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Nursing Pharmacology · NCLEX-RN

Nursing Pharmacology: Musculoskeletal Medications

NSAIDs, muscle relaxants, DMARDs, and gout medications with their key nursing considerations and monitoring points.

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What is the mechanism of action of NSAIDs?
They inhibit cyclooxygenase (COX) enzymes, reducing prostaglandin synthesis.
Why should NSAIDs be taken with food or milk?
To reduce the risk of GI irritation and upset stomach.
Which lab values should be monitored in a patient on long-term NSAID therapy?
Renal function tests (BUN and creatinine).
What cardiovascular risk carries a black box warning for NSAIDs?
Increased risk of myocardial infarction and stroke.
Why should NSAIDs be avoided during the third trimester of pregnancy?
They can cause premature closure of the fetal ductus arteriosus.
What type of NSAID is celecoxib?
A selective COX-2 inhibitor.
Why does celecoxib carry a lower risk of GI bleeding than nonselective NSAIDs?
It spares COX-1, which protects the gastric mucosa.
What is a key teaching point about combining NSAIDs with aspirin or anticoagulants?
Avoid combining them due to increased bleeding risk.
What is cyclobenzaprine primarily used to treat?
Acute, painful musculoskeletal muscle spasm.
What class of medication is cyclobenzaprine structurally related to?
Tricyclic antidepressants.
What is the most common side effect of centrally acting muscle relaxants?
Drowsiness and sedation.
What should patients be taught to avoid while taking a muscle relaxant?
Alcohol and other CNS depressants.
What is baclofen's mechanism of action?
It is a GABA agonist that inhibits spinal reflexes.
What condition is baclofen commonly used to treat?
Spasticity from spinal cord injury or multiple sclerosis.
What life-threatening condition is dantrolene used to treat?
Malignant hyperthermia.

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