Chapter 30 Arthritis, Gout Flashcards
1
Q
aspirin and other salicylates
A
- NSAID
- used for pain, fever, inflammation
- inhibits COX nonspecifically in peripheral tissues and CNS
- longer effect on TXA2 and platelet aggregation
- prophylaxis against MI, CVA, thromboembolism
- avoid in children (reye syndrome)
- AE: GI bleeding, ulceration, tinnitus, hypersensitivity in asthma
2
Q
acetaminophen (tylenol)
A
- NSAID
- analgesic and antipyretic
- safe for children
- weak anti-inflammatory
- preferred for gestational
- AE: risk of renal insufficiency with long term use
3
Q
acetylcysteine (sulfhydryl antidote)
A
- extensive hepatic metabolism, toxic doses deplete hepatic glutathione which leads to APAP OD
- antidote supplants the glutathione and inactivates toxic metabolite
4
Q
ketorolac (toradol)
A
- NSAID
- analgesic, antipyretic, anti inflammatory
- reversibly, non-selectively inhibit COX isoenzymes
- don’t use IV more than 3-5 days, can cause GI issue
- AE: gastric irritation, nausea, dyspepsia, PUD, hepatotoxicity, nephrotoxicity
5
Q
ibuprofen, naproxen
A
- NSAID
- analgesic, antipyretic, anti inflammatory
- reversibly, non-selectively inhibit COX isoenzymes
- AE: gastric irritation, nausea, dyspepsia, PUD, hepatotoxicity, nephrotoxicity
6
Q
caldolor
A
ibuprofen injection formula
7
Q
ofirmev
A
- IV tylenol
- not cost effective
- use suppository if NPO
8
Q
celecoxib (celebrex)
A
- NSAID
- COX2 inhibitor
- analgesic, antipyretic, anti inflammatory
- no inhibition of platelet aggregation
- AE: CV event, diarrhea, dyspepsia, ABD pain,
9
Q
auranofin (ridaura)
A
- DMARD (disease modifying anti-rheumatic drug)
- slow joint erosion in RA
- gold salt
- benefit 3-6 months after therapy starts
- AE: hematologic, dermatologic, GI, renal, flushing, hypotension, tachycardia, rash, stomatitis
10
Q
gold sodium thiomalate (myochrysine, aurolate)
A
- DMARD (disease modifying anti-rheumatic drug)
- slow joint erosion in RA
- gold salt
- benefit 3-6 months after therapy starts
- AE: hematologic, dermatologic, GI, renal, flushing, hypotension, tachycardia, rash, stomatitis
11
Q
prednisone (deltasone)
A
- glucocorticoid
- DMARD
- act more rapidly than other DMARDs
- long term use inhibited by serious AE
- short course therapy for initiation or flare up
12
Q
methotrexate (rheumatrex)
A
- single most effective DMARD available
- benefits early as 2-3 weeks
- folic acid supplement may reduce AE without compromising efficacy
- AE: GI, hematologic, pulmonary, increase LFT, teratogenic
13
Q
leflunomide (arava)
A
- DMARD
- alternative to methotrexate for 1st line Rx
- AE: diarrhea, reversible alopecia, increase LFT, increase hepatoxicity when combined with MTX, teratogenic
14
Q
hydroxychloroquine (plaquenil)
A
- antimalarial and DMARD
- up to 6 months to see benefit
- AE: GI, blurred vision, night blindness
15
Q
etanercept (enbrel)
A
- DMARD
- reserved for RA refractory to MTX and other DMARDs
16
Q
infliximab (remicade)
A
- DMARD
- used in crohn’s and RA
17
Q
probenecid (benemid)
A
- uricosuric used to prevent gout in those who under excrete uric acid
- competitively inhibits reabsorption
- effects may be blunted by ASA
18
Q
allopurinol (zyloprim)
A
- xanthine oxidase inhibitor
- prevent gout attacks in those who overproduce uric acid
- AE: not tolerate by 25% of pts, N/V, hepatitis, skin rash, hypersensitivity
19
Q
febuxostat (uloric)
A
- xanthine oxidase inhibitor
- used to prevent gout attacks in those who overproduce uric acid
- daily dosing with greater efficacy
- AE: increase LFT, nausea, arthralgias, rash
20
Q
pegloticase (krystexxa)
rasburicase (elitek)
A
- catabolic enzyme preparation for gout
- breakdown uric acid
- krystexxa 30k vs elitek 4k
21
Q
indomethacin (indocin)
A
- NSAID
- acute gout attack
22
Q
colchicine (colcrys)
A
- acute gout attack
- blocks urate crystal-induced inflammation
- AE: N/V, diarrhea, ABD cramps
- tolerance limits use
- diarrhea is dose limiting and requires dose titration
23
Q
sulindac
A
- NSAID
- COX 1 and 2 inhibitor
24
Q
piroxicam (feldene)
A
- NSAID
- treat RA and OA
- COX 1/2 inhibitor
25
nabumetone
- NSAID
- manage RA/OA
- COX 1/2 inhibitor
26
etodolac
- NSAID
- RA, OA, juvenile idiopathic arthritis
- COX 1/2 inhibitor
27
meloxicam (mobic)
- NSAID
- RA, OA, JIA
- COX 1/2 inhibitor
28
diclofenac (voltaren)
- NSAID
| - COX 1/2 inhibitor
29
adalimumab (humira)
- DMARD
| - subQ injection
30
anakinra (kineret)
- DMARD
| - subQ injection
31
abatecept (orencia)
- DMARD
| - IV infusion or subQ
32
tocilizumab (actemra)
- DMARD
| - IV or subQ
33
certolizumab (cimzia)
-DMARD
34
golimumab (simponi)
-DMARD
35
penicillamine (cuprimine)
- chelating agent
| - wilson's disease, severe/active RA
36
sulfasalazine (azulifidine)
- 5 aminosalicylic acid derivative
| - RA
37
rasburicase (elitek)
- urate oxidase enzyme
| - manage uric acid levels
