Drugs for Bone and Joint Disorder (Part 02)

Question 1

Drug/s for Acute Gouty Arthritis

Answer 1

1. Indomethacin (Indocin)
2. Colchicine
3. Corticosteroids

Question 2

An NSAID that is potent inhibitor of COX enzyme. As effective as colchicine but less GI toxicity.

Answer 2

Indomethacin (Indocin)

Question 3

Isolated from Autumn crocus (Colchicum autumnale). A microtubule synthesis inhibitor. Inhibit macrophage migration and phagocytic activity.

Answer 3

Colchicine

Question 4

A short-intermediate acting, usually useful in gout. For resistant patients.

Answer 4

Corticosteroids

Question 5

Example/s of Corticosteroids

Answer 5

1. Prednisone
2. ACTH
3. Triamcinolone

Question 6

Drug/s for Chronic Gouty Arthritis

Answer 6

1. Allopurinol (Zyloprim)
2. Uricosuric Agents

Question 7

A xanthine oxidase inhibitor. Indicated for patients with renal failure and leukemia.

Answer 7

Allopurinol (Zyloprim)

Question 8

A non-purine inhibitor of xanthine oxidase that is under clinical trials.

Answer 8

Febuxostat

Question 9

Inhibit renal tubular reabsorption of uric acid. Maintain adequate urine flow, alkalinize urine with NaHCO3.

Answer 9

Uricosuric Agents

Question 10

Example/s of Uricosuric Agents

Answer 10

1. Probenecid
2. Sulfinpyrazone

Question 11

Drug/s for Ostheoarthritis

Answer 11

1. Acetaminophen
2. NSAIDs
3. Corticosteroids
4. Opioid / Narcotic Analgesics
5. Capsaicin (Zostrix)
6. Glucosamine and Chondroitin
7. Hyaluronate Injection

Question 12

It inhibits PG synthesis; dec. pain and inflammation.

Answer 12

Acetaminophen

Question 13

It inhibits COX enzyme, dec. PG synthesis; dec. pain and inflammation.

Answer 13

NSAIDs

Question 14

Only the intraarticular route is effective for osteoarthritis.

Answer 14

Corticosteroids

Question 15

For unresponsive patients, and contraindicated to NSAIDs. Inhibition of mu receptor.

Answer 15

Opioid / Narcotic Analgesics

Question 16

It inhibit substance P (the pain transmitter in the nerves). It is topical indicated for post-herpetic neuralgia, neuropathic pain.

Answer 16

Capsaicin (Zostrix)

Question 17

A transient receptor potential cation channel subfamily V which provides sensation of scalding heat.

Answer 17

Activation of TRPV1

Question 18

The dietary supplements shown to alleviate pain, slows down loss of cartilage.

Answer 18

Glucosamine and Chondroitin

Question 19

These are components of normal cartilage. They are building block of cartilage.

Answer 19

Glucosamine and Chondroitin Sulfate

Question 20

Hylan GF20, reported to decrease pain.

Answer 20

Hyaluronate Injection

Question 21

It promotes the growth and development of cartilage and bone. It increases the growth of new cells and tissues.

Answer 21

Hyaluronic Acid

Question 22

Drug/s for Rheumatoid Arthritis

Answer 22

1. Salicylates and NSAIDs
2. Corticosteroids
3. DMARDs
4. Gold Preparations
5. Azathioprine (Imuran)
6. Penicillamine (Cuprimine)
7. Cyclosporine

Question 23

NSAIDs and COX-2 inhibitors that reduce joint pain and swelling but they do not alter the course of the disease or prevent joint destruction.

Answer 23

Salicylates and NSAIDs

Question 24

It can work well either orally or parenterally. They have excellent anti-inflammatory activity and are immunosuppressants. Used as bridging therapy (as long as DMARDs are taking effect).

Answer 24

Corticosteroids

Question 25

These are not clearly defined but they act at different stages in the pathogenesis to control symptoms and modulate immune response.

Answer 25

DMARDs

Question 26

Drug/s under DMARDs

Answer 26

1. Leflunomide (Arava) 2. Etanercept (Enbrel) 3. Infliximab (Remicide) 4. Anakinra (Kineret) 5. Methotrexate

Question 27

It inhibits pyrimidine synthesis and is indicated as monotherapy for RA.

Answer 27

Leflunomide (Arava)

Question 28

It binds to TNF-alpha and beta, inhibiting the inflammatory response mediated by immune cells. It is indicated as monotherapy or in conjunction with methotrexate.

Answer 28

Etanercept (Enbrel)

Question 29

It binds to TNF-alpha. Superior than methotrexate alone.

Answer 29

Infliximab (Remicide)

Question 30

The newest DMARD is an interleukin-1 receptor antagonist.

Answer 30

Anakinra (Kineret)

Question 31

A class of glycoprotein that is produced by leukocytes for regulating immune response.

Answer 31

Interleukin

Question 32

A DHF reductase inhibitor.

Answer 32

Methotrexate

Question 33

The mechanism of action is unknown. Dermatologic reactions are the most common side effect and are seen in approximately 15% of patients.

Answer 33

Gold Preparations

Question 34

Drug/s under Gold Preparations

Answer 34

1. Aurothioglucose 2. Gold Na Thiomalate 3. Auranofin

Question 35

It is converted to 6-mercaptopurine in the body and is non-specific purine synthesis inhibitor.

Answer 35

Azathioprine (Imuran)

Question 36

The mechanism of action of this drug in rheumatoid arthritis is unknown but it may be related to reduction of collagen formation.

Answer 36

Penicillamine (Cuprimine)

Question 37

It binds to intracellular receptor, cyclophiline. This complex inhibits calcineurin.

Answer 37

Cyclosporine

Question 38

An intracellular phosphatase, which involves activation of the promoter region for the gene encoding cytokine, such as interleukin.

Answer 38

Calcineurin

Question 39

Drug/s for Osteoporosis

Answer 39

1. Calcium Carbonate 2. Biphosphonates 3. SERMs 4. Calcitonin (Calcimar) 5. Teriparatide (Forteo) 6. Estrogen and Hormonal Therapy 7. Phytoestrogens 8. Testosterone and Anabolic Steroids

Question 40

A salt of choice.

Answer 40

Calcium Carbonate

Question 41

Bind to hydroxyapatite in bone and inhibits osteoclast adherence.

Answer 41

Biphosphonates

Question 42

Estrogen agonist at bone but antagonist in the breast and uterus.

Answer 42

SERMs

Question 43

Released in thyroid when calcium is elevated. It acts by decreasing bone resorption (osteoclasts).

Answer 43

Calcitonin (Calcimar)

Question 44

It is more potent and longer lasting compare to human calcitonin.

Answer 44

Salmon Calcitonin

Question 45

A parathyroid hormone analog. It contains first 34 amino acids in human PTH. The 2nd line agent for severe osteoporosis who are at high risk of bone fractures.

Answer 45

Teriparatide (Forteo)