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Pharmacology year 2 > Drugs and arthritis > Flashcards

Drugs and arthritis Flashcards

1
Q

‘Itis’ means…

A

Inflammation

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2
Q

‘Arthro’ means…

A

Joint

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3
Q

What is primary osteoarthritis (OA)?

A

Wear and tear

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4
Q

What is secondary osteoarthritis (OA)?

A

Caused by trauma, disease or obesity

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5
Q

In osteo and rheumatoid arthritis where does the pain come from?

A

Inflammation

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6
Q

OA affects which joints?

A

Synovial

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7
Q

What happens during OA?

A
  1. Cartiledge around bone gets worn away
  2. Change in protein structure so it becomes thin
  3. Bone grows to fill space
  4. Bone spurs develop
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8
Q 
Type 1 collagen
Type 2 collagen
Aggrecan
Matrix metalloproteinases 
Are types of...
A

Proteins

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9
Q

Which protein is located in the bone?

A

Type 1 collagen

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10
Q

Which protein is located in the cartiledge?

A

Type 2 collagen

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11
Q

Which protein is located in the synovial membrane?

A

Aggrecan

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12
Q

Which protein is located in the synovial tissue?

A

Matrix metalloproteinases

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13
Q

What are the most widely prescribed drugs for arthritis?

A

NSAIDs

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14
Q

Ibruprofen is derived from…

A

Propionic acid

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15
Q

Antipyretic
Analgesic
Anti-inflammatory
Are actions of…

A

NSAIDS

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16
Q

Why do we have prostaglandins?

A

To get WBC to the area

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17
Q

What are NSAIDS targets?

A

COX 2

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18
Q

Name some disadvantages of NSAIDS

A

Risk of gastric ulcers
Impair coagulation
Angioedema
CV problems

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19
Q

Why might NSAIDS cause a problem?

A

May inhibit COX 1 as well as COX 2

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20
Q

What are NSAIDs mechanism of action?

A

To inhibit the COX enzyme and decrease prostaglandin production

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21
Q

Name the main NSAIDs used in OA…

A 
Aspirin
Ibuprofen*
Diclofenac
Meloxicam
Indomethacin
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22
Q

Which of the COX enzymes is produced when needed?

A

COX 2

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23
Q

Name the side effects of NSAIDs

A

Risk of gastric ulcers
Impair coagulation
Use with caution in elderly
Risk of CV events in patients with cardiac disease/ hypertension
Risk of asthma attack, angioedema, urticaria or rhinitis

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24
Q

Why is the blocking of the COX 1 enzyme bad?

A

Because it is a housekeeping enzyme

E.g. mucous production/platelet aggregation

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25
Name the 2 drugs that are COX 2 inhibitors...
Celecoxib | Etoricoxib
26
Name the side effects of COX 2 inhibitors...
Headache Dizziness Skin rash Peripheral oedema
27
In what patients might COX 2 inhibitors be used...
Those at risk of GI side effects
28
Name a synthetic prostaglandin...
Misoprostol
29
Synthetic prostaglandins are given alongside...
NSAIDs
30
What do synthetic prostaglandins do...
Preserve lining of GI tract Protects against ulceration Inhibits gastric acid secretion Stimulate increased mucous production
31
Side effects of synthetic prostaglandins...
Diarrhoea Vaginal bleeding (Caution with women of child bearing age)
32
Why is paracetamol not an NSAID?
It has no anti-inflam response
33
Side effects of paracetamol...
Kidney damage | Liver damage
34
``` Exercise Suitable footwear TENS Thermotherapy Weight loss Joint supports Are treatment options for what... ```
OA
35
What are other drugs with potential benefit in osteoarthritis?
Strontium ranelate | Glucosamine sulphate
36
What does strontium ranelate do?
Promotes osteoblast differentiation Inhibits osteoclast activity Stops fractures in osteoporosis
37
Side effects of strontium ranelate...
Risk of MI and thrombotic events
38
Name the main symptoms of RA...
Stiff in morning | Joints feel hot and tender
39
How is RA diagnosed?
Specialist Imaging Blood test Examination
40
Treatment options for RA...
``` NSAIDs Glucocorticoids Immunosuppressants Disease Modifying Antirheumatic Drugs (DMARDS) Anticytokines ```
41
Glucocroticoids are used in the...
Short term to manage flare ups
42
Name the two types of corticosteroids...
Glucocorticoid | Mineralocorticoid
43
What are glucocorticoid mechanism of action?
Metabolic effects Anti-inflammatory Immunosuppressive
44
What are mineralocorticoids mechanism of action?
Water and electrolyte balance e.g. aldosterone
45
Hydrocortisone/corticosterone show actions of what?
MC and GC
46
Name the 3 natural steroids from the lecture...
Hydrocortisone Corticosterone Aldosterone
47
Name examples of corticosteroids... | PPDBBF
``` MIXED GLUCO/MINERALOCORTICOID: Prednisolone Prednisone GLUCOCORTICOID: Dexamethasone Betamethasone Beclomethasone Budesonide MINERALOCORTICOID: Fludrocortisone ```
48
What is the corticosteroids mechanism of action?
Block gene transcription + synthesis of inflammatory proteins, immunosuppressant.
49
Unwanted effects of oral corticosteroids...
``` Buffalo hump Moon face HTN Muscle wasting Poor wound healing Increase abdo fat Thinning of skin Increased infection risk ```
50
Name examples of DMARDS...
Sulfasalazine Pencillamine Gold compds Anti-malarials
51
What are DMARDS mechanism of action?
By scavenging free radicals | Decreasing IL-1
52
Side effects of sulfasalazine...
GI upset Headache Skin reactions Leukopenia
53
Side effects of pencillamine...
``` Rashes Stomatitis Anorexia Taste disturbance Fever N & V ```
54
Name the 2 gold compds...
Auranofin | Sodium auranofin
55
Side effects of gold compds...
Skin rashes Flu-like symptoms Mouth ulcers Blood disorders
56
Side effects of antimalrials...
n+v dizziness blurring of vision
57
Immunosupressants mechanism of action...
Inhibit DNA synthesis or T cell activation.
58
Name the immunosuppressants...
Ciclosporin, azothioprine, methotrexate, leflunomide, cyclophosphamide
59
Name the anticytokine drugs...
Etenercept, infliximab, rituximab, abatacept
60
Side effects of anticytokine drugs...
``` May develop latent disease Opportunistic infection Nausea Ab pain Worsening heart failure Hypersensitivity ```
61
Side effects of ciclosporin...
Nephrotoxicity* Hepatotoxicity Hypertension Also: nausea/ vomiting, gum hypertrophy, GI problems
62
Main effect of azathioprine...
Suppression of bone marrow
63
General problems of immunosuppressants...
Increase risk of infection and cancer

Pharmacology year 2 (7 decks)

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