin D
description
Steroid-like hormone derived from cholesterol
function (3)
Enhances bone formation by ↑ levels of
Ca2+ ad PO4 (phosphates)
increases Ca2+ and PO4 absorption in gut
Decreases Ca2+ and PO4 renal excretion from kidneys
antagonist to what hormone
PTH
so what does it do
limits the synthesis and release of PTH
what occurs if we do not have enough calcium in the blood (hypcalcemia)
then our body will extract calcium that is stored in the bones
Calcitonin
what are they secreted by
C cells of thyroid gland
antagonist to what hormone
PTH
what does this cause (2)
↓ plasma [Ca++] by stimulating bone formation
↑ [Ca++] and PO4 renal excretion
which is more dominant, PTH or calcitonin
PTH
Other hormones
what 2 molecules decrease bone formation
Glucocorticoids and prostaglandins
which 5 hormones increase bone formation
Estrogen (SERMs)
Androgens
Growth Hormone
Insulin
Thyroid Hormone
Diseases and Pharmacological control