Osteoarthritis Flashcards
What is osteoarthritis?
Non-inflammatory abnormality of the synovial joints due to cartilage loss
Where is it most common to get osteoarthritis?
Hands
Knees
Spine
Hips
What are the risk factors for osteoarthritis?
Obesity
Females
Increasing age
Chronic occupational strain
Trauma
Inflammatory disease
How does osteoarthritis present?
Pain worsened by movements
Stiffness after sitting down/waking up in the morning
Pain relieved by rest
Creaking/cracking of joints
What are the non pharmacological treatment options for osteoarthritis?
Weight reduction for obese people
Local heat to affected joint
Physiotherapy
Occupational therapy
Non-weight bearing exercise
TENS machine for pain
What are the pharmacological treatment options for osteoarthritis?
Paracetamol regular dosing
Topical NSAIDs
Oral NSAIDs (+PPI)
Co-codamol/other weak opioids
COX-2 inhibitors, e.g. celecoxib
Capsaicin to generate heat to distract patient from the pain
When would a COX-2 inhibitor be given?
If a patient has a history of GI ulcers/complications with no CV risk
Why cant topical and oral NSAIDs be given together?
Because it will cause greater side effects
Which NSAID would you give in a CV patient, and what dose?
Naproxen 1g
What is the safest dose of ibuprofen a CV patient can take?
1.2g
Which individuals should you not give an NSAID to, and why?
Those on ACEi - risk of renal impairment
Those on antiplatelets/anticoagulants/SSRIs - risk of GI bleeding
Alcoholics - risk of GI bleeding
What side effect can opioids induce, and what should be given for this?
They can induce constipation, so consider laxatives
Why isnt the max dose of ibuprofen (2.4g) given?
Because it has an increased risk of GI/CV toxicity
What should you do to the dose of paracetamol in those with renal impairment, or are <50kg?
Reduce dose to 1g TDS
What other agents could the patient try which can aid in their osteoarthritis pain?
Glucosamine
Cod liver oil
Vitamin E
