Deck 21: Musculoskeletal and Anti-Inflammatory Drugs

Question 1

Jeremy has painful muscle spasms associated with rheumatoid arthritis.He knows that his friend Tanya,who has multiple sclerosis,has experienced relief from her muscle spasms with dantrolene.Is dantrolene also appropriate for Jeremy?

A)Dantrolene should also be used if the spasms are severe.
B)Dantrolene should only be used as a last choice medication when other agents have failed.
C)Yes.It is very likely Jeremy will have a good effect from dantrolene.
D)No.Dantrolene is not indicated for muscle spasms associated with rheumatic conditions.

Answer 1

No.Dantrolene is not indicated for muscle spasms associated with rheumatic conditions.

Question 2

Carla,67 years of age,has a history of breast cancer and thromboembolic disorders,and cannot take hormone replacement or selective estrogen-receptor modifier therapy to treat her osteoporosis.What hormonal agent might be effective?

A)raloxifene
B)calcitonin-salmon
C)risedronate
D)alendronate

Answer 2

calcitonin-salmon

Question 3

Caitlin strained her back and her doctor prescribes a centrally-acting muscle relaxant during the initial checkup.After the pain subsides,her doctor is likely to prescribe .

A)exercise
B)an NSAID
C)immobilization
D)a peripherally-acting muscle relaxant

Answer 3

exercise

Question 4

Prior to orthopedic surgery,Azalea meets with the anesthesiologist who,when explaining the medications that will be used,mentions that one will paralyze all of her muscles,including her diaphragm.What agent has this effect?

A)tizanidine
B)dantrolene
C)carisoprodol
D)succinylcholine

Question 5

Tanya has multiple sclerosis and sometimes experiences painful muscle spasms.What muscle relaxant is indicated for the spasms associated with her condition?

A)methocarbamol
B)dantrolene
C)diazepam
D)misoprostol

Question 6

Just as Kendall is experiencing relief from painful muscle spasms with methocarbamol,her spring allergies hit full force and she cannot stop sneezing.Should this be of additional concern?

A)Possibly,but only if she takes way too much of the antihistamines.
B)No,not if she takes both medications at least 30 minutes apart.
C)Yes,because the effects of muscle relaxants can be potentiated by antihistamines.
D)No,because over-the-counter antihistamines are very safe.

Question 7

Dina has osteoporosis.What factor is most effective in determining her risk of fracture?

A)serum calcium
B)serum vitamin D
C)estrogen level
D)bone mineral density

Question 8

Delbert has cerebral palsy and experiences painful muscle contractions.What peripherally-acting muscle relaxant may help him?

A)dantrolene
B)rocuronium
C)diazepam
D)methocarbamol

Question 9

Lincoln has rheumatoid arthritis and a history of gastrointestinal bleeds.What characteristic of COX-2 inhibitors is important for Lincoln?

A)COX-2 inhibitors increase production of the prostaglandin that is good for the heart.
B)COX-2 inhibitors decrease production of the prostaglandin that is good for the heart,but not the one that is harmful.
C)COX-2 inhibitors increase production of the prostaglandin that is harmful for the heart,but not the one that is beneficial.
D)COX-2 inhibitors decrease production of the prostaglandins that are good and bad for the heart.

Question 10

Myra is taking a bisphosphonate for treatment of osteoporosis.She should take the bisphosphonate with a .

A)protein rich breakfast and glass of milk
B)full glass of water,at least 30 minutes before her first food of the day
C)calcium rich snack before bedtime
D)fatty snack upon arising

Question 11

Cayden is using a diclofenac patch for pain from his recent knee injury.How does the patch compare to oral medications?

A)Drug interactions are more common with the patch.
B)Concentrations in joint tissues are higher with the patch.
C)Serious adverse effects are more common with with the patch.
D)Concentrations in blood are higher with the patch.

Question 12

After a serious gastrointestinal bleed,Alina,who has rheumatoid arthritis,and her doctor discuss options for continued NSAID therapy.He suggests that she take a drug that combines an NSAID with another drug that will protect the gastric mucosa.What agent combines diclofenac with misoprostol?

A)Caldolor
B)Daypro
C)Mobic
D)Arthrotec

Question 13

Rajesh,an active and fit young adult,injures his shoulder in a weekend baseball game.His doctor tells him to take an NSAID and reminds him of the acronym RICE.What does the R indicate?

