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Block 12 Ellen > L10: drugs in the management of musculoskeletal disorders > Flashcards

L10: drugs in the management of musculoskeletal disorders Flashcards

1
Q

iatrogenic=

A

relating to illness caused by medical examination or treatment

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2
Q

osteoblast=

A

cell that makes bone

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3
Q

osteoclast=

A

a multinucleate cell that breaks down bone

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4
Q

pharmacokinetics=

A

the process by which a drug is absorbed, distributed, metabolised and eliminated

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5
Q

outer shell of bone=

A

cortical bone

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6
Q

inner bone=

A

trabecular mesh

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7
Q

osteoporosis =

A

thinning of bone

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8
Q

most commonly affected bones in osteoporosis (3)

A

wrist
hip
spine

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9
Q

osteoclasts sit in

A

Howship lacunae

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10
Q

how do osteoclasts form

A

formed by fusion of many cells derived from monocytes

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11
Q

how do osteoblasts form

A

differentiation of osteogenic cells in the periosteum

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12
Q

how do osteoblasts and osteoclasts communicate

A

cytokines

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13
Q

what do osteoblasts produce

A

RANKL

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14
Q

what does RANK L do

A

binds to RANK receptor on the osteoclast precursor cell to initiate maturation of the osteoclast

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15
Q

what produces OPG

A

osteoblasts and stromal cells

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16
Q

what is OPG

A

a soluble ligand which mops up the RANK L so it can no longer act as a signal

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17
Q

when osteoclasts bind to bone what do they form

A

a celling zone

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18
Q

what mineral is released when bone is broken down

A

calcium

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19
Q

what are bisphosphonates

A

enzyme-resistant analogues of pyrophosphate (which normally inhibits mineralization of bone)

20
Q

how do BPs work

A

decrease osteoclast activity by decreasing osteoclast progenitor development + increase osteoclast apoptosis

21
Q

what binding sites do BPs attach to

A

hydroxyapatite

22
Q

2 types of BPs

A
  • non nitrogen containing

- nitrogen containing

23
Q

e.g of Non-N containing BP

A

Etidronate

24
Q

e.g of nitrogen containing BP

A

alendronate

25
Q

widest adverse effect of BP therapy

A

osteonecrosis of the jaw

26
Q

SERM=

A

selective estrogen receptor modulator

27
Q

e.g of SERM

A

raloxifene

28
Q

SERM used for breast cancer

A

Tamoxifen

29
Q

HRT that increase risk in 2 types of breast cancer

A

breast cancer

ovarian cancer

30
Q

where is calcitonin released from

A

thyroid

31
Q

what does calcitonin do (3)

A
  1. increases osteoblast activity
  2. decrease intestine Ca2+ absorption
  3. Decrease Ca2+ renal absorption
32
Q

what does PTH do

A

increase osteoclast activity

33
Q

4 ways to target Rheumatoid arthritis

A

NSAIDs
Steroids
DMARDs
Biological agents

34
Q

used for severe RA

A

immunosuppression

35
Q

COX-2=

A

inflammation

36
Q

COX-1=

A
  • gastrointestinal tract
  • renal tract
  • platelet function
  • macrophage differentiation
37
Q

steroidal anti-inflammatory drugs target ____ to decrease

A

nuclear receptors to decrease expression of inflammatory cytokines

38
Q

e.g of a SAID

A

prednisolone

39
Q

what gland shrinks when patients are on steroids

A

adrenal gland

40
Q

DMARDs=

A

disease modifying anti-rheumatic drugs

41
Q

what do DMARDs do

A

reduce damage to joints

42
Q

3 DMARDS

A
  • hydroxychloroquine
  • methotrexate
  • sulfasalazine
43
Q

MOA of methotrexate

A

affects dihydrofolate reductase

44
Q

what are biological therapies based on

A

monoclonal antibodies

45
Q

3 biological therapies

A

adalimumab
etanercept
infliximab

46
Q

what do adalimumab, etanercept and infliximab all target

A

tumour necrosis factor alpha

47
Q

immunosuppressant agent of last resort

A

ciclosporin

Block 12 Ellen (25 decks)

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