Dr. Steven I. Dworkin Drugs That Affect the Musculoskeletal System

Dr. Steven I. Dworkin

Drugs That Affect the Musculoskeletal System



Musculoskeletal Disorders

• Variety of drug are used to in the treatment of bone and muscle disorders

• Drug selected on basis of

– Disorder

– Severity

– Patients response to past therapy


Rheumatoid Arthritis

• Chronic disease characterized by inflammatory changes within the body’s connective tissue.

– Early cases respond to the salicylates

– Advanced disease may require gold compounds


Gold Compounds

• Suppress or prevents arthritis and synovitis– Therapeutic effects occur over 6 weeks to 6 months.– Early improvement in morning stiffness,

• Actions– Unknown

• Use– Treat active juvenile and adult rheumatoid arthritis

when cartilage and bone damage has already occurred but in early stage. Cannot reverse structural damage.

• Adverse Reactions– Dermatitis, stomatitis, pruritus


Treatment of Gout

• Actions of Drugs Used

– Allopurinol reduces production of uric acid, decreasing serum uric acid crystals in joints

– Sulfinpyrazone increases excretion of uric acid by kidneys

– Colchicine unknown

– Probenecid increases excretion of uric acid

• Also prolongs the plasma levels of penicillins and chphalosporins.






Skeletal Muscle Relaxants

• Actions

– Not clearly understood independent of sedative effects.

– Cyclobenzaprine appears to effect muscle tone.

• Use

– Various acute, painful conditions such as muscle strains and back pain.

• Adverse reactions

– Drowsiness, sedation


Corticosteroids

• Actions– Hormones useful in treatment of many types of

musculoskeletal disorders.• Use

– Treatment of rheumatic disorders.– Provide relief for inflamed areas of the body.– They lessen swelling, redness, itching, and allergic

reactions.– They are often used as part of the treatment for a

number of different diseases, such as severe allergies or skin problems, asthma, or arthritis.


Adverse Reactions

• When this medicine is used for short periods of time, side effects usually are rare – Less common

• Decreased or blurred vision; frequent urination; increased thirst

– Rare • Blindness (sudden, when injected in the head or neck area);

burning, numbness, pain, or tingling at or near place of injection ; confusion; excitement ; false sense of well-being; hallucinations (seeing, hearing, or feeling things that are not there); mental depression; mistaken feelings of self-importance or being mistreated; mood swings (sudden and wide); redness, swelling, or other sign of allergy or infection at place of injection; restlessness ; skin rash or hives.


Adverse Reactions (continued)

• Long term use– Abdominal or stomach pain or burning (continuing); acne;

bloody or black, tarry stools ; changes in vision; eye pain; filling or rounding out of the face; headache; irregular heartbeat; menstrual problems; muscle cramps or pain; muscle weakness; nausea; pain in arms, back, hips, legs, ribs, or shoulders; pitting, scarring, or depression of skin at place of injection; reddish purple lines on arms, face, groin, legs, or trunk; redness of eyes; sensitivity of eyes to light; stunting of growth (in children); swelling of feet or lower legs; tearing of eyes; thin, shiny skin; trouble in sleeping; unusual bruising; unusual increase in hair growth; unusual tiredness or weakness; vomiting; weight gain (rapid); wounds that will not heal.


Adverse Reactions (continued)• Other Effects not needing medical attention

– More common • Increased appetite; indigestion; loss of appetite (for triamcinolone

only); nervousness or restlessness – Less common or rare

• Darkening or lightening of skin color; dizziness or lightheadedness; flushing of face or cheeks; hiccups; increased joint pain (after injection into a joint); increased sweating; nosebleeds (after injection into the nose) ; sensation of spinning

• Following long term treatment– Abdominal, stomach, or back pain; dizziness ; fainting; fever; loss of

appetite (continuing); muscle or joint pain; nausea; reappearance of disease symptoms; shortness of breath ; unexplained headaches (frequent or continuing) ; unusual tiredness or weakness; vomiting; weight loss.

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Dr. Steven I. Dworkin Drugs That Affect the Musculoskeletal System