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GT BSN/CNL PHARM > Drugs for Bone & Joint Disorders > Flashcards

Drugs for Bone & Joint Disorders Flashcards

1
Q

Three drug classes used in the management of RA

A

NSAIDs
glucocorticoids
DMARDs

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2
Q

Which of the drug classes used in the management of RA does NOT slow disease progression?

A

NSAIDs

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3
Q

List the three types of DMARDs

A

conventional (traditional)
biologic
targeted

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4
Q

What does DMARD stand for

A

disease modifying antirheumatic drugs

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5
Q

What are the differences between the types of DMARDs used for RA?

A

conventional = nonspecific

biologic = targets one specific component of immune system

targeted = targets one specific component of RA immune response

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6
Q

Drug classes that are biologic DMARDs

A

TNF antagonists
B lymphocyte depleting agent
T cell activation inhibitor

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7
Q

Drug classes that are targeted DMARDs

A

IL-6 receptor antagonists
IL-1 receptor antagonist
JAK inhibitors

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8
Q

mechanism of action of methotrexate

A

folate antagonism

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9
Q

adverse effects of methotrexate

A

hepatic fibrosis
bone marrow suppression
GI ulceration
pneumonitis

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10
Q

all DMARDs result in:

A

immunosuppression (risk for infection)

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11
Q

cautions with DMARDs and vaccinations?

A

live vaccinations are contraindicated

inactivated vaccinations may not be as effective

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12
Q

Adverse effects of TNF antagonists

A

infection/neutropenia (black box warning)
injection site reactions
infusion reactions
skin reactions

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13
Q

Drugs used for the management of gout flare up

A

NSAIDs
glucocorticoids
colchicine

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14
Q

Potential mechanism of action of colchicine?

A

inhibition of WBC infiltration via disruption of cellular microtubules

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15
Q

adverse effects of colchicine

A

toxicity to rapidly proliferating cell groups:

  • GI ulcers/perforation
  • myelosuppression
  • myopathy
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16
Q

Drugs used in long term preventative therapy of gout

A

xanthine oxidase inhibitors
probenecid
pegloticase & rasburicase

17
Q

Goal of long term gout preventative therapy?

A

decrease uric acid concentrations

18
Q

methods to decrease uric acid concentrations in the plasma?

A
  1. inhibit formation
  2. accelerate excretion
  3. convert to metabolite
19
Q

List a xanthine oxidase inhibitor

A

allopurinol
febuxostat

20
Q

mechanism of action of xanthine oxidase inhibitors

A

inhibit xanthine oxidase (which is required for uric acid formation)

21
Q

adverse effects of xanthine oxidase inhibitors

A

GI reactions
drowsiness
headaches

initial therapy can induce a gout attack

22
Q

treatment options for hypocalcemia

A

PO or IV calcium

23
Q

treatment options for hypercalcemia

A

mild = drugs that inhibit calcium absorption (see future flashcard)

severe = IV saline + loop diuretic

24
Q

two types of IV calcium

A

calcium chloride
calcium gluconate

25
Q

what is cinacalcet used for

A

hyperparathyroidism

26
Q

mechanism of action of cinacalcet

A

mimics calcium at PTH receptor = negative feedback & prevention of further PTH secretion

27
Q

adverse effects of cinacalcet

A

N/V
diarrhea
hypocalcemia

28
Q

how does exogenous vitamin D increase blood levels of calcium?

A

increased intestinal absorption
increased bone resorption
decreased renal excretion

29
Q

mechanism of action of calcitonin

A

inhibition of osteoclasts (inhibits bone resorption)

inhibition of tubular calcium resorption (increases excretion)

30
Q

What are bisphosphonates

A

structural analog of pyrophosphate, which is a normal constituent of bone

31
Q

mechanism of action of bisphosphonates

A

incorporate into bone & remain active for years (decreases osteoclast activity, decreases bone resorption)

32
Q

adverse effect of bisphosphonates

A

esophagitis! (drink with full glass of water & remain upright)

33
Q

List some bisphosphonates

A

alendronate
risedronate
ibandronate
zoledronate

34
Q

Both IV bisphosphonates can cause:

A

renal damage

35
Q

administration of exogenous estrogen decreases bone resorption via what mechanism?

A

inhibits the increase in osteoclast number

36
Q

Why may a SERM be preferred to exogenous estrogen in the treatment of bone demineralization?

A

increases bone density with less risks

GT BSN/CNL PHARM (26 decks)

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