Arthritis Flashcards
1
Q
- Available OTC and widely prescribed
- Antipyretic, analgesic, anti-inflammatory
- Targets COX enzymes
A
NSAIDs
2
Q
Side effects of NSAIDs
A
Gastric ulcers, impaired coagulation, cardiovascular events, induce asthma attacks, angiodema, rhinitis
3
Q
- Example of an NSAIDs
- Absorbed in stomach
- Inhibits NfKb= reduced transcription of inflammatory mediators
- Minimal side effects
A
Aspirin
4
Q
- Example of an NSAIDs
- Pain-relief
- Anti-inflammatory effects
- Very few side effects (diarrhoea, constipation, gas, mouth sores, headache)
A
Ibuprofen
5
Q
- Has no anti-inflammatory effect so is not an NSAIDs
- Suppresses prostaglandin production
- May stimulate serotenergic pathways involved with pain
- Large doeses= kidney damage, Toxic doses= fatal liver damage
A
Paracetamol
6
Q
- COX inhibitor
- Selectively blocks COX-2 to reduce inflammation
- Cardiovascular side effects (MI and Stroke)
A
Meloxicam
7
Q
- COX inhibitor
- Selectively blocks COX-2 to reduce inflammation
- Used in patients with GI side effects
- Headache, dizziness, skin rash, pheripheral oedema
A
Celecoxib
8
Q
- Targets GI and coagulation pathway
- Its a synthetic prostaglandin
- Used alongside NSAIDs to reduce GI side effects
- Diarrhea and vaginal bleeding
- May induce labour
A
Misoprostol
9
Q
- Targets bones
- Inhibits osteoclast activity
- Reduces osteoblast differentiation
- Reduces pain and prevents fractures
- Risk of MI and thrombolytic events so only used in severe cases
A
Stronium Renelate
10
Q
- Major constituent of extracellular molecules
- Present in cartilage and synovial fluid
- Targets molecules in extracellular matrix
- Not recommended my NICE due to possible long term effects
A
Glucosamine Sulphate
11
Q
- Naturally produced in body
- Manage short- term flare ups
- Long-term is only necessary if all other treatment fails
- Side effects are same as those for Cushings Syndrome
A
Costicosteroids
12
Q
- Glucocorticoid
- Metabolic effects, anti-inflammatory, immnosuppressive
- Immediate effects
- Oral or Intra-articular injection daily
A
Prednisolone
13
Q
- Glucocorticoid
- Metabolic effects, anti-inflammatory, immnosuppressive
- Longer-acting
- Intra-articular injection every 3-21 days
A
Dexamethasone
14
Q
- Mineralocorticoid
- Water and electrolyte balance
- Taken orally daily
A
Fludrocortisone
15
Q
- DMARDs
- Gains products of neutrophils
- Enteric- coated tablet as absorbed poorly
- GI upset, headache, skin reactions, leukopenia
A
Sulfasalazine
16
Q
- DMARDs
- Produced by hydrolysis on penicillin
- Decreases immune response
- Not to be given with gold compounds
- Rashes, stomatitis, taste disturbance, fever, N+V
A
Penicillamine
17
Q
- DMARDs
- Increase pH of intracellular vacuoles- interfers with antigen
- Induces apoptosis in T-lymphocytes
- Used when other treatments fail
- Therapeutic effect may take up to a month
- N+V, dizziness, blurred vision
A
Antimalarials
18
Q
- DMARDs
- Inhibits induction of IL-1 + TNF= decrease in pain and joint swelling
- Given by IM injection
- Effects develop over 3-4 months
- Rashes, flu, mouth ulcers, blood disorders, encepathalopathy, pheripheral neuropathy, hepititis
A
Gold compounds
19
Q
- Immunosuppressants
- Potent
- No affect on acute inflammation
- Inhibits IL-2 gene transcription= reduced T-cell production
- Poorly absorbed orally
- Nephrotoxicity, hepatotoxicity, N+V, gum hypertrophy, GI problems
A
Ciclosporin
20
Q
- Immunosuppressants
- Cytotoxic
- Interfers with purine metabolism, decreasing DNA synthesis
- Depresses cell and antibody mediated immune reactions
- Suppression of bone marrow
A
Azathroprine
21
Q
- Immunosuppressants
- Inhibits pyrimidine synthesis
- Specific inhibitor of activated T-cells
- Absorbed well orally
- Diarrhea, alopecia, increased liver enzymes hepatoxicity
A
Leflunomide
22
Q
- Immunosuppressants
- Used when other therapies have failed
- Inhibits cross-linking DNA
- Pro-drug= administered orally and activated in liver
- Nausea, loss of appetite, abdominal pain, missed periods
A
Cyclophosphamide
23
Q
- Immunosuppressants
- Folic acid antagonist
- Inhibits DNA synthesis, blocking growth and differentiation of rapidly dividing cells
- Inhibits T-cell activation
- Blood abnormalities, liver cirrhosis, folate deficiency, problems in pregnancy
A
Methotrexate
24
Q
Antibodies that bind to cytokines= inhibits immune response
A
Anticytokines
25
- Anti-TNF blocks the action of TNF to reduce inflammation
| - Blocked and runny nose, nausea, mild fever, headaches, dizziness, rash, stomach pain
Etanercept
26
- Anti-TNF reduces inflammation
- Blocked and runny nose, nausea, mild fever, headaches, dizziness, rash, stomach pain
- Affects immune system making it easy to pick up infection
Infliximab
27
- Biological therapy that removes B-cells and helps reduce inflammation that causes joint pain and swelling
- Fever, wheeziness, rash, fall in BP
Rituximab
28
- Biological therapy which blocks T-cell function to reduce inflammation
- Headache and nausea
- Affects immune system making it easy to pick up infection
Abatacept