A)repair
B)rethink
C)rehabilitation
D)rest

Question 14

Ellis is having surgery and a neuromuscular blocking agent has been administered.What else must also be administered?

A)an antihypertensive
B)a loading dose of glucose
C)analgesics and sedatives
D)anticonvulsants

Question 15

For years,the only medication Jayla has taken to help with her severe knee pain is an NSAID.She has just been diagnosed with cancer and is to be treated with,among other agents,methotrexate.What is the potential interaction between the methotrexate and the NSAID?

A)decreased effectiveness of methotrexate
B)potentiation and increased risk of methotrexate toxicity
C)decreased effectiveness of the NSAID
D)potentiation and increased risk of adverse effects of the NSAID

Question 16

Kolby is a long distance truck driver,and despite taking regular breaks and stretching,he often experiences painful muscle spasms.Would taking a muscle relaxant be an appropriate solution for Kolby?

A)Probably,as long as he restricts his driving to daytime hours.
B)No.Muscle relaxants can cause confusion and sedation.
C)Probably,as long as he increases his caffeine intake.
D)Yes.Muscle relaxants are considered safe to use.

Question 17

While helping her friend move into a third floor walk-up,Elisabeth experiences painful muscle spasms in her back.Her doctor prescribes a centrally acting muscle relaxant.This medication is most likely .

A)rocuronium
B)dantrolene
C)diazepam
D)diclofenac

Question 18

Alice has experienced a number of fractures due to Paget's disease of the bone.What agent is indicated for treatment of this disease?

A)risedronate
B)calcitonin-salmon
C)raloxifene
D)teriparatide

Question 19

Francesca attends doctor's appointments with her mother,who is in her late 80s.Her mother is taking NSAIDs for arthritis pain and Francesca asks what might indicate that her mother was having a GI bleed as a result.What should the doctor tell Francesca?

A)Even serious GI bleeds may be silent in the elderly and have no warning signs.
B)Elderly individuals usually show many signs of GI bleed,including vomiting blood..
C)GI bleeds are very uncommon in elderly females like her mother.
D)Elderly individuals typically have dramatic but nonspecific signs,such as sudden onset delirium.

Question 20

The labels of non-selective NSAIDs must indicate that they .

A)should be used in strict accordance with label directions
B)are highly addictive
C)may increase risk of diabetes
D)can only be safely used for up to 60 days

Question 21

Billie,an active 72-year-old,becomes concerned about the risk of osteoporosis after a close friend suffers an osteoporosis-related spinal fracture.She asks her doctor about estrogen replacement.What is the current consensus on estrogen for osteoporosis prevention?

A)Research has confirmed that long-term estrogen replacement is safe for postmenopausal women.
B)Estrogen should only be used if Billie is unable to take other medications and the potential benefits outweigh the risks.
C)High dose estrogen should be used initially and then Billie should be switched to a maintenance dose.
D)Estrogen is the first line agent for postmenopausal women like Billie.

Question 22

Marianne,62 years of age,is discussing osteoporosis prevention with her doctor,with concerns about the action of estrogen replacement on breast and uterine tissue.Marianne might be interested in selective estrogen-receptor modifiers (SERMs)because they have an estrogen .

A)antagonist effect on breast and uterine tissue
B)antagonist effect throughout the body
C)agonist effect on breast and uterine tissue
D)agonist effect throughout the body

Question 23

Adam is astounded when he is diagnosed with osteoporosis,which he has always thought of as a women's disease.What agent can be prescribed that will increase GI calcium absorption and renal tubular reabsorption of calcium?

A)raloxifene
B)calcitonin-salmon
C)alendronate
D)teriparatide

Question 24

Marlee has heard that COX-2 inhibitors are less likely to cause GI bleeds than are NSAIDs.What property of COX-2 inhibitors makes them less likely to cause GI bleeds?

A)COX-2 inhibitors form a protective coating in the stomach as they dissolve.
B)COX-2 inhibitors increase the production of protective mucous.
C)COX-2 inhibitors do not inhibit platelet aggregation.
D)COX-2 inhibitors decrease the production of stomach acids.

Question 25

Alyssia is taking an agent that acts directly to inhibit bone reabsorption.What is an example of such an agent?

A)calcitonin-salmon
B)ibandronate
C)teriparatide
D)raloxifene