MUSCULOSKELETAL
PHARMACOLOGY MASTERY: EXAM
QUESTIONS & ANSWERS ON
ANALGESICS, DMARDS, AND MUSCLE
RELAXANTS
A health care professional is caring for a patient who was given
succinylcholine during a surgical procedure. The patient develops rigid
muscles, tachycardia, and a sudden spike in temperature. What should be
suspected? Malignant hyperthermia
Which medication is the specific antidote for malignant
hyperthermia? Dantrolene
Dantrolene reduces skeletal muscle spasticity by what mechanism of
action? Interfering with the release of calcium from the sarcoplasmic
reticulum
A patient with a history of myasthenia gravis is prescribed neostigmine.
What adverse effect should the nurse monitor for, and what medication
should be readily available as an antidote? Monitor for cholinergic crisis
(bradycardia, excessive salivation); have Atropine ready
Neostigmine and pyridostigmine are prototype drugs for which class, and
what is their primary use? Cholinesterase inhibitors; used for improving
muscle strength and endurance in myasthenia gravis
,What are the three categories of Disease-Modifying Antirheumatic Drugs
(DMARDs)? DMARDs 1 (e.g., Methotrexate), DMARDs 2 (Biologics, e.g.,
Etanercept), and older medications (used in severe cases)
Methotrexate is a first-line DMARD for rheumatoid arthritis. What are its
significant adverse effects? Liver damage, bone marrow suppression,
increased infection risk, and GI bleeding
Etanercept is a biologic DMARD. What serious adverse effects are
associated with its use? Infections, reactivation of TB, heart failure, and
severe skin reactions
A patient taking a DMARD should be monitored for which key laboratory
values and clinical signs? CBC (for bone marrow suppression), liver
function tests, signs of infection, and GI bleeding
What is a critical contraindication for methotrexate therapy? Pregnancy
(Pregnancy Risk Category X) and liver/renal insufficiency
Raloxifene is a prototype drug for which class of medications used for
osteoporosis? Selective Estrogen Receptor Modulators (SERMs)
What are the severe adverse effects associated with SERMs like
raloxifene? Pulmonary embolism, deep vein thrombosis (DVT), and hot
flashes
What should a nurse monitor for in a patient taking a SERM? Bone density
and signs of thromboembolic events
What lifestyle modifications should be taught to a patient taking a
SERM? Consume adequate calcium and Vitamin D, and perform daily
weight-bearing exercises
, What is the mechanism of action of bisphosphonates like alendronate in
treating osteoporosis? They decrease the activity of osteoclasts, thereby
reducing bone resorption
A patient is prescribed alendronate for osteoporosis. Which adverse effect
should they be instructed to monitor for? Joint pain, jaw pain, and
blurred vision
A patient is prescribed calcitonin-salmon for postmenopausal osteoporosis.
What important step must be taken before the first dose? Perform skin
testing to check for allergies to salmon
What are the contraindications for calcitonin therapy? Allergy to salmon
and renal insufficiency
A patient with hypocalcemia may be prescribed what type of
supplement? Calcium citrate or calcium carbonate
What are the adverse effects of calcium supplements? Hypercalcemia and
kidney stones
A patient taking calcium supplements should be educated to avoid which
foods due to potential interactions? Spinach and whole grains
What class of diuretics should be avoided in a patient taking calcium
supplements due to the risk of hypercalcemia? Thiazide diuretics
What are the contraindications for calcium supplements? Hypercalcemia,
low phosphate levels, kidney stones, and cardiac dysrhythmias
A patient with impaired kidney function or hypoparathyroidism may require
what form of Vitamin D therapy? Calcitriol
What are the side effects of calcitriol? Hypercalcemia, headache, dry
mouth, muscle/bone pain, and increased urination
PHARMACOLOGY MASTERY: EXAM
QUESTIONS & ANSWERS ON
ANALGESICS, DMARDS, AND MUSCLE
RELAXANTS
A health care professional is caring for a patient who was given
succinylcholine during a surgical procedure. The patient develops rigid
muscles, tachycardia, and a sudden spike in temperature. What should be
suspected? Malignant hyperthermia
Which medication is the specific antidote for malignant
hyperthermia? Dantrolene
Dantrolene reduces skeletal muscle spasticity by what mechanism of
action? Interfering with the release of calcium from the sarcoplasmic
reticulum
A patient with a history of myasthenia gravis is prescribed neostigmine.
What adverse effect should the nurse monitor for, and what medication
should be readily available as an antidote? Monitor for cholinergic crisis
(bradycardia, excessive salivation); have Atropine ready
Neostigmine and pyridostigmine are prototype drugs for which class, and
what is their primary use? Cholinesterase inhibitors; used for improving
muscle strength and endurance in myasthenia gravis
,What are the three categories of Disease-Modifying Antirheumatic Drugs
(DMARDs)? DMARDs 1 (e.g., Methotrexate), DMARDs 2 (Biologics, e.g.,
Etanercept), and older medications (used in severe cases)
Methotrexate is a first-line DMARD for rheumatoid arthritis. What are its
significant adverse effects? Liver damage, bone marrow suppression,
increased infection risk, and GI bleeding
Etanercept is a biologic DMARD. What serious adverse effects are
associated with its use? Infections, reactivation of TB, heart failure, and
severe skin reactions
A patient taking a DMARD should be monitored for which key laboratory
values and clinical signs? CBC (for bone marrow suppression), liver
function tests, signs of infection, and GI bleeding
What is a critical contraindication for methotrexate therapy? Pregnancy
(Pregnancy Risk Category X) and liver/renal insufficiency
Raloxifene is a prototype drug for which class of medications used for
osteoporosis? Selective Estrogen Receptor Modulators (SERMs)
What are the severe adverse effects associated with SERMs like
raloxifene? Pulmonary embolism, deep vein thrombosis (DVT), and hot
flashes
What should a nurse monitor for in a patient taking a SERM? Bone density
and signs of thromboembolic events
What lifestyle modifications should be taught to a patient taking a
SERM? Consume adequate calcium and Vitamin D, and perform daily
weight-bearing exercises
, What is the mechanism of action of bisphosphonates like alendronate in
treating osteoporosis? They decrease the activity of osteoclasts, thereby
reducing bone resorption
A patient is prescribed alendronate for osteoporosis. Which adverse effect
should they be instructed to monitor for? Joint pain, jaw pain, and
blurred vision
A patient is prescribed calcitonin-salmon for postmenopausal osteoporosis.
What important step must be taken before the first dose? Perform skin
testing to check for allergies to salmon
What are the contraindications for calcitonin therapy? Allergy to salmon
and renal insufficiency
A patient with hypocalcemia may be prescribed what type of
supplement? Calcium citrate or calcium carbonate
What are the adverse effects of calcium supplements? Hypercalcemia and
kidney stones
A patient taking calcium supplements should be educated to avoid which
foods due to potential interactions? Spinach and whole grains
What class of diuretics should be avoided in a patient taking calcium
supplements due to the risk of hypercalcemia? Thiazide diuretics
What are the contraindications for calcium supplements? Hypercalcemia,
low phosphate levels, kidney stones, and cardiac dysrhythmias
A patient with impaired kidney function or hypoparathyroidism may require
what form of Vitamin D therapy? Calcitriol
What are the side effects of calcitriol? Hypercalcemia, headache, dry
mouth, muscle/bone pain, and increased urination
