Musculoskeletal

The exact cause of chronic pain of a nonmalignant nature may or may not be known. This type of pain includes the pain associated with various neuropathic and musculoskeletal disorders such as headaches, fibromyalgia, rheumatoid arthritis, and osteoarthritis. 

Before giving a nonnarcotic analgesic to a patient, the nurse assesses the type, onset, and location of the pain. It is important to determine if this problem is different in any way from previous episodes of pain or discomfort. If the patient is receiving a nonnarcotic analgesic for an arthritic or musculoskeletal disorder or soft tissue inflammation, the nurse should examine the joints or areas involved. The appearance of the skin over the joint or affected area or any limitation of motion is documented. The nurse evaluates the patient s ability to carry out activities of daily living. This important information is used to develop a care plan, as well as to evaluate the response to drug therapy. 

Relief of signs and symptoms of osteoarthritis, rheumatoid arthritis, and other musculoskeletal disorders (see Chap. 19 for more information on these disorders)... 

Drugs Used to Treat Disorders of the Musculoskeletal System... 

Discuss important preadministration and ongoing assessment activities the nurse should perform on the patient taking drugs used to treat musculoskeletal disorders. 

List some nursing diagnoses particular to a patient taking a drug for the treatment of musculoskeletal disorders. 

List the types of drugs used to treat musculoskeletal disorders. 

Arthritis is the inflammation of a joint. The term is frequently used to refer to any disease involving pain or stiffness of the musculoskeletal system. 

I ARY DRUG TABLE DRUGS USED TO TREAT MUSCULOSKELETAL DISORDERS (Cbntinued)... 

The mode of action of many skeletal muscle relaxants, for example carisoprodol (Soma), baclofen (Lioresal), and chlorzoxazone (Paraflex), is not clearly understood. Many of tiiese dragp do not directly relax skeletal muscles, but dieir ability to relieve acute painful musculoskeletal conditions may be due to their sedative action. Cyclobenzaprine (Flexeril) appears to have an effect on muscle tone, tiius reducing muscle spasm. 

The exact mode of action of diazepam (Valium), an antianxiety drug (see Chap. 30), in die relief of painful musculoskeletal conditions is unknown. The drug does have a sedative action, which may account for some of its ability to relieve muscle spasm and pain. 

Skeletal muscle relaxants are used in various acute, painful musculoskeletal conditions, such as muscle strains and back pain. 

Drowsiness is the most common reaction seen with the use of skeletal muscle relaxants. Additional adverse reactions are given in die Summary Drug Table Drugp Used to Treat Musculoskeletal Disorders. Some of the adverse reactions tiiat may be seen with the administration of diazepam include drowsiness, sedation, sleepiness, letiiargy, constipation or diarrhea, bradycardia or tachycardia, and rash. 

The bisphosphonates are drags used to treat musculoskeletal disorders such as osteoporosis and Fhget s disease. This chapter will discuss the use of these drugs in the treatment of osteoporosis. 

Corticosteroids are hormones secreted from the adrenal cortex. These hormones arise from the cortex of the adrenal gland and are made from the crystalline steroid alcohol cholesterol. Synthetic forms of the natural adrenal cortical hormones are available The potent antiinflammatory action of the corticosteroids makes these drugs useful in the treatment of many types of musculoskeletal disorders. The corticosteroids are discussed in Chapter 50. 

The miscellaneous drugp are used to treat a variety of musculoskeletal disorders. Ffenicillamine, methotrexate (MTX), and hydroxychloroquine are used to treat rheumatoid arthritis in patients who have had an insufficient therapeutic response to or are intolerant of other antirheumatic drugp such as the sailcylates and NSAIDs. The Summary Drug Table Drug s Used to Tream Musculoskeletal Disorders provides additional information about these and other drug s. One compound, hylan G-F 20, listed in the Summary Drug Table is not used for rheumatoid arthritis, but rather, for osteoarthritis knee pain. It is a viscous, elastic... 

Promoting an Optimal Response to Therapy The patient with a musculoskeletal disorder may be in acute pain or have longstanding mild to moderate pain, which can be just as difficult to tolerate as severe pain. Along with pain, there may be skeletal deformities, such as the joint deformities seen with advanced rheumatoid arthritis. For many musculoskeletal conditions, drug therapy is a major treatment modality. Therapy with these drugs may keep the disorder under control (eg, therapy for gout), improve the patient s ability to carry out the activities of daily living, or make the pain and discomfort tolerable. 

Fhtients with a musculoskeletal disorder often have anxiety related to the symptoms and the chronicity of their disorder. In addition to physical care, these patients often require emotional support, especially when a disorder is disabling and chronic. The nurse explains to the patient that therapy may take weeks or longer before any benefit is noted. When this is explained before therapy is started, the patient is less likely to become discouraged over the slow results of drug therapy. 

Robaxin) PO for a musculoskeletal disorder. Available for administration are 500-mg tablets. The nurse administers. ... 

Table 1. Associated Musculoskeletal Disorders in Patients Susceptible to Malignant Hyperthermia...

No studies were located regarding gastrointestinal, hematological, musculoskeletal, or dermal effects in humans or animals after inhalation exposure to methyl parathion. Dean et al. (1984) reported that seven children exposed to methyl parathion by many routes exhibited pinpoint pupils, abdominal pain, and diarrhea. The respiratory, cardiovascular, hepatic, and renal effects reported by Fazekas (1971) that were found in humans acutely exposed to methyl parathion intoxication resulted from exposure by all three routes however, the results did not distinguish between the routes. 

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