⬢ Musculoskeletal / Pain / InflammationPain, arthritis, gout, muscle spasm, and bone health — from acetaminophen to opioids to biologics.
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NSAIDs 8 drugs Block COX enzymes to cut pain, fever, and inflammation at the source.
Treats: Pain · Arthritis · Fever · Dysmenorrhea
Boxed warnings: GI bleeding/ulcers and cardiovascular events (MI, stroke); kidney injury; avoid in CKD, heart failure, and third-trimester pregnancy. ibuprofen, naproxen, meloxicam, celecoxib, diclofenac +3 more
Acetaminophen 1 drugs Lowers pain and fever through the brain — no anti-inflammatory or bleeding effect.
Treats: Pain · Fever · Osteoarthritis (first-line)
Liver failure above ~4 g/day or less with alcohol/liver disease; hidden in many combo products — a leading cause of acute liver failure. acetaminophen
Opioids 9 drugs Bind opioid receptors to blunt severe pain — powerful, and the reason for the overdose epidemic.
Treats: Moderate-severe acute pain · Cancer pain · Palliative care
Boxed warnings: respiratory depression, addiction, and fatal interaction with benzodiazepines/CNS depressants; constipation is universal; keep naloxone available. morphine, oxycodone, hydrocodone-acetaminophen, hydromorphone, fentanyl +4 more
Skeletal Muscle Relaxants 6 drugs Ease painful muscle spasm — most work by sedating the central nervous system.
Treats: Acute low back spasm · Spasticity (baclofen, tizanidine) · Malignant hyperthermia (dantrolene)
Sedation and falls, especially with opioids/benzos and in older adults (Beers); cyclobenzaprine is anticholinergic; never stop baclofen abruptly — withdrawal seizures. cyclobenzaprine, methocarbamol, baclofen, tizanidine, carisoprodol +1 more
Gout Agents 5 drugs Two jobs: calm the acute flare, and lower uric acid long-term to prevent the next one.
Treats: Acute gout flare · Chronic gout (urate-lowering)
Never start or stop urate-lowering therapy during a flare; allopurinol can cause fatal hypersensitivity (higher in HLA-B5801); colchicine toxicity with renal impairment and CYP inhibitors. allopurinol, febuxostat, colchicine, probenecid, pegloticase
DMARDs & Biologics (Inflammatory Arthritis) 7 drugs Disease-modifying drugs that slow joint destruction in rheumatoid and related arthritis.
Treats: Rheumatoid arthritis · Psoriatic arthritis · Ankylosing spondylitis
Serious infection and TB reactivation — screen before biologics; methotrexate is weekly (not daily) and hepatotoxic; live vaccines contraindicated. methotrexate, hydroxychloroquine, sulfasalazine, leflunomide, adalimumab +2 more
Bone Health Agents (Osteoporosis) 7 drugs Slow bone breakdown or build new bone to prevent fractures.
Treats: Osteoporosis · Fracture prevention · Paget disease
Oral bisphosphonates cause esophageal erosion — take upright with water, stay up 30 min; osteonecrosis of jaw and atypical femur fractures with long use; denosumab rebound if stopped. alendronate, risedronate, zoledronic acid, denosumab, teriparatide +2 more
