Osteoarthritis In Practice Flashcards
What are the differences between osteoarthritis and rheumatoid ?
RHEUMATOID:
-can occur at any age
-autoimmune and inflammatory process
-can have systemic effects e.g. dry mouth, fatigue etc.
-onset is rapid over weeks and months
-joints are painful hot and swollen
-morning stiffness lasts longer than one hour
-affects joints symmetrically
OSTEOARTHRITIS:
-occurs at older age
-occurs due to wear and tear of the cartilage
-no systemic involvement
-onset is slow
-joints ache but will have minimal swelling and wont be hot and red.
-morning stiffness lasts less than an hour
-mainly affects the knees, and the spine.
What do we aim for when treating osteoarthritis?
IT IS USUALLY MANAGED IN PRIMARY CARE.
Recognising: pain when using joints and restriction with mobility.
Aims:
1. To reduce pains and stiffness
2.maintain/improve functional capacity
3.prevention of progression of joint damage
4.improve quality of life
Is there a cure for osteoarthritis?
There is no cure for osteoarthritis and it is therefore simply symptom management.
What is the pharmacists role in osteoarthritis patients?
1.Recognise the presentation
2.patient education on management e.g both pharmacological and non Pharmacological.
3.signposting where to receive appropriate support and advice e.g. exercise, weight reduction programmes etc
4.medication reviews
5.lifestyle advice
6. Surgery( what pre medication will the patient need)
E.g. laxatives /anti emetics
When can osteoarthritis be diagnosed?
It can be clinically diagnosed if the patient is under the age of 45 years old and they’re experiencing activity related joint pain and morning stiffness less than 30 minutes or no morning stiffness at all.
What treatment is there available for osteoarthritis?
1st LINE= paracetamol
Other options:
-topical NSAIDs
-oral NSAIDs or opioids (low doses naproxen/ibuprofen)
-adjuncts (capsaicin)
What should we consider if treating with an NSAIDs?
-cardiovascular risk
-GI risk (give PPI to aid stomach protection)
-renal risk
What other treatments can be given in the most extreme cases of OA?
Surgery e.g. knee/ hip replacements.
