Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MSK > Arthritis pharmacology > Flashcards

Arthritis pharmacology Flashcards

1
Q

When would you give an NSAID?

A

Inflammatory arthritis
mechanical MSK pain
Serositis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What kind of drug is celecoxib?

A

Cox-2 inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How do cox-2 inhibitors work?

A

They inhibit cyclooxygenase-2 which stops the formation of prostaglandins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Give an example of a cox-1 inhibitor

A

aspirin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Why does taking NSAIDs increase risk of peptic ulcers?

A

Prostaglandin is inhibited by NSAIDs.
Prostaglandin inhibits HCl secretion in stomach.
No prostaglandins then more HCl in the stomach, leading to peptic ulcers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What can be other adverse effects of NSAIDs?

A

Wheeze
Rash
Renal impairment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the analgesic pathway ?

A

Non-opioid e.g. aspirin, NSAID, paracetamol,

THEN

Weak opioid e.g. codeine

THEN

Strong opioid e.g. morphine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is a DMARD?

A

Disease modifying anti-rheumatic drug

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Why use a DMARD?

A

Reduces inflammation

Reduces the rate of joint damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What do you need to keep in mind when using DMARDs?

A

Must have regular blood tests

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Within what time period of symptom onset is a DMARD aimed to begin?

A

Within 3 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Which DMARDs are used for RA?

A

Methotrexate

Sulfsalazine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

In what other conditions is methotrexate prescribed?

A

Connective tissue disease
vasculitis
Psoriatic arthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What adverse effects must you remember about methotrexate?

A

Hepatitis- limited alcohol
Mouth ulcers
Leucopenia
N&D

FBCs and LFTs monitored

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Methotrexate is teratogenic. What time period must it be stopped before conception?

A

3 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the adverse effects of sulfsalazine?

A

Rash
Neutropenia
Hepatitis
oligozoospermia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is oligozoospermia?

A

Low sperm count

18
Q

When is hydroxychloroquine used?

A

SLE, Sjogrens and RA

19
Q

Why is it used in these conditions?

A

Can help to clear skin, joints and general malaise

20
Q

What other DMARDs can be given?

A 
Sodium aurothiomalate (gold) 
Penicillamine
21
Q

What are biologics?

A

Anti-TNF drugs e.g. infliximab, etanercept

22
Q

In what conditions can anti-TNFs be given?

A

RA, AS and psoriatic arthritis

23
Q

What is the mechanism of anti-TNFs?

A

???TNF is a cytokine.

24
Q

What are the adverse effects of anti-TNFs?

A

TB reactivation

Possible malignancy risk espec. malignant melanoma

25
Q

When can anti-TNFs be given?

A

When DMARDs have been unsuccessful

High disease activity score as per DAS28

26
Q

What treatment would you give for acute gout?

A

NSAIDs

Colchine if NSAIDs contra-indicated but beware D&V

27
Q

What treatment would you give for gout prophylaxis?

A

Allopurinol

Febuxostat

28
Q

How is prophylactic gout treatment started?

A

Need cover for 2-4 weeks with NSAID and prophylactic drug since can trigger flare

29
Q

How does allopurinol work?

A

It is a xanthine oxidase inhibitor which prevents uric acid from forming

30
Q

What can be a side effect of allopurinol?

A

Rashes

31
Q

When is febuxostat used?

A

If allopurinol cannot be tolerated.

32
Q

What are cautions with febuxostat?

A

Renal impairment

Caution in ischaemic HD

33
Q

What is a uricosuric and give an example.

A

Increases excretion of uric acid in the urine

Benzbromarone

34
Q

When would steroids be used?

A

Connective tissue disease
Polymyalgia rheumatica
Vaculitis
RA

35
Q

What modes of administration can be used for steroids?

A

Oral
IM
Intra-articular
IV

36
Q

What can be adverse effects of corticosteroids?

A 
Weight gain
Muscle wasting
Osteoporosis
Diabetes
Skin atrophy
37
Q

How can the toxicity of steroids be reduced?

A

Lowest dose for the shortest time

Osteoporosis prophylaxis

38
Q

Why are cox-2 inhibitors less likely to cause peptic ulcers?

A

Target only cox-2 receptors so affects acid secretion less

39
Q

A patient is feeling nauseous while taking methotrexate. What can you do?

A

Change to methotrexate subcutaneously.

40
Q

What is the benefit of using etanercept over infliximab?

A

Can be self given via a pen device.

41
Q

How is the DAS28 score calcuated?

A

Number of 28 joints that are swollen
Number of 28 joints that are tender
Patient rating 1- 10 of how disease is

42
Q

What DAS28 score allows a patient to have an anti-TNF?

A

> 5.1

MSK (30 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions