OA Pharm: Fitz Flashcards
first step in pain relief for OA . .. WITHOUT inflammation
Acetaminophen analgesic
symptoms of Acetaminophen overdose
- emesis
- jaundice
- altered mental status
- history of depression
Acetaminophen overdose finding in liver
Centrolobular necrosis
acetaminophen gets metabolized by CYP450 to what? This then gets metabolized by what?
NAPQI
-GSH . . reduced glutathione
Antidote for Acetaminophen overdose?
give when?
- N-Acteylcysteine NAC
- ASAP within first 24 hours
second phase of OA treatment . . inflammation develops
NSAIDs
what is the only NSAID in injectable form
Ketorolac
what is the risk when taking a low dose aspirin for cardioprotection and also taking another NSAID
risk for upper GI bleed
if you start an OA patient on an NSAID and you get side effects of intolerance then what
switch to different NSAID in different chemical class
what is the worst tolerated NSAID
indomethacin
Naproxen is same class as what NSAID
Ibuprofen
besides switching classes. what is another way you can get GI protection when using NSAIDs
- add a prostaglandin
- Diclofenac + misoprostol . . .
- this really just displaces the GI issues to later down the GI system
-can also add a PPI
what is the best way to help GI issues with NSAID use
use a coxib
Rofecoxib was removed from market why
CV risk
what if symptoms persist and NSAIDs fail?
Intra articular anti-inflammatory steroid
- Triamcinolone . . corticosteroid
- COX-2 mRNA and protein INDUCTION is repressed . . les PGs formed
