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Pharmacology > Arthritis > Flashcards

Arthritis Flashcards

1
Q
  • Available OTC and widely prescribed
  • Antipyretic, analgesic, anti-inflammatory
  • Targets COX enzymes
A

NSAIDs

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2
Q

Side effects of NSAIDs

A

Gastric ulcers, impaired coagulation, cardiovascular events, induce asthma attacks, angiodema, rhinitis

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3
Q
  • Example of an NSAIDs
  • Absorbed in stomach
  • Inhibits NfKb= reduced transcription of inflammatory mediators
  • Minimal side effects
A

Aspirin

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4
Q
  • Example of an NSAIDs
  • Pain-relief
  • Anti-inflammatory effects
  • Very few side effects (diarrhoea, constipation, gas, mouth sores, headache)
A

Ibuprofen

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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

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6
Q
  • COX inhibitor
  • Selectively blocks COX-2 to reduce inflammation
  • Cardiovascular side effects (MI and Stroke)
A

Meloxicam

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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

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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

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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

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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

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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

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12
Q
  • Glucocorticoid
  • Metabolic effects, anti-inflammatory, immnosuppressive
  • Immediate effects
  • Oral or Intra-articular injection daily
A

Prednisolone

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13
Q
  • Glucocorticoid
  • Metabolic effects, anti-inflammatory, immnosuppressive
  • Longer-acting
  • Intra-articular injection every 3-21 days
A

Dexamethasone

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14
Q
  • Mineralocorticoid
  • Water and electrolyte balance
  • Taken orally daily
A

Fludrocortisone

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15
Q
  • DMARDs
  • Gains products of neutrophils
  • Enteric- coated tablet as absorbed poorly
  • GI upset, headache, skin reactions, leukopenia
A

Sulfasalazine

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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
Q
  • Anti-TNF blocks the action of TNF to reduce inflammation

- Blocked and runny nose, nausea, mild fever, headaches, dizziness, rash, stomach pain

A

Etanercept

26
Q
  • 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
A

Infliximab

27
Q
  • Biological therapy that removes B-cells and helps reduce inflammation that causes joint pain and swelling
  • Fever, wheeziness, rash, fall in BP
A

Rituximab

28
Q
  • Biological therapy which blocks T-cell function to reduce inflammation
  • Headache and nausea
  • Affects immune system making it easy to pick up infection
A

Abatacept

Pharmacology (11 decks)

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