Musculoskeletal Drugs (and Gout Drugs) Practice Questions with Answers and NCLEX® Review

Introduction to Musculoskeletal Medications

The musculoskeletal system is one of the most complex parts of the body. This system allows movement including the muscles that enable breathing. Musculoskeletal medications help with pain, inflammation, and joint damage related to conditions like gout. 

Allopurinol is used to treat gout, kidney disease, and hyperuricemia. It reduces the production of uric acid (a waste product of purines) by inhibiting xanthine oxidase. Colchicine is an anti-inflammatory medication for gout and other inflammatory conditions. It’s used to treat acute gout attacks by reducing uric acid levels in the blood.

Calcium carbonate is used to treat conditions like hyperparathyroidism and osteoporosis by increasing bone mineral density and preventing bone loss. 

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Dantrolene is a muscle relaxant that prevents spasms of skeletal muscles associated with Parkinson’s disease or spinal cord injury.

Cyclobenzaprine is another muscle relaxant that relieves symptoms associated with injuries and overuse of muscles or joints (e.g., back pain). It works by blocking nerve impulses from reaching muscles in the body. 

Like Cyclobenzaprine, Carisoprodol is used to treat muscle spasms associated with spinal cord injuries and cerebral palsy (CP). These medications can be habit-forming if taken for more than three months. 

Baclofen is used to treat muscle spasticity in people who have spinal cord injuries or multiple sclerosis (MS). It also helps relieve muscle stiffness and pain caused by osteoarthritis or spinal cord injury. These medications should only be taken under supervision of a health care provider (HCP).

Baclofen

Baclofen is a muscle relaxant used to treat spasticity in multiple sclerosis, spinal cord injury, and stroke. It works by reducing the excitability of spinal neurons involved in transmitting signals from the brain to muscles. As a result, it relaxes the muscles, which reduces muscle spasms and stiffness.

Nursing interventions

• Monitor vital signs (blood pressure, pulse rate)
• Assess for adverse effects such as drowsiness or fatigue
• Prepare equipment needed for administering Baclofen

Memory Trick

• Baclofen – Back off slowly (do not abruptly stop)

Allopurinol & Colchicine

Allopurinol and colchicine are both used to treat gout by reducing uric acid. Both medications are safe for most clients, however nurses need to be aware of their differences and the implication of administering these medications.  Allopurinol is a medication used to reduce the amount of uric acid in the blood, while colchicine is used to reduce inflammation and swelling. 

Allopurinol can cause diarrhea, nausea, vomiting, kidney failure, and allergic reactions like skin rash or itching. It’s important to take the drug exactly as the HCP prescribes it. Colchicine can cause diarrhea, nausea, and vomiting; however, it is more likely to cause kidney failure than Allopurinol.

Memory trick

• AlloPurinol – Prevents gout
• Colchicine – for aCute gout attacks

Nursing Interventions

• Increase fluids and take with full glass of water
• AVOID clients with Kidney & Liver Disease
• Evaluation of effectiveness? = Normal uric acid levels

Calcium Carbonate

Calcium carbonate is commonly used as a calcium supplement used to treat gastrointestinal disorders like peptic ulcers, gastritis, and dyspepsia (heartburn). It works by inhibiting bone reabsorption and reducing osteoclast activity (which breaks down the bone).

Nursing interventions

• Monitor the client’s vital signs, electrolytes, and fluid balance.
• Assess symptoms.
• Evaluate laboratory values.
• Educate clients on how to manage side effects.

Memory Trick

• Since calcium makes bones hard, just think Calcium makes bowels hard too.
• High CAL = Hard bowel
• Low CAL = Loose bowel

Dantrolene

Dantrolene is a drug that’s used to treat symptoms from spinal cord injuries, cerebral palsy, and multiple sclerosis (MS). It works by inhibiting calcium release in the skeletal muscles, which reduces muscle contraction.

Nursing interventions

• Administer medication by mouth or intravenously (IV).
• Monitor the client’s heart rate, blood pressure, and respiratory rate. 
• Assess for signs of dehydration, heart failure, low potassium levels, and increased risk of infection.

Memory Trick

• Calcium contracts muscles
• Less calcium = Less contraction

Cyclobenzaprine & Carisoprodol

Cyclobenzaprine is a muscle relaxer used to treat muscle spasms and stiffness in people with Parkinson’s disease. It can also be used to treat shingles pain, fibromyalgia, and menstrual cramps. Cyclobenzaprine has a longer half-life than carisoprodol, as it stays in the system longer and will have a longer effect on the muscles.

Carisoprodol is another muscle relaxer that is often used for similar conditions to cyclobenzaprine.

Both of these drugs work by blocking the transmission of nerve impulses in the spinal cord and brain. This results in muscles relaxing and becoming more flexible. The main difference between these two medications is the duration of action.

Musculoskeletal and Gout Medications Conclusion

Musculoskeletal drugs help with pain, inflammation, and joint degeneration caused by conditions such as gout.

Gout, renal disease, and hyperuricemia are all treated with Allopurinol. By blocking xanthine oxidase, it lessens the synthesis of uric acid, a waste product of purines. For gout and other inflammatory disorders, Colchicine is an anti-inflammatory drug. It lowers blood levels of uric acid, which is used to treat acute gout attacks.

By boosting bone mineral density and halting bone loss, calcium carbonate is used to treat disorders like hyperparathyroidism and osteoporosis. Dantrolene stops the skeletal muscle spasms brought on by Parkinson’s disease or spinal cord damage.

Another muscle relaxant that eases the symptoms of muscle or joint injury and overuse is Cyclobenzaprine. It functions by preventing bodily muscles from receiving nerve impulses. 

Carisoprodol is used to treat muscle spasms brought on by spinal cord injury and cerebral palsy. But if taken for longer than three months they can become addictive. This medication should only be prescribed under close HCP supervision.

Clients with MS or spinal cord injuries who have muscle spasticity can use Baclofen to treat it. Additionally, it aids in reducing muscle stiffness and pain brought on by osteoarthritis or spinal cord damage.

Sources

https://medlineplus.gov/druginfo/meds/a682673.html 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4656054 

https://medlineplus.gov/druginfo/meds/a601032.html 

https://www.ncbi.nlm.nih.gov/books/NBK535398/ 

https://www.ncbi.nlm.nih.gov/books/NBK513362/ 

https://www.ncbi.nlm.nih.gov/books/NBK553077 

https://medlineplus.gov/druginfo/meds/a682530.html