MSK Medications

Question 1

Paracetamol MoA

Answer 1

Inhibits prostaglandin synthesis pathway by reducing availability of COX-2. This interferes with transmission of pain signals between the spinal cord and higher centres reducing pain sensitivity.

Question 2

Side Effects of Paracetamol

Answer 2

Liver Failure- in an overdose

Question 3

Warnings / Contraindications of Paracetamol

Answer 3

Reduced Dose of paracetamol (IV) in
-Malnutrition and low body weight
-Severe liver impairment

AVOID PRESCRIBING PARACETAMOL WITH DRUGS CONTAINING PARACETAMOL…
-co codamol
-co dydramol

Question 4

Contraindication of NSAIDs to be used in…

Answer 4

Pregnancy

Question 5

Methotrexate, employed in the treatment of rheumatoid arthritis, it should not be co-prescribed with medications which interact with folic acid metabolism …….

Answer 5

such as trimethoprim, as this can cause severe myelosuppression.

Question 6

Postmenopausal women, men age ≥50, who are treated with oral glucocorticoids for ≥7.5 mg/day prednisolone or the next 3 months -

What do they need to start and why?

Answer 6

start bisphosphonates at the same time - don’t wait for a DEXA scan

to help reduce the risk of glucocorticoid-induced osteoporosis

Question 7

MoA of Methotrexate ?

Answer 7

Methotrexate is an antimetabolite that inhibits dihydrofolate reductase, an enzyme essential for the synthesis of purines and pyrimidines. It is considered an ‘important’ drug as whilst it can be very effective in controlling disease the side-effects may be potentially life-threatening - careful prescribing and close monitoring is essential.