Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharm Exam 1 > NSAIDS, RA and OA > Flashcards

NSAIDS, RA and OA Flashcards

1
Q

4 Goals of NSAIDS

A
  1. decrease inflammation
  2. reduce fever
  3. relieve mild-moderate pain
  4. inhibit platelet aggregation (anticoagulation)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the original NSAID?

A

Aspirin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Is Acetaminophen an NSAID?

A

No, Tylenol does not decrease inflammation or have anticoagulation properties

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are Prostaglandins?

A

A hormone that helps to regulate cell function under normal conditions and pathological conditions- all cells expect RBCs can produce them

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How do NSAIDs work?

A

During an injury there is an increase in prostaglandin production. NSAIDs Interfere with the synthesis of prostaglandins by inhibiting the COX enzyme (this enzyme is the first step in the synthesis of prostaglandin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Which COX enzyme is considered more harmful?

A

COX-2. It produces prostaglandins that mediate pain and other aspects of the inflammatory response primarily in injured cells. However, NSAIDS are non-selective and thus block COX-1 and COX-2.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Why is it beneficial to take a regular aspirin?

A

-decreases chances of colorectal cancer
-prevent GI cancers and non-GI cancers
-prevents tumor growth by inhibiting COX-2 enzyme which could cause abnormal cell division in these tissues

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Side effects of NSAIDS

A

-GI damage (most common)
-cardiovascular issues
-liver problems
-kidney problems
-associated with Reye Syndrome
-inhibits bone healing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is Aspirin Intoxication or Positioning? What are the Symptoms?

A

Aspirin overdose
-HA
-tinnitus
-difficulty hearing
-confusion
-GI distress
-metabolic acidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Is Aspirin beneficial for those with a fracture or s/p spinal fusion?

A

No! Aspirin inhibits bone healing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Aspirin Vs. other NSAIDs

A

Aspirin:
-10-20x cheaper than prescription NSAIDs
-5x cheaper than nonprescription NSAIDs

Others:
-less GI discomfort, but has some stomach irritation
-some are less toxic to liver and kidneys

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the only COX-2 selective drug still on the market?

A

Celebrex- most NSAIDs are nonselective, meaning they inhibit both COX-1 and COX-2 enzymes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Why have most of the COX-2 selective drugs been taken off the market?

A

The cause an increase in upper respiratory infections, along with an increased risk of heart attack and stroke in those with cardiac risk factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is Acetaminophen used for mostly?

A

Used to treat non-inflammatory conditions and used in early stages of OA or other non-inflammatory MSK conditions. Also used for fevers in children and teens
-especially used when the patient has a history of gastric damage =

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How does Acetaminophen work?

A

inhibits the COX enzyme- it is unknown why it doesn’t have anti-inflammatory or anti-coagulant effects like NSAIDS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is RA?

A

A chronic systemic disorder that causes destruction of the articular cartilage within joints- results in pain, stiffness, and inflammation of joints of the hands, feet, and knees

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the two goals of RA treatment?

A
  1. Decrease joint inflammation
  2. Decrease or stop the progression of the disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the three categories of drugs used for RA?

A
  1. NSAIDs
  2. Glucocorticoids
  3. Disease-modifying antirheumatic drugs (DMARDs)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Which drugs are used first to treat RA?

A

DMARDs are used first because they slow the progression of RA- NSAIDs are used for reducing inflammation and pain

20
Q

Why are NSAIDs typically used over Glucocorticoids?

A

Glucocorticoids reduce inflammation to a great extent, however large doses are required to have an effect which can result in serious side effects

21
Q

Why is Acetaminophen not recommended for treating RA?

A

It has no anti-inflammatory properties

22
Q

Should DMARDs and Glucocorticoids be taken together?

A

Yes. Since DMARDs take several weeks to become effective, using small doses of glucocorticoids in combination with DMARDs can help control pain and inflammation until DMARDs take effect

23
Q

When can glucocorticoids be used?

A

Can be used during acute-flare ups or exacerbations of RA- can be injected directly into the joint but only 2-3 injections per joint per year are allowed

24
Q

What is the Mechanism of Action of Glucocorticoids?

