Drugs used for Osteoarthritis

Question 1

In general what is osteoarthritis?

Answer 1

Degeneration of cartilage in joints

–knees, hips and hands are most affected sites

Question 2

Several pharmacologic therapies are used for treating osteoarthritis. None of them prevents progression of the disease. The choice of medication depends upon the severity of disease or presence or absence of inflammatory changes. First drug is Acetaminophen, what are some features?

Answer 2

First line treatment for mild to moderate osteoarthritis without inflammation
–fewer adverse effects than NSIDs

Question 3

2nd drug for osteoarthritis are NSAIDs, what are some features?

Answer 3

If clinical presentation is inflammation or if Acetaminophen is not working then use NSAIDs
–can be used in combo with acetaminophen
NSAID: Diclofenac
Topical gel or solution for local treatment
–topical is useful in patients with symptomatic disease

Question 4

There are other drugs used for Osteoarthritis, the first is Duloxetine, what are some features?

Answer 4

SNRIs

–tx of chronic musculoskeletal pain

Question 5

2nd other drug for osteoarthritis is Tramadol, what are some features?

Answer 5

Moderate to moderately severe chronic pain in adults

Question 6

3rd other drug for osteoarthritis is opioids, what are some features?

Answer 6

Last resort for tx of intractable osteoarthritis pain

–hydrocodone, morphine and oxycodone

Question 7

4th other drug for osteoarthritis is Capsaicin, what are some features?

Answer 7

Topical application is effective
Usually used as an adjunct in patients with inadequate benefit from oral or topical NSAIDs
Adverse Effects:
–severe skin burns and nerve damage at site of application

Question 8

The last recommended drugs are Intra-articular corticosteriods, what are some features?

Answer 8

Commonly used:
–Betamethasone and Triamcinolone
Only if one or few affected joints
Relieve pain even in joints that are not obviously inflamed