Arthiritis Flashcards
How is osteoarthritis worsened and what treatment options are available?
Worsened by movement
Treatment- steroid injections, NSAIDs/ COX-2 inhibitors, surgery
Is Rheumatoid arthritis an inflammatory disorder? What are the symptoms and lab tests used?
Chronic inflammatory
Symptoms- pain, stiffness, joint swelling, joking deformity
Lab tests- increased WBC, increased erythrocyte sedimentation rate (ESR), anaemia, rheumatoid factor
What improves RA?
Movement
What does DMARD stand for?
Disease modifying anti rheumatic drugs
What is the general mechanism of DMARDs?
Inhibit cell proliferation by inhibiting cytokines including interleukins, interferons and TNF alpha
What are the general counselling points of DMARDs?
Dose increased gradually Improvement may take months Nausea Monitoring necessary Report signs of blood dycrasias, liver or lung toxicity
What is the mechanism of action of methotrexate?
Inhibits dihydrofolate reductase so DHF can’t be converted to THF preventing DNA synthesis
How often should methotrexate be taken and why is folic acid taken with it and when?
Weekly
Reduce side effects of methotrexate
Not on the same day as methotrexate
Is osteoarthritis an inflammatory disorder?
Non inflammatory impede ting the cartilage in joints
How does age effect the metabolism and excretion of methotrexate?
Decreases them
How does sulphasalazine work?
Metabolised to 5-ASA which inhibits leukotriene and prostanoid synthesis
How does leflunomide work?
Metabolised to teriflunomide which inhibits dihydroorotate dehydrogenase inhibiting pyrimidines therefore preventing DNA synthesis
Why is IM gold better than oral?
More efficient however oral has less side effects
How do monoclonal antibody drugs work?
TNF alpha blocking
