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Rheumatology > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

What stage on the WHO pain ladder is this: “Opiod for moderate to severe pain plus non opiod with/without adjuvant analgesic”

A

Step 3

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2
Q

List sme adverse effects of NSIADs

A 
Peptic ulcers
Renal impairement
CVS events 
Wheeze
rash
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3
Q

What NSAID mechanism is particularly bad for CVS events?

A

Cox 2 inhibitors

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4
Q

Do DMARDs have an analgesic effect?

A

Not directly (pain may improve as inflammation reduces though!)

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5
Q

What should be given before DMARDs are started?

A

Vaccines (not live)

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6
Q

What is the first choice DMARS?

A

Methotrexate

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7
Q

What is the mechanism of action of methotrexate?

A

Folate antagonist

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8
Q

What conditions is methotrexate used in?

A

RA, Psoriatic arthritis, connective tissue disease, vasculitis

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9
Q

What do you need to monitor in a patient who is on methotrexate?

A

FBC

LFTs

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10
Q

List the adverse effects of methotrexate

A 
Leucopenia/Thrombocytopenia
Hepatitis/cirrhosis
Pneumonitis
Rash/mouth ulcers
Nausea/diarrhoea
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11
Q

List the adverse effects on sulfasalazine

A 
Nausea
Rash/mouth ulcers
Neutropenia
Hepatitis
Oligozoospermia (reversible)
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12
Q

What do you need to monitor in a patient on sulfasalzine?

A

LFTs

FBC

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13
Q

What conditions is hydroxychloroquine used in?

A

Connective tissue disease such as SLE, sjogrens and RA

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14
Q

What is a rare side effect that can occur with hydroxychloroquinines?

A

Retinopathy

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15
Q

How does ciclosporin work?

A

Inhibits the activation of T cells

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16
Q

What adverse effects can occur with ciclosporin use?

A

Nephrotoxicity

Hypertenion

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17
Q

How do antimalarial drugs work as DMARDS?

A

Interfere with antigen processing

18
Q

What adverse effects can occur with azathriopine?

A

Hepatotoxicity
Myelotoxicity
GI problems

19
Q

Give 4 subcutaneous anti TNF medications

A

Etanercept
Adalimumub
Certolizumab
Golimumab

20
Q

Give an example of an IV anti TNF medication

A

Infliximab

21
Q

What three conditions is anti TNF mediation licensed for?

A

Rheumatoid arthritis
Psoriatic arthritis
Ankylosing spondylitis

22
Q

What is the major risk with anti TNF treatments?

A

Infection

23
Q

In what two conditions in anti TNF treatment contraindicated?

A

Pulmonary fibrosis

Heart failure

24
Q

What is rituximab?

A

A monoclonal antibody against B lymphocytes

25
Q

What does tocilizumab do?

A

Inhibits IL - 6

26
Q

What does abatecept do?

A

Blocks full activation of T lymphocytes

27
Q

What does ustekinumub do?

A

Inhibts IL12 and IL23

28
Q

What are the adverse effects of colchicine?

A

Diarrhoea and vomiting

29
Q

How do you treat an acute episode of gout?

A

NSAIDS
Colchicine
Steroids

30
Q

Name three urate lowering drugs

A

Allopurinol
Febuxostat
Uricosurics

31
Q

What kind of drug is allopurinol?

A

Xanthine oxidase inhibitor

32
Q

How is purine converted to uric acid?

A

Purine in converted to Xanthine. This is then converted to uric acid by xanthine oxidase

33
Q

List some adverse effects of allopurinol

A

Rash (vasculitis)
Interacts with azathioprine
Inhibits warfarin
Marrow aplasia (extremely rare)

34
Q

List 4 uricosurics

A

Probenecid
Sulphinpyrazone
Benzbromarone
Azapropazone

35
Q

How do urocosurics work?

A

By increasing the excretion of uric acid in the urine, and so decreasing the levels in the blood.

36
Q

Where do uricosurics work?

A

Proximal tubule of the kidney

37
Q

What rheumatological conditions are corticosteroids used in?

A 
Connective tissue disease
Polymyalgia rheumatica
Giant cell arteritis
Vasculitis
Rheumatoid arthritis
38
Q

Give 4 metabolic effects of corticosteroids

A

Salt & water retention
Increases gluconeogeneis.
Increased hepatic glycogen deposition
Increased protein breakdown

39
Q

List some adverse effects of corticosteroids

A 
Weight gain
Muscle wasting
Skin atrophy
Osteoporosis
Diabetes
Hypertension
Cataracts
Gluacoma
Fluid retention
Adrenal suppression
Immunosuppression
AVN of the femoral head
40
Q

Give 4 ways in which you can reduce the toxic effects of corticosteroids?

A

Lowest possible dose for shortest time.
Consider steroid sparing agents
Osteoporosis prophylaxis
Control CVS risk factors

Rheumatology (7 decks)

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