Musculoskeletal Medications — NCLEX-PN Pharmacology Review | Chapter 58: Saunders

Musculoskeletal Medications — NCLEX-PN Pharmacology Review | Chapter 58: Saunders

Chapter 58 of Saunders Comprehensive Review for the NCLEX-PN® Examination (7th Edition) by Linda Anne Silvestri and Angela E. Silvestri offers a detailed overview of medications used for musculoskeletal disorders. It includes skeletal muscle relaxants, antigout agents, antiarthritic therapies, and osteoporosis drugs—covering drug actions, side effects, safety protocols, and NCLEX-focused teaching points.

Watch the lecture above for a complete musculoskeletal pharmacology review, then use the detailed breakdown below for NCLEX-PN exam preparation.

Saunders NCLEX-PN Examination Review book cover

Skeletal Muscle Relaxants

  • Examples: baclofen, cyclobenzaprine, dantrolene.
  • Mechanisms: central vs peripheral action on muscle tone.
  • Side effects: drowsiness, CNS depression, liver toxicity.
  • Precautions: avoid alcohol/CNS depressants, monitor LFTs, caution with renal/cardiac disease.

Antigout Medications

  • Allopurinol, colchicine, probenecid — reduce uric acid or inflammation.
  • Teaching: low-purine diet, hydration (2–3 L/day), avoid aspirin, monitor renal function.
  • Report rash, GI upset, or signs of kidney impairment promptly.

Antiarthritic Medications

  • DMARDs: methotrexate, hydroxychloroquine, sulfasalazine, leflunomide — slow disease progression.
  • Biologics: etanercept, infliximab, adalimumab — immune suppression, infection risk, injection site reactions.
  • Monitoring: CBC, liver enzymes, signs of infection, avoid live vaccines.
  • Gold salts: risk of rash, metallic taste, bone marrow suppression; antidote: dimercaprol.

Osteoporosis Medications

  • Bisphosphonates: alendronate, risedronate, ibandronate — take with water, remain upright 30–60 min to prevent esophagitis.
  • Calcitonin: monitor for hypocalcemia, alternate nostrils for intranasal form.
  • Raloxifene: estrogen agonist/antagonist, risk of thrombosis, stop before prolonged bed rest.
  • Teriparatide: stimulates bone growth; high fracture risk patients; rare risk of bone cancer.

Medication Interactions & Precautions

  • Avoid NSAIDs with antigout drugs to prevent renal damage.
  • Avoid high vitamin C intake with allopurinol.
  • Never skip doses of maintenance medications.

NCLEX-Priority Teaching Points

  • Recognize early signs of drug toxicity.
  • Stress importance of lab monitoring for liver and kidney function.
  • Educate clients on safe administration timing and positioning for osteoporosis drugs.
  • Highlight infection prevention for immunosuppressive therapies.

Conclusion

Chapter 58 reinforces critical pharmacology knowledge for musculoskeletal disorders, ensuring safe medication administration, complication prevention, and optimal client outcomes—skills essential for NCLEX-PN success.

Subscribe to Last Minute Lecture for more NCLEX-focused lectures and pharmacology reviews.

View the complete Saunders Comprehensive Review for the NCLEX-PN® Examination (7th Edition) playlist here: Complete NCLEX-PN Review Playlist

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