Neostigmine (Prostigmin) cholinesterase inhibitor. Prolongs action of acetylcholine. Used to tx myasthenia gravis or to revers muscle paralysis r/t intubation or surgery. pancuronium (Pavulon) nondepolarizing neuro-muscular blocking agent. Prevents muscle contractions. Use caution in pt's with hyperkalemia, myasthenia gravis, or respiratory depression. Increased effects with aminogylcosides or tetracycline antibiotic use. succinylcholine (Anectine) depolarizing neuromuscular blocking agent. Also an increased effect with use of aminoglycoside or tetracyline antibiotics. Causes muscle paralysis making mechanical ventilation required. Use caution in pt's with hyperkalemia, myasthenia gravis, or respiratory depression. dantrolene (Dantrium) skeletal muscle relaxant given to tx malignant hyperthermia & spasticity. naloxene (Narcan) opiod antagonist. Given to reverse effects of opiods. calcitonin (Calcimar)= oralmiacalcin= intranasal tx of osteoporosis, hypercalcemia secondary to hyperthyroidism, or page'ts disease. Decreased bone resorption, increases calcium excretion. Inhibits osteoclasts. Do not give if allergic to fish or salmon. Decreased effectiveness with long term use. Encourage diet high in calcium & Vit D. leflunomide (Arava) DMARD 1: Immunosuppressive drug. Used to tx RA. Monitor for liver toxitcity, bleeding r/t decreased platelets & bone marrow production. Monitor also for s/sx of pulmonary fibrosis, infection, or GI ulcerations. ibandronate (Boniva) Bisphosphonate. Tx's osteo-porosis by decreasing bone resorption. Monitor for esophagitis, GI disturbance, muscle or joint pain, eye pain, or vision change (rare). Given 30 min before breakfast. Must be able to sit up for 30 min after taking & with a full glass of water. Contraindicated with low calcium levels, renal insufficiency, or if can't sit up for 30min. Calcium & dairy will decrease absorption. Given atleast 30 min from eachother. calcium citrate (Citracal) calcium supplement. Give with Vit D to increase absorption. Given 1 hr after meal & with full glass water, and at bedtime. Don't take >600mg at one time. Contraindicated with low phosphate levels, heart dysrythmias, or kidneystones. Side effects: N&V, constipation, polyuria, depression, & Kidney stones. adalimumab (Humira) DMARD II: tumor necrosis factor antagonist. Decreases inflammation in joints. Can cause HF, reactivation of TB, increased risk of infections r/t immunosuppression. Contraindicated with active infection, bleeding disorders, malignancy, or pregnancy. Use caution with autoimmune disorders & live vaccines. etanercept (Enbrel) DMARD II: Tumor necrosis factor antagonist. Can cause HF, reactivation of TB, increased risk of infection r/t immunosuppression. Given sq twice per week. Contraindicated wtih active infection, blood disorders, malignancy, or pregancy. Report any skin rash: Can cause serious skin infections. calcium carbonate (Tums) antacid. Sometimes used as calcium supplement. Take 1hr after meals & at bedtime. Don't take >600mg at a time. Contraindicated with low phosphate levels or kidney stones. edrophonium (Tensilon) Cholinesterase Inhibitor. Used for diagnosing myasthenia gravis, not treatment of. methotrexate (Rheumatrex) DMARD I: Immunosuppressor used to tx RA. Sometimes used in large doses to tx cancer. Take with a folic acid supplement to decrease risk of toxicity. Monitor for signs of liver toxicity, bleeding r/t bone marrow suppression, and decreased production of platelets. Also monitor for signs of pulmonary fibrosis, infection, & GI ulcerations. Take on empty stomach. Drink plenty of water to promote excretion. alendronate (Fosamax) Bisphosphonate. Tx's osteo-porosis by decreasing bone resorption. May cause musculoskeletal pain, joint pain, nausea, or blurred vision. Take on empty stomach. Sit up for 30 min afterwards to prevent esophagitis. Contraindicated for pt's who can't sit up 30 min after, difficulty swallowing, low calcium, or renal insufficiency. Take with full glass of water. Calcium & Dairy decrease absorption so give atleast 30min apart. raloxifene (Evista) SERM. Decreases bone resorption & bone loss. Mimicks effects of estrogen on the bones, but blocks estrogen receptors in other tissues. Contraindicated with pregnancy/breastfeeding. Not recommended to give with estrogen. Watch for s/sx of DVT, CVA, PE. Increased risk of endometrial cancer. Teach pt to increase activity, and increase intake of calcium & VIT D. infliximab (Remicade) DMARD II: Tumor necrosis factor antagonist. Decreased inflammation in the joints. Can cause HF, reactivation of TB, increased risk of infection r/t immunosuppression. Contra- indicated wtih active infection, blood disorders, malignancy, or pregancy. Report any skin rash: Can cause serious skin infections. Use caution with autoimmune disorders & live vaccines. risedronate (Actonel) Bisphosphonate. Tx's osteo-porosis by decreasing bone resorption. May cause musculoskeletal pain, joint pain, nausea, or blurred vision. Take on empty stomach. Sit up for 30 min afterwards to prevent esophagitis. Contraindicated for pt's who can't sit up 30 min after, difficulty swallowing, low calcium, or renal insufficiency. Take with full glass of water. Calcium & Dairy decrease absorption so give atleast 30min apart. pyridostigmine (Mestinon) Cholinesterase Inhibitor. Inhibits acetylcholinesterase, allowing for stronger/longer muscle contractions. Prolongs action of acetylcholine. Monitor apical pulse. Increase intestinal motility & salivation. Can cause bradycardia. If muscle weakness &/or respiratory paralysis within 1hr of administration= serum levels are too high. If 3hrs after taking, then levels are too low. I'm sure there is much more drug info about these. I only included info obtained from the tutorial & test for ATI musculoskeletal, under pharmacology 2.0. Email me if you have any questions. AMY Hope you have a great day. This is the most boring thing I have studied yet!! LOL.