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Musculo-Skeletal > Musc-Skel Pharmacology > Flashcards

Musc-Skel Pharmacology Flashcards

1
Q

This medication if administered in a pulsitile fashion may help in the treatment of osteoporosis (by stimulating osteoblasts). Continuous administration will actually erode bones. It is a synthetic analog of PTH hormone.

A

Teriperitide- a once daily injection that can only be used for 2 years, then switch over to bisphosphonate to keep the new bone formation.

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2
Q

This medication is a monoclonal antibody that is a RANKL inhibitor, thus inhibits osteoclast development and activity. What drug is at hand?

A

Denosumab

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3
Q

What is the metabolite in acetaminophen, and why is it toxic?

A

NAPQI - it depletes glutathione levels in the liver. Without glutathione, AST and ALT levels rise.

Rescue: N-acetylcyseine as it helps regenerate levels of glutathione in the liver.

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4
Q

What type of reaction can Cox-2 inhibitors cause?

A

Sulfa drug allergy

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5
Q

What is the long term treatment of Rheumatoid arthritis?

A

Disease Modifying Anti-Rheumatic Drugs (DMARDs):

  • Methotrexate (low dose)
  • Hydroxyquinolone
  • Sulfasalazine
  • TNF-alpha inhibitors (etanercept, infliximab, adalimumab, certolizumab, golimumab)
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6
Q

What are the three main functions of NSAIDs?

A

Treat: Reduction of inflammation, reduction of pain, and reduction of fever.
—> anti-inflammatory, analgesia, anti-pyrexia

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7
Q

What is the treatment of choice for acute painful gout?

A 
#1: Indomethacin or an NSAID
#2: colchicine 
#3: oral steroid
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8
Q

What is the treatment of choice for chronic painful gout?

A
  • Allopurinol - inhibits xanthine oxidase (to make UA)
  • Probenecid - inhibits reabsorption of uric acid in the PCT (also decr. excretion of penicillin).

-Feboxustat - inhibits xanthine oxidase as well.

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9
Q

What is the treatment for seronegative spondylar arthropathies?

A

NSAIDs
Steroids
DMARDs
TNF-alpha inhibitor drugs

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10
Q

What is the MOA of TNF-alpha drugs? What is a common side effect?

A

Bind to TNF-alpha, thus prevents it from activating the immune system.

SE: since they inhibit the immune system, they are at increased risk for infection, thus has the possibility of reactivating latent TB, so must check a PDD before administering.

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11
Q

This disease affects children (onset before age 10), persistent joint swelling (synovial thickening, accumulation of synovial fluid). There are 3 different subtypes. What is the disease, and the 3 subtypes?

A

Juvenile Idiopathic Arthritis

  • Polyarticular JIA
  • Pauciarticular JIA
  • Systemic-onset JIA
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12
Q

This type of Juvenile Idiopathic Arthritis presents with severe symmetrical arthritis, dactylitis. Which subtype is at hand?

A

Polyarticular JIA

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13
Q

This type of Juvenile Idiopathic Arthritis typically involves large joints; 20-25% have uveitis. Which subtype is at hand?

A

Pauciarticular JIA

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14
Q

This type of Juvenile Idiopathic Arthritis begins with systemic symptoms (fever, rash, elevated WBC, anemia, hepatosplenomegaly, lymphadenopathy); arthritis later. Which subtype is at hand?

A

Systemic-onset JIA

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15
Q

What medications cause drug induced Lupus, and what antibody is associated with this pathology?

A 
SHIPP:
Sulfonamides
Hydralazine
Isoniazid 
Phenytoin 
Procainamide
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16
Q

What is the treatment for Lupus? What is the treatment for advanced Lupus?!

A

Steroids
NSAIDs
Hydroxychloroquine

Advanced Lupus:
Cyclophosphamide

17
Q

What are the medications that can cause Steven-Johnson Syndrome?

A 
-Anti-convulsants: CLEPP
(Carbamazepine, lamotragine, ethosuximide, Phenytoin, phenobarbital)
-Sulfa drugs
-Penicillin 
-Allopurinol
18
Q

What are the medications that can cause Steven-Johnson Syndrome?

A 
-Anti-convulsants: CLEPP
(Carbamazepine, lamotragine, ethosuximide, Phenytoin, phenobarbital)
-Sulfa drugs
-Penicillin 
-Allopurinol
19
Q

What is the max dose of acetaminophen (grams/day)?

A

4g/day

20
Q

What is the treatment of osteoarthritis?

A
  • Acetaminophen
  • NSAIDs
  • Steroids (intraarticular)
  • Hyaluronic acid (intraarticular)
  • Opioids
  • Joint replacement
21
Q

What are the 4 MC TNF-alpha drugs?

A

Etanercept, Infliximab, Adalimumab, Golimumab, Certolizumab

22
Q

What drugs and diseases cause a decrease in Uric Acid excretion?

A
  • Use of Thiazide or loop diuretic
  • Lesch Nyhan Syndrome
  • Treatment for leukemia or lymphoma (increasing cell turnover and tumor lysis causing increased UA)
23
Q

How does N-acetylcysteine act as an antidote for acetaminophen overdose.

A

Regeneration of glutathione

Musculo-Skeletal (6 decks)

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