Rheum Treatments Flashcards
OA
General
Non-Pharm (PT, lifestyle, weight loss)
Topical Agents
Anti-inflammatories
Surgery
OA
Non-Pharm
PT, mucle toning, quad strength
Exercise bike, elliptical, walking fitness program
Cane, walker, shoe inserts, grab bars, toilet extenders, seat lifts chair
Parking permit
Weight loss 5kg (50% less chance of developing OA, slows progression)
OA
Topical Agents
Capsain (depletes substance P) Methysalicylate, menthol, camphor Bio-Freeze Diclofenac topical Flector patch Pennsaid lotion
OA
Anti-inflammatories
NSAIDs Acetaminophen (OTC) Tramadol Codeine III or IV Oxycodone II Morphine II & derivatives
OA
Procedures
Joint aspirations Joint injections (steroids, anesthetic, Aristospan, hyaluronic acid) TKR if night pain doesn't respond to meds, major inability, interferes w/ daily living, unable to walk/work, bone-on-bone
RA
General
DMARDs NSAIDs TNF inhibitors B cells T cells JAK Kinase Inhibitors BRMs (pre-drug screening)
RA
DMARDs
Corticosteroids Hydroxychloroquine Sulfsalazine Methotrexate Leflunomide Azathiprine
RA TNF Inhibitors (Biologics)
Etanercept Infliximab Adalimumab Golimumab Certolizumab pegoles
RA
Others (non-DMARDs/TNF)
B cells: Rituximab T cells: Abatacept I-6: Tocilizumab JAK: Tofacitinib BRMs (pre-drug screening)
JRA
General
PT/exercise Tylenol/NSAIDs DMARDs Corticosteroids Enbrel
JRA
MC Tylenol/NSAID
Naproxen & Ibuprofen
OA
Treatment goal
Pain relief
RA
Treatment goal
Slow/stop disease progression
Ankylosing Spondylitis
General
Reduce pain & stiffness - NSAIDs, glucocorticoids, DMARDs
BRMs (TNFs)
Pt education
Joint protection
Lifelong PT for posture & slow Dz progression
Ankylosing Spondylitis
DMARDs
Methotrexate
Sulfsalazine
Ankylosing Spondylitis
BRMs
Etanercept Infliximab Adalimumab Golimumab Certolizumab
Psoriatic Arthritis
General
NSAIDs Glucocorticoids DMARDs BRMs Pt education Joint protection/lifelong PT
Psoriatic Arthritis
DMARDs
Methotrexate
Sulfsalazine
Psoriatic Arthritis
BRMs
Etanercept Infliximab Adalimumab Golimumab Certolizumab
Reactive Arthritis
General
Abx based on pathogen
Reactive Arthritis
Chlamydia
3 mo Doxycycline or Tetracycline
D preferred over T
Gout
General
NSAIDs Colchicine Steroids ULT Lifestyle/Dietary changes Pegloticase
Gout
NSAIDs
Motrin
Indocin
Naprosyn
Celecoxib
Gout
ULT
Allopurinol
Febuxostat
Take w/ low-dose colchicine or NSAID 2 wks before starting ULT
Pseudogout
General
No Tx
Intra-articular corticosteroids (acute)
NSAIDs (moderate sx)
Colchicine (Tx sx)
Acute LBP
General
Control pain
Minimize activity
Subacute LBP
General
Control pain
Maximize activity
Chronic LBP
General
Multidisciplinary
LBP
Pain Control
Anti-inflammatories Tramadol Opioids Muscle relaxants Epidural injections
LBP
Muscle relaxants
Methocarbamol
Fibromyalgia
General
Antidepressants
Pain control
Exercise, improve sleep, treat psychological distress
Fibromyalgia
Antidepressants
SNRIs
Duloxetine
Cyclobenzaprine
Fibromyalgia
Pain Control
Pregabalin
Tramadol
Milnacipran
Sjogren’s
General
Tx oral dryness (OTC, Rx)
Tx eye dryness (OTC, Rx)
Sjogren’s
OTC oral
Biotene products
Sugar-free chewing gum
Sugar-free lozenges (Xylitol)
Sjogren’s
Rx oral
Muscarinic cholinergic agnoists
Cevimeline
Pilocarpine
Sjogren’s
OTC eye
Systane
Refresh tears
Sjogren’s
Rx eye
Ophthalmologist Rx
Restasis
Keratoconjunctivitis Sicca
OTC
Systane
Refresh tears
Keratoconjunctivitis Sicca
Rx
Ophthalmologist Rx
Restasis
