Bone and joint drugs Flashcards

1
Q

Analgesia in RA?

A

Paracetamol
Paracetamol-opioid combinations
NSAIDS

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2
Q

What is first line of treatment for RA?

A

NSAIDS and analgesics

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3
Q

2nd line treatment for RA?

A

DMARDS

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4
Q

Examples of DMARDS?

A

Methotrexate
Sulphasalazine
Azathioprine

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5
Q

3rd line RA treatment?

A

DMARDS combo

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6
Q

4th line RA treatment?

A

Immunotherapy

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7
Q

4 categories of immunotherapy used to treat RA?

A
CSA 
steroids
Cyclophosphamides
TNFa therapies
Anti-CD20
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8
Q

What has changed recently about RA treatment?

A

Now treat with DMARDS immiediately

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9
Q

Methotrexate - how does it act?

A

Competitively inhibits dihydrofolate reductase (DNA synth)

Also has other anti inflame and cytokine modulating effects

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10
Q

Systemic adverse effects of methotrexate?

A

Mouth ulcers/nausea - Rx with folic acid

Bone marrow suppression inc neutropenia

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11
Q

Biggest problem with immunosuppression?

A

TB reactivation

- screen people before you start patients on them

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12
Q

Osteoarthritis lifestyle advice?

A

Exercise
Avoid excessive weight bearing (e.g. heels)
Lose weight

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13
Q

Why can diuretics > gout?

A

Uric acid clearance is reduced

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14
Q

Pain treatment of gout?

A

Pain relief

- NSAIDS, eg. high dose indomethacin

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15
Q

Gout treatment that inhibits leukocyte micro-tubular formation and migration. Side effects?

A

Colchine

GI problems - diarrhoea

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16
Q

In an acute setting, what should you not give for gout?

A

LT gout treatment, can make it worse (look up)

17
Q

Osteoporosis treatment (2)

A

Calcium/vit D

Bisphosphanates (inhibits bone resorption - osteoblasts)

18
Q

Name 2 bisphosphanates

A

Alendronate

Etidonate

19
Q

Side effects of bisphosphanates

  • common (2)
  • uncommon (2)
A

Oesophageal ucleration and hypophosphataemia

Osteonecrosis of the jaw, atypical femoral fracture