MUSCULOSKELETAL MEDICATIONS
GENERAL GUIDELINES:
 Suppression of inflammation processes poses risk of increased infection
 Many have risk to renal and liver function. Lab values should be regularly assessed
 Some pose risk of venous thrombosis development
CLASSIFICATION
THERAPEUTIC USES
Osteoporosis Medications
Biphosphonates
Post-menopausal
Osteoporosis
Paget’s Disease
Selective Estrogen
Same as above
Receptor Modulator
Osteoclast Inhibitor
Same as above +
Hypercalcemia
Vitamin/Mineral
Supplements
Same as above
MECHANISM OF ACTION
DRUG EXEMPLARS
Inhibits osteoclast activity resulting in
decreased bone resorption
alendronate
(Fosamax)
Mimics endogenous estrogen, binding to
estrogen receptors and decreasing bone
resorption
Mimics endogenous calcitonin. Inhibits
osteoclast activity resulting in decreased
bone resorption.
Increases renal calcium excretion
Calcium is the primary mineral
responsible for bone formation
Vitamin D is needed for absorption of
calcium by the bones
raloxifene (Evista)
calcitonin (Fortical)
Calcium &
Vitamin D
Disease-Modifying Antirheumatic Drugs (DMARDS)
DMARDS I
Slows joint
Inhibits folic acid metabolism preventing
Non-biologics
degeneration in
cell reproduction.
Rheumatoid Arthritis Inhibits normal immune response
DMARDS II
Biologics
Same as above
methotrexate
(Rheumatrex)
hydrosychloroquine
(Plaquenil)
Inhibits action of endogenous tumor
dalimumab
necrosis factor (TNF) to block steps in the (Humira)
inflammatory cascade and reduce joint
onfiximab
inflammation
(Remicade)
Blocks interleukin-2 to inhibit normal
cyclosporine
immune response
(Sandimmune)
DMARDS III
Same as above
Immunosuppressants
+ Anti-Inflammatory Medications: Glucocorticoids, NSAIDS
Anti-Gout Medications
Uricosurics
Chronic gout
Uric Acid Inhibitors
Chronic gout
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Mobilizes uric acid stored in the tissues
into bloodstream and renal excretion
Blocks essential enzyme needed for the
formation of uric acid.
probenecid
(Probalan)
allopurinol
(Zyloprim)