PHRM 825: OA Flashcards
What is the pathogenesis of OA?
Degenerative changes that occur in cartilage and the associated bone
What is OA characterized by?
Increased destruction and subsequent proliferation of cartilage and bone; regenerated articular surfaces do not possess the same qualities and architecture as the original joint
In what population is OA more common?
- Older (85% of patients >75 years old)
- Female
What joints are most commonly affected by OA?
- Distal interphalangeal joint (DIP)
- Hips
- Knees
What are risk factors for OA?
- Increasing age
- Obesity
- Congenital/anatomical defects
- Muscle weakness
- Female gender
- Repetitive stress
- Major joint trauma
- Heredity
How does OA present?
- Pain in joints (worse with activity)
- AM stiffness is BRIEF
- Crepitus
- Asymmetric involvement
- Muscle atrophy
- Herberden’s nodes
- Bouchard’s nodes
- Instability of weight bearing joints
Goals of treatment for OA
- Relief of pain and discomfort
- Maintain function and strength of joint
- Prevent deformities and progressive changes
- Can NOT reverse damage
What is the step-wise treatment for OA?
Step 1: Non-pharmacologic Step 2: Acetaminophen Step 3: NSAIDs Step 4: Opioid analgesics Step 5: Surgery
What are non-pharmacological treatment options for OA?
- Psychological support
- Education
- Rest
- Physical activity/exercise
- Heat/ice
- Physical therapy
- Occupational therapy
- Weight loss
What patients are at an increased risk of nephrotoxicity with NSAIDs?
- CHF
- HTN
- Renal dysfunction
- Dehydration
What is a potential benefit of COX-2 inhibitors?
-Lower incidence of severe GI bleeding
What are potential risks associated with COX-2 inhibitors?
- Increased risk of CV disease
- Increased costs
- Same impact on renal functions and INR
How long do new joints last after surgery?
10-15 years
