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Pharmacy Pre-reg exam 2020-2021 > Musculoskeletal > Flashcards

Musculoskeletal Flashcards

1
Q

1st line treatment options for RA (3)

A

Methotrexate, Leflunomide, Sulfasalazine

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2
Q

How long does is take for DMARDs to take effect?

A

2-3 months

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3
Q

Main side-effect of Hydroxychloroquine

A

Retinal toxicity

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4
Q

Main side-effect of Leflunomide

A

Liver toxicity

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5
Q

What kind of half-life does Leflunomide have and what does it affect?

A

Very long half-life. As it is teratogenic - contraception needed for 2 years after stopping treatment.

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6
Q

What food do you need to avoid on Leflunomide?

A

Alcohol

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7
Q

Acute gout attack management

A

High-intensity NSAIDs (eg indometacin, ketoprofen, diclofeac, etoricoxib)

Colchicine - alternative to NSAIDs, can be given in HF and with anti-coagulants

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8
Q

Long-term gout management options (2)

A

Allopurinol

Febuxostat

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9
Q

When do you initiate Allopurinol/Febuxostat?

A

1-2 weeks after acute gout attack

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10
Q

Would you discontinue Allopurinol during an acute gout attack?

A

No

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11
Q

When hyperuricaemia has been corrected, for how long would you need to continue NSAIDs/Allopurinol?

A

1 months

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12
Q

Side-effect of allopurinol

A

Rash

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13
Q

Admin directions for Allopurinol (2)

A

Take with food + with full glass of water

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14
Q

When are dose adjustments needed for Allopurinol and Colchicine?

A

Renal impairment

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15
Q

What are the main risks/SEs of NSAIDs (4)

A

Can exacerbate asthma

GI side-effects

Small increase in VTE risk

Skin reactions

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16
Q

Which NSAID has the highest risk of GI side-effects

A

Piroxicam

17
Q

Risks of GI side-effects of NSAIDs and examples

A

Low risk: Cox-2 inhibitors, ibuprofen
Medium risk: Naproxen, Indometacin, Diclofenac
High risk: Piroxicam, Ketoprofen, Ketorolac

18
Q

Which NSAIDs are associated with the most VTE risk? (3)

A

Ibuprofen, Diclofenac, Cox-2 inhibitors

19
Q

When do you need to avoid/adjust the dose of NSAIDs?

A

Renal impairment

Pharmacy Pre-reg exam 2020-2021 (20 decks)

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