Orthopedic pharm

Question 1

MOA of NSAIDs

Answer 1

block PG synthesis via inhibiting COX enzymes at the site of injury, in the periphery and in the brain

Question 2

what does acetaminophen not have antiinflammatory properties

Answer 2

inactivated by peroxides generated by leukocytes in inflamed tissues

Question 3

what is motrin/advil

Answer 3

ibuprofen

Question 4

what is aleven

Answer 4

naproxen

Question 5

what is indocin

Answer 5

indomethacin

Question 6

what is toradol

Answer 6

ketorolac

Question 7

MOA: inhibit AA activation of platelets and decreases platelet function and/or a decrease in PG METABOLITES

Answer 7

acetylsalicylic acid/asprin (bayer)

Question 8

SE of aspirin

Answer 8

tinnitus
anemia
gastritis

Question 9

clinical use for ibuprofen

Answer 9

mild to moderate pain or dysmenorrhea

inflammatory disorders - OA and RA

Question 10

clinical use of naproxen (aleve)

Answer 10

inflammatory disorders - gouty arthritis, OA, RA, ankylosing spondylitis, patent ductus arteriosus in premies

reserved for pts not responding to less toxic drugs

(same as indomethacin)

Question 11

clinical use of indomethacin (indocin)

Answer 11

inflammatory disorders - gouty arthritis, OA, RA, ankylosing spondylitis, patent ductus arteriosus in premies

reserved for pts not responding to less toxic drugs

(same as naproxen)

Question 12

drug for short term management of pain

available as IM injection

prolongs bleeding time; use must be limited to 5 days or less

Answer 12

Ketorolac

Question 13

what are the selective COX-2 inhibitor NSAIDs

Answer 13

celecoxib

meloxicam

Question 14

clinical use of celecoxib

Answer 14

OA and RA

Question 15

what are the strong opiate agonists

Answer 15

fetanyl

mepridine

morphine

Question 16

what are the moderate opiate agonists

Answer 16

codeine - mild-moderate pain

hydrocodone - often combined with acetaminophen or NSAID

Question 17

Tramadol is a 1 (class of drug) and is a synthetic analgesic. Like morphine, it binds to receptors in the 2 that transmit pain sensation. It is not an NSAID and does not increase the risk of 3 and 4 that can occur with NSAIDs

Answer 17

1. non-narcotic
2. brain
3. stomach ulceration
4. internal bleeding

Question 18

inject medication around a SPECIFIC nerve to block sensory and motor fibers distal to the block

Answer 18

regional nerve block

Question 19

bupivacaine is what

Answer 19

local anesthetic - inhibits the ionic fluxes; blocks fast voltage gated Na+ channels

Question 20

what can lidoderm patch treat

Answer 20

post-herpetic neuralgia

maybe low back pain

Question 21

PO route muscle relaxers

Answer 21

metaxolone

carisoprodol

cyclobenzaprine

PO, IM, IV = benzos –> diazepam and midazolam

Question 22

Tx for gout that inhibits uric acid synthesis

Answer 22

allopurinol

Question 23

Tx for gout that increases uric acid excretion with uricosuric agents (and blocks renal tubular reabsorption of uric acid)

Answer 23

probenecid

sulfinpyrazone

Question 24

what is the most widely used agent for decreasing the frequency of ACUTE gouty attacks

Answer 24

colchicine

Question 25

Tx for gout that inhibits leukocyte entry into the affected joint

Answer 25

colchicine

Question 26

drugs that help reduce inflammation and slow disease progression

Answer 26

DMARDs

Question 27

in RA or PsA, ____ can cause your immune system to attack healthy tissues in your body and cause inflammation and damge

Answer 27

TNFalpha

Question 28

Most serious side effect of TNF blockers

Answer 28

increased frequency of infections, especially TB --> TB skin text required before starting TNF therapies

Question 29

3 TNF blocker drugs

Answer 29

infliximab etanercept adalimumab

Question 30

what does MTX treat

Answer 30

RA PsA at small doses

Question 31

when taking MTX what is also necessary to take?

Answer 31

vitamin folic acid

Question 32

what can azulfidine (sulfasalzine) used to treat

Answer 32

- arthritis | - intestinal lesions in IBD

Question 33

drug that may help to keep cartilage healthy by absorbing fluid into the CT

Answer 33

chondroitin

Question 34

what can glucosamine be used to treat - what is its beneft?

Answer 34

OA - particularly of the knee benefit in synovial fluid - strengthens cartilage and aids in glycosaminoglycan synthesis

Question 35

what does hyaluronic acid treat and what does it do? (orthovisc, synvisc, supartz)

Answer 35

OA supplements knee fluid to relieve pain and improve the knee joint's natural shock absorbing abilities restore viscoelasticity of synovial fluid, augment flow of fluid, normalize synthesis, inhibit degradation of endogenous hyaluronic acid and relieve joint pain

Question 36

corticosteroids use

Answer 36

pain relief of arthritis or bursitis

Question 37

why would you not use corticosteroids in achilles tendonitis

Answer 37

risk of tendon rupture

Question 38

what might steroid use cuase in diabetic patients

Answer 38

hyperglycemia

Question 39

actions of glucocorticoids

Answer 39

anti-inflammatory immunosuppressent

Question 40

short acting injectable corticosteroids

Answer 40

cortisone hydrocortisone

Question 41

intermediate acting injectable corticosteroids

Answer 41

prednisolone tebutate triamcinolone and methylprednisolone

Question 42

long acting injectable corticosteroids

Answer 42

dexamethasone beamethasone