A

Binds to a receptor to form a glucocorticoid-receptor complex, this complex binds to genes that regulate the inflammatory process which inhibits the production of inflammatory substances and then the production of anti-inflammatory proteins occurs

25
Q

Side effects of Glucocorticoids

A

-osteoporosis
-muscle wasting/weakness
-HTN
-aggravation of MD
-glaucoma
-cataracts
-increased risk of infection

26
Q

Why are DMARDs so beneficial?

A

These can slow the disease progression of RA and promote remission before the joints become too damaged- they inhibit certain aspects of the immune response that is the cause of RA

27
Q

What are the the different DMARDs drugs?

A

-Antimalarials
-Gold Compounds
-Nonbiological DMARDs
-Biological DMARDs (Tumor Necrosis Factor Inhibitors)
-Other

28
Q

When are Antimalarials used?

A

They are not the first choice of DMARD of choice and are only used for those who cannot tolerate other DMARDs

29
Q

Why has the use of Gold Compounds decreases significantly?

A

There is a concern that gold therapy suppresses the immune system long term- only used for patients who don’t respond to other DMARDs

30
Q

Which drug is a cancer treatment but also used to treat RA in children and adults?

A

Methotrexate- decreases synovitis, decreases bone erosion, and decreases the narrowing of the joint space

31
Q

Side effects of Methotrexate

A

-very toxic drug (low TI)
-GI problems
-pulmonary problems
-hematological disorders
-liver dysfunction
-hair loss

**primarily with long term use

32
Q

What is TNF-alpha?

A

A protein that is released from cells involved in inflammatory responses. This protein promotes joint erosion and inflammation in those with RA

33
Q

How do Tumor Necrosis Factor Inhibitors work?

A

Inhibits TNF-alpha which slows the progression of the destructive effects of RA- must be given as subcutaneous injection or by slow IV fusion

34
Q

When will physicians choose to prescribe other immunosuppressants for RA management?

A

When patients haven’t responded to traditional DMARDs because these other drugs are more toxic

35
Q

What is considered the cornerstone drug for RA and what is it often combined with?

A

Methotrexate is the cornerstone and Tumor Necrosis Factor Inhibitors are usually combined with it- combining DMARDs may provide the best success for RA remission

36
Q

Beneficial Foods for RA Treatment

A

-food high in fish oil and omega-3 fatty acids: helpful in controlling inflammation
-fruits and veggies: high in antioxidant properties
-low meat and proteins: these foods can exacerbate symptoms
-no smoking

37
Q

What causes OA?

A

An intrinsic defect in the remodeling of joint cartilage and underlying subchondral bone which causes progressive deterioration of articular cartilage- NOT an immune system response

38
Q

Treatment Goals for OA

A

-PT
-weight loss
-joint replacements in advanced stages

**non-pharmacological interventions- joint inflammation is NOT a major focus

39
Q

What is the goal of drug therapy for OA?

A

Used to manage pain and maintain active lifestyle- focuses on acetaminophen and NSAIDS

40
Q

What is the first drug used for OA?

A

Acetaminophen

41
Q

Why are NSAIDs used for OA?

A

They are used to treat pain. Their anti-inflammatory properties can also help with mild synovitis that occurs with the joint destruction

42
Q

Which drugs have started to emerge that slow or reverse the pathological changes of OA?

A

DMOADs

43
Q

Which type of DMOAD uses hyaluronic acid to restore the lubricating properties of synovial fluid in arthritic joints?

A

Viscosupplementation- it is injected into the joint to restore viscosity which helps limit joint destruction progression in OA patients

44
Q

Viscosupplementation Timeline

A

-3-5 weekly injections can be given
-there will be a decrease in pain within days
-is beneficial for 6 months-1 year after a series of injections
-delays the need for more aggressive treatment: joint replacement

45
Q

What are two key ingredients in dietary supplements are needed to produce synovial fluid and articular cartilage?

A

Glucosamine and Chondroitin Sulfate- may help to protect cartilage or reverse the joint deterioration in OA- types of DMOADs

Pharm Exam 1 (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions