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The Holy Grail (Drugs) > MSK Drugs > Flashcards

MSK Drugs Flashcards

1
Q

Name some NSAIDs

A 
Ibuprofen
Aspirin
Naproxen
Diclofenac
Indometacin
Etodolac
Celecoxib
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2
Q

When to use Etodolac?

A

symptomatic relief of osteoarthritis and rheumatoid arthritis.

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3
Q

Side Effects of Indometacin?

A

headache, dizziness, and gastro-intestinal disturbances

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4
Q

When to use Celecoxib?

A

relief of pain in osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis

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5
Q

MoA of Ibuprofen

A

It is a propionic acid derivative with anti-inflammatory, analgesic, and antipyretic properties.

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6
Q

MoA of NSAIDS

A

They reduce the production of prostaglandins by inhibiting the enzyme cyclo-oxygenase.

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7
Q

Why do you need to stay on NSAIDS for a while?

A

Pain relief starts soon after taking the first dose and a full analgesic effect should normally be obtained within a week, whereas an anti-inflammatory effect may not be achieved (or may not be clinically assessable) for up to 3 weeks.

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8
Q

Why is Naproxen good to use in clinical practice?

A

because it combines good efficacy with a low incidence of side-effects

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9
Q

When are NSAIDS contraindicated?

A

Asthmatics

GI patients- prescribe in combination with a PPI to protecti GI tract.

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10
Q

Name some Analgesics

A 
Paracetamol 
Codeine
Co-codamol
Dihyrocodeine 
Tramadol
Amytriptyline 
Gabapentin
Morphine
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11
Q

Name some Disease Modifying Anti-Rheumatoid Drugs (DMARDS)

A

Methotrexate
Sulphasalazine
Leflunomide
Hydroxychloroquine

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12
Q

MoA of Methotrexate

A

inhibition of enzymes involved in purine metabolism

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13
Q

MoA of Sulphasalazine

A

Suppression of IL-1 & TNF-alpha, induce apoptosis of inflammatory cells and increase chemotactic factors

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14
Q

MoA of Leflunomide

A

Pyrimidine synthesis inhibitor

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15
Q

MoA of Hydroxychloroquine

A

induces apoptosis of inflammatory cells and decrease chemotaxis

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16
Q

Side effects of Methotrexate

A
  • hepatitis, cirrhosis, pneumonitis, rash, ulcers, reduction of white blood cells,
  • it’s teratogenic
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17
Q

What should be done whilst on Methotrexate?

A
  • on contraceptives

- Regular LFTs and FBCs

18
Q

Name some Anti-TNFs?

A 
Etanercept 
Adalimumab
Certolizumab
Infliximab
Golimumab
19
Q

How are Anti-TNFs given?

A

Subcutaneous injection

20
Q

How can Anti-TNFs become more effective?

A

by being taken alongside DMARDS

21
Q

What are side effects of Anti-TNFs?

A

Risk of infection, especially TB

22
Q

MoA of Anti-TNFs

A

They suppress the physiologic response to tumour necrosis factor (TNF), which is part of the inflammatory response.

23
Q

Name some Biologics

A 
Rituximab
Tocilizumab
Abatacept
Ustekinumab
Secukinumab
24
Q

MoA of Rituximab

A

monoclonal antibody against B lymphocytes

25
Q

MoA of Tocilizumab

A

inhibits IL6

26
Q

MoA of Abatacept

A

composed of CTLA-4 Ig- that blocks activation of T lymphocytes

27
Q

MoA of Ustekinumab

A

inhibits IL12 and IL23

28
Q

MoA of Secukinumab

A

inhibits IL17

29
Q

Name some urate-lowering drugs

A

Allopurinol

Febuxostat

30
Q

When would you use Febuxostat?

A

For those who cannot tolerate allopurinol

31
Q

MoA of Allopurinol and Febuxostat

A

xanthine oxidase inhibitors

32
Q

Side effects of Allopurinol

A

rash in elderly / renal patients

interacts with azathioprine

33
Q

MoA of Azathioprine

A

Azathioprine inhibits purine synthesis. Purines are needed to produce DNA and RNA. By inhibiting purine synthesis, less DNA and RNA are produced for the synthesis of white blood cells, thus causing immunosuppression.

34
Q

What kind of drug is azathioprine?

A

Immunosuppressant

35
Q

What should you always prescribe with Allopurinol?

A

NSAIDS- as Gout can be exacerbated due to rapid reduction in uric acid level

36
Q

Name some Uricosuric drugs

A

Probenecid
Sulphinpyrazone
Benzbromarone

37
Q

MoA of Uricosuric drugs

A

they increase the excretion of uric acid in the urine by acting on the proximal tubule

38
Q

When are uricosuric drugs contraindicated?

A

Renal patients

39
Q

MoA of Colchicine

A

interrupts the cycle of monosodium urate crystal deposition in joint tissues and the resultant inflammatory response that initiates and sustains an acute attack

40
Q

Side effects of colchicine

A

GI upset

Dont’s take with macrolides: erythromycin/ clarithromycin

The Holy Grail (Drugs) (15 decks)

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