Osteoarthritis Flashcards
Acute ingestion of Acetaminophen 7 to 10 g can cause
hepatotoxicity
ingestion of Acetaminophen 10 to 13 g daily dose
lethal
Within what duration of ingestion,should N-acetyl cysteine be administered
with 8 hours of overdose.
if >2 g of acetaminophen is used,anticoagulant effect of Warfarin gets?
Increased
High dose of acetaminophen combined with
CBZ,
phenytoin,
barbiturates may
↑ acetaminophen metabolism and can cause hepatotoxicity.
NSAIDs are preferred when
inflammation is present or main complain( as the name suggests)
What drug is 5-ASA
Mesalamine
Can we prescribe NSAID if the patient is unresponsive to acetaminophen?
NSAIDs are alternative for those do not respond to acetaminophen
At initiating NSAIDs patient should be assessed for and is contraindicated in?
1)gastrointestinal-peptic ulcer disease, inflammatory
bowel disease
2) cardiovascular (MI, stroke, fluid retention, hypertension:worsen pre-existing hypertension. ,severe uncontrolled congestive heart failure),Hyperkalemia
3)renal risk factors(CrCl <30 ml/min)-can cause RF
4)should be monitored for toxicities.
ASA or NSAIDS allergy patient only can use?
acetaminophen
Patient with congestive heart failure and experiencing knee arthritis What is appropriate for pain relief?
Acetaminophen
PPI which can be taken without regard of food and timing
Dexlansoprazole
Which patient group should combine acetaminophen with PPI or misoprostol?
Elderly patients over 65
history of GI ulcers,
cardiovascular disease patient taking long term NSAID
Contraindications of Cox-2 Inhibitors?
Serious heart diseases(H/o MI, stroke, serious heart diseases, chest pain, and CHF). Exacerbate hypertension promote edema sulfa allergy
DOC in patient with the potential for a GI, cardiovascular complications?
Topical NSAIDs
For topical NSAIDs, adequate pain relief occurs in?
4 to 5 weeks regular use.
Patient with GI ulcers history should avoid ?
NSAIDs
Cox-II
anticoagulants
corticosteroids
Topical NSAID to avoid in NSAIDs allergies?
Diclofenac Topical
Topical NSAID to avoid in ASA allergic patients?
Methyl Salicylate
Drug interaction with warfarin
Acetaminophen-(Inc anticoag effect,in Acet. >2g)
NSAIDs(increase risk of GI bleeding and renal disease)
Methyl Salicylate( Inc anticoag effect)
How can we decrease transient burning/tingling on capsaicin topical application?
pre-treatment with Lidocaine
Which steroid is used for intra articular injections in OA?
Methylprednisone. Betamethasone acetate/betamethasone sodium phosphate Methylprednisolone acetate Triamcinolone acetonide
What is the maximum intra articular injections that can be taken per year in OA?
Maximum 3 injections/joint/year.
Capsaicin, as a member of the________ family
vanilloid
Capsaicin, binds to a receptor called
vanilloid receptor subtype 1 (TRPV1)
Consider_______ if a patient with OA presents with concomitant depression and/or
neuropathic pain
duloxetine
Opioid analgesic in OA
Morphine, Oxycodone, Tramadol(MOA: agonist at opioid receptors)
S.E of Opioid analgesic
Respiratory depression, sedation, ataxia, constipation, seizures, nausea, orthostatic hypotension.
NSAID With anticoagulants (warfarin) or antiplatelet drugs (clopidogrel).
Increased risk of bleeding
NSAID WITH antihypertensives.
May decrease antihypertensive effect
NSAID WITH SSRIs.
Increased risk of GI bleeding
NSAID WITH Lithium
May decrease renal clearance of lithium; monitor lithium levels when NSAID added.
Indomethacin can cause__________ and _________ blood disorders
Agranulocytosis and aplastic anemia
Nabumetone is a prodrug, which undergoes hepatic biotransformation to the active
component, __________________
6-methoxy-2-naphthylacetic acid (6MNA),
Selective COX inhibitor binds to COX__ receptor
COX 2 receptor
Naproxen has a higher risk of ______ adverse effects than ibuprofen, but have the lowest risk
among NSAIDs for ____________
GI, cardiovascular events
MOA of Diflunisal ?
Diflunisal is a prostaglandin synthetase inhibitor,
BONE VIDEO
https://youtu.be/Ei4seya3dOg
