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Pharmacology > Applied Pharmacology - Arthritis Drugs > Flashcards

Applied Pharmacology - Arthritis Drugs Flashcards

1
Q

What are the risk factors for osteoarthritis? (5)

A 
Obesity
Age >40
Female sex
Previous joint injury
Genetics
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2
Q

What do prostaglandins do?

A

Increase power of histamine and bradykinin

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3
Q

Which COX enzyme is common in most tissues?

A

COX 1

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4
Q

What induces COX 2? (3)

A

Injury, infection, cytokines

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5
Q

Name 5 NSAIDs

A 
Aspirin
Ibuprofen
Diclofenac
Meloxicam
Indomethacin
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6
Q

What actions do NSAIDs have? (4)

A

Antipyretic
Analgesic
Anti-inflammatory
May scavenge free radicals

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7
Q

What are the adverse effects of NSAIDs

A

Gastric problems
Impair coagulation
Risk of CV events

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8
Q

Name a COX 2 selective drug

A

Meloxicam

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9
Q

Who are celecoxib and etoricoxib prescribed to?

A

Patients at high risk of gastric ulcers

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10
Q

What are the side effects of celecoxib and etoricoxib? (4)

A

Headache
Rash
Peripheral Oedema
Dizziness

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11
Q

Name a synthetic prostaglandin

A

Misoprostol

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12
Q

What is the purpose of giving misprostol with arthritis meds?

A

Preserve GI tract

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13
Q

Side effects of misprostol? (2)

A

Diarrhoea, vaginal bleeding

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14
Q

Who should precautions be taken with when giving misprostol?

A

Women of childbearing age

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15
Q

What are the effects of paracetomol? (4)

A

Antipyretic
Analgesic
Decreases prostaglandin production
May involve COX-3

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16
Q

What are the risks of large paracetomol doses?

A

Kidney damage

Liver damage

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17
Q

Name 4 treatments for osteoarthritis that aren’t drugs

A

Exercise
Weight loss
TENs machine
Suitable Footwear

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18
Q

What other treatments are there for OA? (4)

A

Topical NSAIDs
Paracetomol
Opioids
Steroid injections

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19
Q

What does strontium ranelate do? (3)

A

Promotes osteoblast activity
Reduces osteoclast activity
Prevents fractures

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20
Q

What risks does stronium ranelate carry? (2)

A

Increases risk of MI

Increases risk of thrombotic events

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21
Q

Name 4 glucocorticoids

A

Dexamethasone
Beclomethasone
Betamethasone
Budesonide

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22
Q

Name a mineralocorticoid

A

Fludrocortisone

23
Q

Name 2 short acting steroids

A

Cortisone

Hydrocortisone

24
Q

Name an intermediate acting steroid

A

Prednisolone

25
Q

Name a long acting steroid

A

Dexamethasone

26
Q

How are short acting steroids administered?

A

Daily cream x 2 or intra-articular injection

27
Q

How are intermediate acting steroids administered?

A

Daily Oral tablet or intra-articular injection

28
Q

How are long acting steroids adminstered

A

intra-articular injection

29
Q

Describe 4 actions of glucocorticoids

A

Decrease transcription of cytokines
Decrease circulating lymphocytes
Decrease arachidonic-acid release
Increase synthesis of anti-inflammatory proteins

30
Q

What does DMARD stand for?

A

Disease Modifying Anti-Rheumatic Drugs

31
Q

Name 3 DMARDs

A

Sulfasalazine
Gold Compounds
Penicillamine

32
Q

What are the effects of Sulfasalazine

A

Scavenges free radicals

Causes remission in active RA

33
Q

What are the side effects of Sulfasalazine? (4)

A

headache, skin reactions, leukopenia, GI disturbance

34
Q

How does penicillamine work?

A

Decreases fibroblast activity

Decreases immune response

35
Q

Side effects of penicillamine?

A

rashes, stomatitis, anorexia, taste disturbance,

36
Q

Name 2 Gold Compounds

A

Auranofin

Na Auranofin

37
Q

Side effects of gold compounds? (6)

A

Skin rash, flu, mouth ulcers, encephalopathy, peripheral neuropathy

38
Q

When are anti-malarials used in arthritis treatment?

A

As a last resort

39
Q

Name an anti-malarial

A

Chloroquine

40
Q

How do anti-malarials help in arthritis

A

Apoptosis of T lymphocytes, stops the destruction in joints

41
Q

What are the side effects of anti-malarials? (4)

A

Nausea, vomiting, dizziness, blurred vision

42
Q

Name 2 anti-cytokines

A

Adalimumab

Etenercept

43
Q

What are anti-cytokines?

A

Engineered anti-bodies,used as last resort

44
Q

Side effects of anti-cytokines?

A

Nausea, latent disease, oppurtunistic infection

45
Q

Name 5 immunosuppresants

A 
Ciclosporin
Azathioprine
Methotrexate
Leflunomide
Cyclophosphamide
46
Q

How does ciclosporin work?

A

Reduces T cell proliferation

47
Q

Side effects of ciclosporin? (6)

A

Nephrotoxicity, Hepatotoxicity, HTN, nausea & vomiting, gum hypertrophy, GI problems

48
Q

How does azathioprine work?

A

INterferes with purine metabolism, decreasing DNA synthesis

49
Q

How does methotrexate work? (2)

A

Folic acid antagonist, inhibits DNA synthesis

Inhibits T cell activation

50
Q

Side effects of methotrexate? (3)

A

Blood dyscrasias, liver cirrhosis, folate deficiency

51
Q

How does leflunomide work?

A

Inhibits activated T cells

52
Q

What are the side effects of leflunomide? (3)

A

Diarrhoea, alopecia, increase liver enzymes&raquo_space; risk of hepatotoxicity

53
Q

How does Cyclophosphamide work?

A

Liver activates to phosphoramide mustard and acrolein

54
Q

Side effects of cyclophosphamide? (2)

A

Increases Risk of infection, risk of cancer

Pharmacology (18 decks)

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