I wanted to talk about musculoskeletal pharmacology for some time. We’ll talk about four different types of pharmacology related to the musculoskeletal system.

Musculoskeletal Molecules

NON-OPIOID AGENTS

We’ll start with non-opioid agents. The purpose of these drugs is to provide analgesia, anti-inflammatory effects, and antipyretic effects, so, to reduce fever. These work by reducing prostaglandin formation which decreases the inflammatory process. They can also decrease uterine contractions, lower fevers and reduce pain.

Side effects include nausea, vomiting, vertigo, abdominal pain, GIT distress and bleeding, especially with overuse, ulcer formation and Reye’s (Reye) syndrome, which occurs in children with aspirin.

Pharmacist should be aware of patients using non opioids because of masked pain, as well as complaints of stomach pain.

Examples include Tylenol, NSAIDS, such as ibuprofen, aspirin, Advil, and Celebrex.

OPIOIDS

Opioids provide analgesia for acute severe pain. They stimulate opioid receptors within the central nervous system to help with pain dependency or withdrawal.

Side effects include mood swings, sedation, confusion, vertigo, cognitive impairments, orthostatic, hypotension, constipation, in-coordination, physical dependence, tolerance and death due to overdose. 

Examples include morphine, Demerol, OxyContin, which is a brand name, oxycodone, the generic name, fentanyl and codeine.

GLUCOCORTICOID AGENTS

Glucocorticoid agents, aka, corticosteroids, they provide a hormonal anti-inflammatory effect as well as metabolic effects and vasoconstriction. 

Side effects include muscle atrophy, GIT distress, glaucoma, drug induced Cushing’s syndrome, osteoporosis, mood changes, hypertension, and fatigue. 

Examples include hydrocortisone, cortisol, prednisone, prednisolone, methylprednisolone, dexamethasone, and nasonex.

ANTIRHEUMATIC AGENTS

And finally, antirheumatic agents are also known as disease modifying antirheumatic agents, these slow or stop the progress of rheumatic disease, If used early enough in the disease process, they work by inducing remission of disease.

Side effects include nausea, joint pain, swelling, toxicity, GIT distress, sore throat fever, liver damage, hair loss, sepsis, and retinal damage. 

Pharmacist should know that antirheumatic agents have a very high risk of toxicity.

Examples include methotrexate, chloroquine, and tumor necrosis factor inhibitors. 

That’s it for musculoskeletal pharmacology (micro preview).