Pharmacology

Question 1

1st line NSAID in Tayside for arthritis

Answer 1

naproxen

Question 2

drug for inflammatory arthritis, MSK mechanical pain, pleurisy/pericardial pain =

Answer 2

NSAIDs

Question 3

adverse effects of NSAIDs (10)

Answer 3

worsens asthma / wheeze
dyspepsia
PUD
oesophagitis
gastritis
bowel ulcers
renal impairment
increased CV risk
fluid retention
rash

Question 4

COX 2 selective inhibitor =

decreases risk of ___ (side effect of other NSAIDs)

Answer 4

celecoxib

PUD

Question 5

class of drugs used in arthritis that are purely anti-inflammatory, decrease inflammatory markers and decrease rate of joint damage - they need regularly ___

Answer 5

DMARDs

monitored

Question 6

folate antagonist DMARD

Answer 6

methotrexate

Question 7

4 diseases that can be treated with methotrexate

Answer 7

RA
psoriatic arthritis
CT disease
vasculitis

Question 8

if want to have a baby then both M and F must stop methotrexate ___ before conception

Answer 8

3 months

Question 9

adverse effects of methotrexate and leflunomide

Answer 9

leuco/thrombocytopenia
hepatitis/cirrhosis
pneumonitis
rash/mouth ulcers
nausea/diarrhoea

Question 10

use _+__ to monitor methotrexate

Answer 10

LFTs

FBC

Question 11

leflunomide is safe or not in pregnancy ?

Answer 11

no

it is teratogenic

Question 12

leflunomide has a very long ___ and so need a wash out

Answer 12

t1/2

Question 13

adverse effects of sulfasalazine

Answer 13

neutropenia
rash/mouth ulcers
nausea
hepatitis
reversible oligozoospermia

Question 14

3 diseases where hydroxychloroquine is used

Answer 14

SLE
RA ( no effect on joint damage)
Sjogrens

Question 15

rare side effect if on hydroxychloroquine long term

Answer 15

retinopathy

Question 16

2 side effects of IM gold for RA

Answer 16

bone marrow suppression

glomerulonephritis

Question 17

anti-TNFs are used for which arthritises?

Answer 17

RA
ank spond
psoriatic

Question 18

examples of anti TNFs

Answer 18

etanercept
adalimumab
certolizumab
infliximab
golimumab

Question 19

most effective anti TNF drug for arthritis

Answer 19

adalimumab

Question 20

adverse effects of anti TNF drugs

Answer 20

infection
reactivate latent viruses
skin malignancy risk?
contra-ind in HF and pulmonary fibrosis

Question 21

biologic against B cells used in RA and CT disease

Answer 21

rituximab

Question 22

IL6 inhibitor used for RA

Answer 22

tociluzumab

Question 23

biologic that decreases T cell activity in RA

Answer 23

abatacept

Question 24

IL12 and 23 inhibitor used for psoriatic arthritis

Answer 24

ustekinumab

Question 25

IL17 inhibitor used for psoriatic arthritis and ank spond

Answer 25

secukinumab

Question 26

common side effect of colchicine

Answer 26

diarrhoea

Question 27

inhibitor of xanthine oxides =

Answer 27

allopurinol (1st line)

febuxostat - (if cant tolerate allopurinol)

Question 28

always co prescribe a __ for the 1st few weeks on allopurinol
side effect = ___ so use a lower dose in elderly and renally impaired

Answer 28

anti-inflammatory

vasculitis rash

Question 29

allopurinol + azathioprine =>

Answer 29

irreversible bone marrow aplasia

Question 30

be cautious of using febuxostat to lower urate if ptnt has ___

Answer 30

ischaemic heart disease

Question 31

uricosurics (a type of urate lowering drug) egs (4)

Answer 31

probenecid
sulfinpyrazone
azapropazone
benzbromarone

Question 32

drugs used in CT disease, PMR/GCA, vasculitis and RA =

Answer 32

steroids

Question 33

AVN of femoral head, glaucoma, muscle wasting, cataracts, adrenal suppression, fluid retention are all side effects of __

Answer 33

steroids