regulate calcium
RANKL inhibitor, stops formation and function of osteoclasts, ADR is infections like endocarditis, UTIs and osteonecrosis
denosumab
last resort, reduction of pain indirectly by decreasing inflammation, does not reduce levels, ADRs GI effects and bone marrow suppression
colchicine
folate anti-metabolite with immunosuppressive effects (inhibits dihydrofolate reductase, reduces activity of B lymphocytes, inhibits replication and function of T lymphocytes stimulating cytokines), ADRs are GI ulcer, bone marrow suppression, hepatoxic, nephrotoxic, pneumonitis- fast acting DMARD- folic acid supplement necessary
methotrexate
this increases and perserves cGMP levels (erection)- administer PRN- take PRN, avoid NITRATE because it can cause low blood pressure, sexual stimulation is required- one dose in 24 hours-priapism (erection that lasts longer than 4 hours) and treatment (ER)
sildenafil
centrally acting- enhances the inhibitory effects of gamma-aminobutyric acid
diazepam
recombinant form of PTH, only used for osteoporosis to increase bone mineral density, causes bone cancer
teriparatide
inhibits uric acid production, may cause acute gout attacks, used d/t chemotherpay (start before chemo), fatal hypersensitivity syndrome, decreases chance of nephropathy
allopurinol
inhibits enzyme in mitochondria responsible for synthesis of pyrimidines, inhibits antibody production by B lympocytes, inhibits t lymphocytes- loading dose is needed- measure to take if pregnant
leflunomide
administer PRN or daily- 48 hours before nitrate- contraindicated in nitrates and alpha blockers- sexual stimulation is not required- effects occur in 2 hours
tadalafil (PDE5 inhibitor)
centrally acting, promotes inhibition by acting as an alpha1 agonist on presynaptic neurons
tizanidine
SERM's, activates estrogen receptors, decreases risk of endometrial and breast cancer, agonist and antagonist, doesn't involve estrogen deficiency, stop 72 hours if immobilization is anticipated, antagonist or agonist, ADR is thrombus
raloxifene
stops reabsorption of uric acid at proximal convoluted tubule increasing uric acid excretion, ADR is renal injury deposotion, can cause acute gout, avoid ASA because. urine can become acidic and wont let med excrete
pegloticase
binds to TNF and prevents it from interacting with its receptors- ADRs are sepsis, TB, fungal. infections- pretest for TB and HepB
etancercept
THIS TYPE means there are too many alpha1 adrenergic receptors on smooth muscle cells in neck of bladder and prostate gland, when activated, these receptrs cause smooth muscle to contract narrowing urethral lumen and is alphar1 adrenergic blocker:::::::::: THIS TYPE means the gland enlarges under influence of testosterone, enlarged gland creates physical obstruction or urine outflow at neck of bladder and is 5alpha reductase inhibitor
DYNAMIC::::::: MECHANICAL
centrally acting- drug interaction with antidepressants (increased risk of serotonin syndrome)
cyclobenzaprine
bisphosphonate, ADR is osteonecrosis of jaw and esophgeal erosion, take sitting up for 30 min with a full glass of water
alendronate
primary use is hyperuricemia d/t chemotherapy, its accelerates uric acid removal
rasburicase
B lymphocyte depleting agent- monoclonal antibdoy directed against CD20-antigen on B lymphocyte (decrease number of B lymphocytes)- ADRs are infusion-induced hypertensives reaction and mucocutaneous reactions: SJS vesiculobullous dermatitis, HEP B, PML
rituximab
used in those with large prostate- inhibits 5 alpha reductase, eliminates hormonal signal for prostate growth, shrinks enlarged prostate and EFFECTS ON PSA include decreasing levels of PSA (marker for prostate cancer) and childbearing women should wear gloves
5alpha reductase inhibitor
direct-acting- acts on skeletal muscle fiber to interfere with release of calcium, prevents muscle from contracting- decreases muscle strength-treats malignant hyperthermia- hepatoxic
dantrolene
increases sensitivity of calcium on PTH receptors, can happen in primary and secondary hyperparathyroidism::::: this regulator is released from thyroid, inhibits bone resorption and increases calcium excretion, antagonist to PTH
cinacalcet::::::: calcitonin
t cell activation ihibitors, binds to APC receptors and prevents t cell activation, ADR is increases risk of serious infections lke pneuomina and pyelnephritis
abatacept
used in minor enlarged prostate- relaxes muscle in prostate capsule, bladder neck, urethra, increases urine flow
alpha 1 receptor blockers
centrally acting- acts in spinal cord to suppress hyperactive reflexes- does not decrease muscle strength
baclofen