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MSK > Pharmacology of Arthritis > Flashcards

Pharmacology of Arthritis Flashcards

1
Q

Pure analgesics such as paracetamol, have what properties?

A

Analgesic
Little anti-inflam activity
Anti-pyretic

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2
Q

What is co-codamol made with?

A

Codeine and paracetamol

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3
Q

What type of drug is amitryptiline?

A

Anti-depressant

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4
Q

What type of drug is Gabapentin?

A

Anti-convulsant

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5
Q

Give some side effects of opiod drugs?

A 
dizzy 
Nausea 
vomiting 
sleepy 
confused
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6
Q

Give some side effects of long term opiod drug use?

A 
constipation 
itching 
weight gain 
lack of sex drive 
reduced fertility 
erectile dysfunction 
irregular periods 
decreased ability to fight infection
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7
Q

What is the effect of NSAID on inflammation?

A

Symptomatic relief of inflammation but does not decrease inflammation to where the disease actually stops

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8
Q

Give some examples of NSAIDs?

A

Naproxen
Ibruprofen
Diclofenac

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9
Q

List some side effects of NSAIDs.

A 
dyspepsia and peptic ulcers 
oesophagitis 
gastritis 
small/ large bowel ulceration 
rash 
wheeze (avoid in asthmatics)
fluid retention
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10
Q

What is DMARDs onset of action like?

A

Slow acting - weeks to months

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11
Q

What should be given over the lag phase of DMARDs?

A

Steroids

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12
Q

Do DMARDs show any analgesic effect?

A

No

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13
Q

How quickly should patients who present with RA be started on DMARDs?

A

Aim for within 3 months of symptom onset - patients do not present at the onset of symptoms

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14
Q

What should be given prior to starting DMARDs?

A

Vaccinations - flu & pneumococcal

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15
Q

Are DMARDs normally started individually?

A

No, normally methotrexate an sulphasalazine are started together

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16
Q

What does Methotrexate work as in the body?

A

folate antagonist

17
Q

How is MTX given?

A

Oral

Subcutaneously if GI SE of oral MTX

18
Q

What conditions is MTX used in?

A

RA
Psoriatic arthritis
CTD
Vasculitis

19
Q

Give some side effects of MTX.

A

Leucopenia/ thrombocytopenia
Hepatitis/ cirrhosis
rash and mouth ulcers
pneumonitis

20
Q

Is MTX teratogenic?

A

Yes, should be stopped in males and females at least 3 months before conception

21
Q

Are there any contraindications to giving MTX?

A

Pre-existing pulmonary fibrosis

22
Q

What is sulphasalazine made of?

A

Azo-ester of sulphapyridine and 5-aminosalicylic acid

23
Q

What is the main worrying SE of sulphasalazine?

A

Neutropenia

24
Q

When is hydroxychloroquin used?

A

CTD
SLE
Sjogren’s syndrome
RA

25
Q

What should HCQ be avoided in?

A

psoriatic arthritis

26
Q

Why should azathioprine never be used with allopurinol?

A

Irreversible agranulocytosis occurs

27
Q

In the UK, currently what is Anti-TNF licensed for?

A

RA
Psoriatic arthritis
ankylosing spondylitis

28
Q

Are Anti-TNF drugs, more effective when used in combination with DMARDs or alone?

A

In combination with DMARDs

MSK (19 decks)

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