Pharmacology of arthritis

Question 1

what drugs are used for symptom relief?

Answer 1

paracetamol
opiate compounds
NSAIDS
atypical analgesics

Question 2

what are the disease modifiers?

Answer 2

DMARDs

Biologics

Question 3

examples of DMARDs?

Answer 3

Methotrexate
sulphalasize
hydroxychloroquine

Question 4

examples of Biologics?

Answer 4

Anti-TNF
rituximab
tocilizumab

Question 5

Example of a pure analgesic.

adverse effects?

Answer 5

Paracetamol

Rare - dangerous in overdose

Question 6

Analgesics?

Answer 6

Co-codomol 
Dihydrocodeine
Tamadol 
Amitryptiline
Gabapentin

Question 7

Most commonly used NSAID in tayside?

Answer 7

Naproxen

Question 8

S.E of NSAIDs

Answer 8

dyspepsia
oesophagitis 
gastritis 
peptic ulcer 
bowel ulceration 
renal impairment 
fluid retention 
wheeze
rash

Question 9

NSAIDs mechanism

Answer 9

selectively target COX-2 - an enzyme responsible for inflammation and pain

Question 10

DMARD mechanism

Answer 10

slow acting - weeks to months
pure anti-inflammatory, no direct analgesic
reduce joint damage
most need regular monitoring

Question 11

DMARD indications

Answer 11

aim to start with inflammatory arthritis on DMARD within 3 months of symptom onset

Question 12

which DMARDs are not safe in pregnancy?

Answer 12

methotrexate and leflunomide

Question 13

methotrexate action?

Answer 13

folate antagonist so need to take folic acid supplements

Question 14

first DMARD given?

its properties?

Answer 14

methotrexate
orally or subcutaneously
if nausea present then injection works better
TETRATOGENIC - must be stopped 3 months before conception in males and females

Question 15

SE of methotrexate

Answer 15

leucopenia, thrombocytopenia, hepatitis, cirrhosis, pneumonitis, rash, MOUTH ULCERS, NAUSEA, diarrhoea

need to monitor FBC and LFTs

Question 16

Pregnancy and Leflunomide?

Answer 16

its not advised to pregnant people 2 weeks after taking it