2- pharmacology arthtitis Flashcards
what are the basic pharmacology steps for pain treatment?
- step 1 = non opioid like paracetamol or NSAID
- step 2= weak opioid like codeine
- step 3 = strong opioid like morphine
→aim is to get manageable/controlled pain (not zero pain)
what are NSAIDs that can be used if GI symptoms?
COX 2 inhibitors like celecoxib or etoricoxib
what are some opiates analgesics?
= codeine or tramadol
co codamol has mix of 2 analgesics
why do we try limit opiate use?
drowsy, nauseous, fatigue, limit due to opiate dependent (limit for short period)
what are the commonly used DMARDs?
methotrexate, sulphasalazine, leflunomide, hydroxychloroquine
what medication do you give to people with RA before DMARDs start to work?
steroids like prednisolone
what conditions are DMARDs used to treat?
rheumatoid arthritis, psoriatic arthritis, connective tissue disease, vasculitis
when would you move onto using biologics after DMARDs?
after failure of 2 DMARDs (one of which is methotrexate)
what biologic is 1st line (what does it target)?
anti-TNf
what are some examples of anti-TNF drugs?
etanercept, adalimumab, certolizumab, infliximab, golimumab
what medication groups are used in gout acute flare?
- colchicine
- NSAIDs
- steroids
what are medications that could be used in gout prophylaxis?
allopurinol is 1st line then febuxostat 2nd line (both xanthine oxidase inhibitors so stops uric acid production)
also uricosurics e.g. probenecid, sulphinpyrazone, benzbromarone →make pee out
