Treatment of Osteoarthritis Exam 1 Flashcards
1
Q
What are the possible treatment for OA?
A
- NSAIDs
- APAP
- Opioids
- Tramadol
- Duloxetine
- ASA
2
Q
monitoring parameters for NSAIDs
A
- edema
- weight
- urinalysis
- Cr (renal function)
- CBC
- GI discomfort
- K levels
- LFT’s
- CNS effects
- skin reactions
3
Q
monitoring parameters for APAP
A
Live function (LFTs)
4
Q
monitoring parameters for opioids
A
- weakness
- fractures
- falls
5
Q
monitoring parameters for tramadol
A
- seizure episodes
- QT interval
- diaphoresis
- myoclonus
- shivering
- fever
- tachycardia
- semicomatose
6
Q
monitoring parameters for duloxetine
A
CNS effects
7
Q
monitoring parameters for ASA
A
- CBC
- GI discomfort
8
Q
What are the non-drug treatment of OA?
A
- pt education and self-mgmt
- social support
- diet + weight reduction
- PT / OT
- surgery
- genetic manipulation
- misc. therapies
9
Q
What are examples of PT / OT?
A
- Low impact aerobic exercise
- Assistive devise
- Joint protection
- Heat
- TENS
10
Q
What are examples of supplements that patients may take?
A
- fish oil, evening primrose oil vitamins or minerals; herbal pills (may contain corticosteroids); honey and apple cider vinegar; golden raisins and gin
- Flavocoxid (Limbrel) – medical food (inhibits COX 1 & 2 & lipoxygenase); reports of acute liver injury
11
Q
What are the types of surgery that can be performed?
A
- joint debridement
- osteophyte removal
- joint replacement
- joint fusion
12
Q
What are misc non-drug therapies?
A
- relaxation therapy
- massage
- prayer
- copper bracelet
- magnets
- DMSO
- urine injections
- WD40
- bee stings
- ant or snake venom
- acupuncture / acupressure
- balneotherapy (thermal mineral baths)
- mud packs
- topical marijuana
13
Q
Acetaminophen (Tylenol) dosing
A
Limit to 650 mg/dose, 3250 mg/d; if pt has liver disease, restrict to 2g/day
14
Q
Tramadol (Ultram) clinical pearls
A
- decreases seizure threshold
- can prolong QTc interval
- risk for serotonin syndrome if used with tricyclic antidepressants or selective serotonin reuptake inhibitors
15
Q
Duloxetine (Cymbalta)
A
- FDA-approved for OA
- affects CNS pain pathways