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Musculoskeletal > 4.1.1 Pharmaceuticals for Musculoskeletal Pain > Flashcards

4.1.1 Pharmaceuticals for Musculoskeletal Pain Flashcards

1
Q

What is the immune response?

A

Immunologically competent cells are activated in response to foreign organisms.

May be beneficial or deleterious

Numerous molecular mediators

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2
Q

What is the general strategy in pain management?

A

Relief of pain

Delay or arrest of disease process

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3
Q

Arachadonic acids is a precursor molecule for?

A

Prostaglandins

Thromboxane

Prostacyclin

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4
Q

Where in the arachidonic acid pathway do the COX enzymes work?

A
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5
Q

What is the difference between COX1 and COX2

A

COX1 - Constitutively active, provides protection in the gut, protective function

COX2 - Inducible, inflammatory response

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6
Q

How does acetaminophen differ from other drugs?

A

Acetaminophen works on the CNS as well

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7
Q

What are the anti-inflammatory effects of asprin?

A

Nonselective inhibitor or COX isoforms

Irreversibly inhibits COX and platelet aggregation

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8
Q

What are the analgesic effects of asprin?

A

Most effective in reducing pain of mild to moderate intensity through reducing inflammation

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9
Q

What are the antipyretic effects of asprin?

A

Antipyretic effects probably mediated by both COX inhibition in the CNS and inhibition of IL-1

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10
Q

What are some of the adverse effects of asprin?

A

Gastric Upset

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11
Q

How is ibuprofen different that asprin?

A

Often prescribed in lower doses with analgesic, but not anti-inflammatory efficacy

NSAIDS

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12
Q

What is a good use for indomethacin?

A

Particularily popular for gout and ankylosing spondylitis

NSAID

Mainly used for severe inflammation

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13
Q

What are the characteristics of COX-2 selective inhibitors?

A

Inhibit prostaglandin synthesis by COX-2 induced at sites of inflammation.

Lower liability for GI upset

No impact on platelet aggregation though

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14
Q

What are some of the COX-2 selective inhibitors?

A

Celecoxib

Etoricoxib

Meloxicam

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15
Q

What are the characteristics of acetaminophen?

A

Weak inhibitor of COX enzymes

Central direct analgesic effects

Not an anti-inflammatory at typical doses

Antipyretic

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16
Q

Describe the dietary manipulation of inflammation,

17
Q

What are the characteristics of the Disease-Modifying Anti-Rheumatic Drugs (DMARDs)?

18
Q

What are the characteristics of methotrexate?

A

Inhibition of AICAR tranformylase leading to secondary effects on chemotaxis

19
Q

What are the characteristics of cyclophosphamide

A

Cross-linking DNA to prevent cell replication

20
Q

What are the characteristics of cyclosporine?

A

Inhibits IL-1 and IL-2

21
Q

What are the characteristics of Azathioprine?

A

Suppresses B and T cell function Ig production and IL-2 secretion

22
Q

What are the characteristics of sulfasalazine?

A

IgA and IgM rheumatoid factor production are decreased

23
Q

What are the two meanings for biologic therapies?

24
Q

What are the anti-TNF agents?

A

Etanercept - cytokine receptor fusion protein

Infliximab - anti-TNF chimeric monoclonal antibody

Adalimumab - anti-TNF monoclanal antibody

25
Q

What is the action of rituximab?

A

B-cell depleting agents

26
Q

What is the action of abatacept?

A

T-cell co stimulation inhibitor

27
Q

What are the actions of leflunomide?

A

Cell growth arrestors - G1 phase

28
Q

What is the action of anakinra?

A

IL-1 inhibition

29
Q

What is the action of Secukinumab (Costenyx)?

A

IL-17A inhibitors

30
Q

What is the action of Ixekizumab (Taltz)?

A

IL-17A used in plaque psoriasis

31
Q

What are the characteristics of steroidal anti-inflammatory therapy?

A

Inhibition of NF-kB and AP-1 transcription

Net result is decreased lymphocytes, monocytes, eosinophils and basophils

32
Q

What are the different steroid medication and what are their durations? Why do physicians do not what to keep patients on for extended periods?

33
Q

What is gout?

A

Metabolic disease characterized by recurrent episode of acute arthritis due to depositions of monosodium urate in joints and cartilage

34
Q

What are the therapeutic goals for gout?

A

Providing control of pain and inflammation

35
Q

What are the characteristics of Colchicine?

A

Inhibits microtubule aggregation which disrupts leukocyte chemotaxis and phagocytosis

Inhibition of crystal-induced production of chemotatic factors

Producesdiarrhea and other GI side effects

36
Q

What treatments have replaced colchicine?

A

NSAIDs

Indomethacin - inhibits urate crystal phagocytosis

37
Q

What are the drugs that are used in the prophylaxis of gout?

A

Xanthine Oxidase inhibitors

Allopurinol - blocks conversion of xanthine to uric acid

Febuxostat - New class of xanthine oxidase inhibitor, more selective

38
Q

What are the characteristics of the Uricosuric drugs?

39
Q

What are the characterisitcs of Opoid analgesics? Not super specific

A

Morphine is derived from opium

Musculoskeletal (53 decks)

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