Arthritis Drugs Flashcards
acetaminophen
indications
pharmacodynamics
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.
acetaminophen
caution and contraindications
avoid in severe hepatic impairment and active liver disease.
compatible in pregnancy and lactation
approved in peds.
acetaminophen ADRs
rash, dizziness, hypersensitivity reactions.
Nonsteroidal anti- inflammatory drugs
ibuprofen, Naproxen, voltaren Gel
Nonsteroidal anti- inflammatory drugs(NSAIDS)
ibuprofen, naproxen, voltaren gel.
indications and pharmacodynamics
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
NSAIDs contraindications and cautions
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.
NSAIDs ADRs
alcohol, edema, skin rash, dizziness, gi disturbances, dyspepsia, htn, bleeding (PLT aggregation), elevated transaminases.
NSAID BBW
increased risk for thrombotic events, serious GI bleed, ulcerations, and perforations.
Tramadol
indications and pharmacodynamics
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
Tramadol caution and contraindications
pts with hx of substance abuse, hx of seizure, renal & hepatic impairment, elderly, pediatrics < 12, caution with other CNS depressants
Tramadol ADRs.
dizziness, drowsiness, sweating, nausea.
mi receptor agonist ADRS: constipation, dependency, euphoria, resp depression.
risk of serotonin syndrome with combined with serotonin agents.
disease modifying Antirheumatic Drugs
methotrexate
Antitheumatic drugs
Methotrexate
pharmacodynamics
a folic acid antagonist, thought to affect leukocyte suppression, decreasing inflammation that results from immunologic by products.
methotrexate ADRs
nausea, diarrhea, arthralgias, oral ulcers, alopecia, rash, dizziness, photosensitivity, elevated transaminates.
methotrexate contraindications and cautions
AVOID in pregnancy and lactation,
blood dyscrasias,
renal and hepatic impairment
Methotrexate BBW
risk of hepatotoxicity, renal impairment, pneumonitis, bone marrow suppression, GI toxicity, active stomatits, derm reactions, opportunistic infections.
Biologic DMARDS (TNF inhibitors)
Rituximab (Rituxan) and
abatacept (Orencia)
Rituximab (Rituxan) and
abatacept (Orencia)
indications &
pharmacodynamics
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
Rituximab (Rituxan) and
abatacept (Orencia)
contraindications & cautions
patient with new/recurrent infections,
update vaccines before initiating therapy,
safe in peds >2 y/o.
limited pregnancy and lactation data
Rituximab (Rituxan) and
abatacept (Orencia) ADRs
injection site reactions, infusion reaction, infection, dizziness, headache, nausea
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)?
heart failure, vasculitis and vision issues.
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?
3 grams per day
