Arthritis Drugs

Question 1

acetaminophen

indications
pharmacodynamics

Answer 1

mild to moderate OA.

exerts its action on CNS and COX which results in decreased prostaglandin synthesis. active as an analgesic and antipyretic but NOT anti-inflammatory.

Question 2

acetaminophen

caution and contraindications

Answer 2

avoid in severe hepatic impairment and active liver disease.

compatible in pregnancy and lactation
approved in peds.

Question 3

acetaminophen ADRs

Answer 3

rash, dizziness, hypersensitivity reactions.

Question 4

Nonsteroidal anti- inflammatory drugs

Answer 4

ibuprofen, Naproxen, voltaren Gel

Question 5

Nonsteroidal anti- inflammatory drugs(NSAIDS)

ibuprofen, naproxen, voltaren gel.

indications and pharmacodynamics

Answer 5

mild to moderate OA, RA.

exerts its anti-inflammatory action by inhibiting the conversion of arachidonic acid to prostaglandin, prostacyclin, and thromboxanes, all are mediators of pain and inflammation

Question 6

NSAIDs contraindications and cautions

Answer 6

CAD, 
avoid in pregnancy
compatable in lactation.
caution in elderly. BEERS LIST.
caution in hepatic and renal impairment.
avoid GFR < 30.

approved in peds >6months.

Question 7

NSAIDs ADRs

Answer 7

alcohol,
edema,
skin rash,
dizziness,
gi disturbances,
dyspepsia,
htn,
bleeding (PLT aggregation),
elevated transaminases.

Question 8

NSAID BBW

Answer 8

increased risk for thrombotic events, serious GI bleed, ulcerations, and perforations.

Question 9

Tramadol

indications and pharmacodynamics

Answer 9

when pain of OA is past responsiveness to APAP and NSAIDS.

Mu opioid receptor agonists that when binds, ascending pain pathways are inhibited. tramadol inhibits the reuptake of serotonin and norepinephrine which are also involved in the ascending pain pathway

Question 10

Tramadol caution and contraindications

Answer 10

pts with hx of substance abuse,
hx of seizure,
renal & hepatic impairment,
elderly,
pediatrics < 12,
caution with other CNS depressants

Question 11

Tramadol ADRs.

Answer 11

dizziness, drowsiness, sweating, nausea.

mi receptor agonist ADRS: constipation, dependency, euphoria, resp depression.

risk of serotonin syndrome with combined with serotonin agents.

Question 12

disease modifying Antirheumatic Drugs

Answer 12

methotrexate

Question 13

Antitheumatic drugs

Methotrexate

pharmacodynamics

Answer 13

a folic acid antagonist, thought to affect leukocyte suppression, decreasing inflammation that results from immunologic by products.

Question 14

methotrexate ADRs

Answer 14

nausea, diarrhea, arthralgias, oral ulcers, alopecia, rash, dizziness, photosensitivity, elevated transaminates.

Question 15

methotrexate contraindications and cautions

Answer 15

AVOID in pregnancy and lactation,
blood dyscrasias,
renal and hepatic impairment

Question 16

Methotrexate BBW

Answer 16

risk of hepatotoxicity, renal impairment, pneumonitis, bone marrow suppression, GI toxicity, active stomatits, derm reactions, opportunistic infections.

Question 17

Biologic DMARDS (TNF inhibitors)

Answer 17

Rituximab (Rituxan) and

abatacept (Orencia)

Question 18

Rituximab (Rituxan) and
abatacept (Orencia)

indications &
pharmacodynamics

Answer 18

RA

act by bidning the circulating TNF aloha, rendering it inactive. this then reduces the chemotactic effect of TNF-alpha and reducing infiltration of inflammatory cells into the joint. cell lysis also occurs

Question 19

Rituximab (Rituxan) and
abatacept (Orencia)
contraindications & cautions

Answer 19

patient with new/recurrent infections,
update vaccines before initiating therapy,
safe in peds >2 y/o.
limited pregnancy and lactation data

Question 20

Rituximab (Rituxan) and

abatacept (Orencia) ADRs

Answer 20

injection site reactions, 
infusion reaction, 
infection, 
dizziness, 
headache, 
nausea

Question 21

Tumor necrosis factor (TNF) inhibitors used for the treatment of rheumatoid arthritis (RA) are associated with serious side effects, such as increased risk of which condition(s)?

Answer 21

heart failure, vasculitis and vision issues.

Question 22

The recommended maximum daily dose of acetaminophen for a person who is suffering from moderate osteoarthritis (OA) pain, and has a history of alcohol and drug use with hepatic issues, is a maximum of how many grams per day?

Answer 22

3 grams per day