Orthopaedic pharmacology

Question 1

MOA of NSAID

Answer 1

Inhibit COX resulting in inhibition of prostagladin and thromboxaane synthesis

Question 2

Example of NSAID

Answer 2

Ibuprofen, aspirin, diclofenac, celecoxib, piroxicam

Question 3

MOA of Opioid

Answer 3

Mimic endogenous opioid peptide by causing prolonged activation of opioid receptors eg: Mu receptor

Question 4

Adverse effect of opioid

Answer 4

Adverse effect:
I. Respiratory depression reversal: Naloxone
Ii. Nausea and vomiting
Iii. Constipation
Iv: Tolerance and dependence

Question 5

MOA of Midazolam

Answer 5

Increase efficiency of GABA neurotransmitter on GABAA receptors, resulting in chloride channels opening more frequently and therefore causing neural inhibition

Question 6

MOA Vitamin K

Answer 6

Blocks vitamin K dependent gabba carboxylation of glutamate residue
Acts on factor II, VII, XI, X

Question 7

MOA Heparin

Answer 7

Forms complex with antithrombin III, protease inhibitor that inactivates thrombin when bound to heparin

Question 8

Class of Penicilin

Answer 8

Beta lactam antibiotic

Question 9

MOA of penicillin

Answer 9

act by inhibition bacterial peptidoglycan synthesis by binding to penicillin binding proteins

Question 10

MOA and example of
Cephalosporin

Answer 10

act by inhibition of bacterial cell wall synthesis
Cephalexin, cefuroxime, ceftriaxone, cepemin

Question 11

MOA and example of Aminoglycoside

Answer 11

Act by inhibition of bacterial protein synthesis by binding to cytoplasmic ribosomal RNA (30s subunit)

Gentamicin, neomycin, amikasin

Question 12

Management for MRSA septic arthritis

Answer 12

IV Glycopeptide

Question 13

Investigation for Tuberculosis septic arthritis

Answer 13

Early morning sputum sample
Stains: Ziehl Neelsen stain
Cultures: Lowenstein Jensen medium for 6 weeks
Biopsy: Classic granuloma with caseating central necrosis
Skin test: Heaf test and mantoux test
Blood test: Selective immunological interferon gamma test (IGT)