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PHTH 565 - Rheumatology > Medications > Flashcards

Medications Flashcards

1
Q

Only __ in __ RA pt’s take their meds as prescribed in >80% adherence.

A

1/5

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2
Q

Often ___ and ____ around medication

A

fear; stigma

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3
Q

PT role in medication or adherence?

A
  1. reassurance

2. education

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4
Q

3 categories of barriers to medication adherence?

A
  1. patient related factors
  2. drug related factors
  3. other factors
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5
Q

Arthritis medications groups?

A
  1. analgesics

2. disease modifiers

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6
Q

Point of analgesics?

A
  1. control pain

2. control some inflammation

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7
Q

Disease modifiers control disease by modifying or suppressing ______ _______ response

A

immune inflammatory

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8
Q

5 example of analgesics?

A
  1. acetaminophen/paracetamol
  2. NSAIDs
  3. steroids
  4. drugs for off label use
  5. opioids
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9
Q

Drugs for off label use are used in what types of pain?

A
  1. central pain

2. neuropathic pain

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10
Q

4 types of disease modifying drugs?

A
  1. NSAIDs
  2. corticosteroids
  3. DMARDs
  4. Biologic DMARDs
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11
Q

NSAIDs are only used as a disease modifying drug in _______

A

spondylitis

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12
Q

Acetaminophen primarily controls inflammation in the ____

A

CNS

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13
Q

_______ is the first line of rx in OA

A

acetaminophen

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14
Q

How long does acetaminophen take to take effect

A

1-2 hours

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15
Q

Precautions for PT with acetaminophen?

A

none

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16
Q

More than _____mg a day of acetaminophen + alcohol can result in liver damage

A

4000

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17
Q

NSAIDs 3 examples ?

A
  1. aspirin
  2. ibuprofen
  3. naproxen
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18
Q

Fx of NSAIDS?

A

Decrease pain, swelling, stiffness and fever

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19
Q

NSAIDs primarily used n ____

A

OA

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20
Q

High NSAID intake slows new bone formation in individuals with increased _____ only

A

CRP

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21
Q

How long for analgesia and steady state to take effect w/ NSAIDS ?

A
  1. analgesia 30-60 mins

2. steady state = 2 days

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22
Q

5 NSAID precautions for PT?`

A
  1. raises BP
  2. increase CV event risk (but risk lower than smoking or HTN)
  3. make sure not combining 2 types together
  4. GI upset with long term use
  5. topicals have similar benefits and safer
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23
Q

5 examples of opioids?

A
  1. codeine
  2. hydromorphone
  3. oxycodone
  4. fentanyl
  5. morphine
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24
Q

______ are second line rx for moderate to severe OA pain, not commonly used as often risk>benefit

A

opiods

25
Q

Opioids work within _ hour

A

1

26
Q

3 precautions for PT w/ opioids?

A
  1. drowsiness, dizziness, constipation
  2. opiod tolerance with prolonged use can sensitize pain
  3. risk of dependence with chronic use
27
Q

Example of “other” category analgesics?

A

serotonin-norepinephrine reuptake inhibitor (SNRI)

28
Q

Fx of SNRIs?

A

second line analgesic agent where no/partial response to acetaminophen / NSAIDS

29
Q

SNRI’s take effect within __ week

A

1

30
Q

Use of SNRIs?

A

neuropathic pain in OA

31
Q

2 precautions for PT with SNRIs?

A
  1. dizziness / light headedness

2. may raise BP

32
Q

4 things opioids may be prescribed for?

A
  1. acute/chronic pain resulting from disease, sx or injury
  2. moderate to severe cough and diarrhea
  3. to treat addiction to other opioids such as heroin or oxycodone
  4. controlling pain in terminal illness
33
Q

Long term use of opioids can lead to what 3 things?

A
  1. increased tolerance to the drug so that more needed to produce same pain relieving effect
  2. dependence
  3. withdrawal symptoms
34
Q

Bulk of its who need relief from chronic moderately-severe non-cancer pain have ____ _____ or ____

A

back pain;OA

35
Q

________ ________ used for control of abnormal inflammatory pathways in inflammatory arthritis

A

disease modifiers

36
Q

1st line treatments in disease modifiers?

A

DMARDs

37
Q

2nd line treatments in disease modifiers?

A

Biologics

38
Q

3 adjuncts to disease modifiers?

A
  1. corticosteroids
  2. analgesics
  3. NSAIDS
39
Q

Example of DMARD?

A

methotrexate

40
Q

Methotrexate can take up to ___ months for full effect

A

3

41
Q

4 disease methotrexate used for?

A
  1. RA
  2. JIA
  3. psoriatic arthritis
  4. lupus
42
Q

Precautions for PT w/ methotrexate?

A

side effects can include nausea and fatigue day after with use of methotrexate

43
Q

Biologics can be taken in what two ways?

A
  1. subcutaneous injection

2. IV infusion

44
Q

Fx of biologics?

A

same as DMARDs, used for pts who don’t respond to DMARDs

45
Q

2 diseases biologics used for?

A
  1. RA

2. axial spondylitis

46
Q

2 precautions for PT w/ biologics?

A
  1. increased risk of serious infections

2. sterile technique is dry needling, keep environment hygienic

47
Q

_____ drugs are large, complex proteins made from living cells through highly complex manufacturing process

A

biologics

48
Q

______ tends to be more variable and structurally complex than chemically synthesized drugs

A

biologics

49
Q

______ are drugs that enter the market subsequent to a previously authorized version who patent has expired

A

biosimilars

50
Q

Biosimilars are approved only after showing that it is highly similar to an approved biological product in terms of what 4 things ?

A
  1. safety
  2. purity
  3. potency
  4. efficacy
51
Q

2 examples of ways you can take corticosteroids?

A
  1. oral tablet

2. injection

52
Q

Type of prescription oral tablet corticosteroid?

A

prednisone

53
Q

______ = most efficacious anti-inflammatory drug available

A

corticosteroids

54
Q

Oral corticosteroids take effect within __-__ days

A

1-4

55
Q

2 disease corticosteroids used for?

A
  1. OA

2. inflammatory arthritis

56
Q

7 PT precautions with pts taking corticosteroids > 2 months?

A
  1. decreased bone density and risk of #
  2. increased blood sugar
  3. increased muscle wasting
  4. increased infection risk
  5. small risk of avascular necrosis
  6. dont combine alcohol or large amounts of NSAIDS
  7. risk of GI ulceration
57
Q

Axial spondylitis rx = strongly recommended to use ____ as 1st line rx

A

NSAIDs

58
Q

Axial spondylitis rx = strongly recommended anti-___ inhibitors for people who do not respond to NSAIDs

A

TNF (biologics)

59
Q

General recommendation for pts with high level inflammation = use of corticosteroids despite risk of cartilage / tendon effects, as long as you’re not on it too long (T/F)

A

TRUE (benefits > risks)

PHTH 565 - Rheumatology (8 decks)

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