wk6 Flashcards
what is osteomalacia (rickets in children)
- Softening of the bones due to defective bone mineralization
- Common cause is Vitamin D deficiency
Insufficient sunlight exposure, poor nutrition, malabsorption
Renal disease
Liver disease
- Treatment options
sunlight exposure
calcium and vitamin D
what are bisphosphonates
bisphosphonates: anti-resorptive medicine, slow or stop the natural process that dissolves bone tissue. Treats pagets as well
- Fosamax: by mouth
- Alendronate, etidronate and risedronate
- Zoledronic acid
what are selective oestrogen receptor modulators
- Oestrogen deficiency causes both the early and late forms of osteoporosis in postmenopausal women
- Raloxifene a ‘designer’ oestrogen
- Act like oestrogen on bone- protecting its density
- Approved for postmenopausal prevention and treatment of osteoporosis
what is calcitonin used for
calcitonin protects against calcium loss from skeleton during periods of calcium mobilization
decreases risk of spinal fractures, osteoporosis
osteoarthritis treatment includes:
o Physical- reduce stress on joints
o Improve strength
o Lose weight
o Range of motion exercises
- No available therapies to cure disease
- Therapies directed at pain relief and minimising functional disability
o Step 1: non-opioid- aspirin, paracetamol or NSAID
o Step 2: weak opioid for mild to moderate pain- codeine
o Step 3: strong opioid for moderate to severe pain- morphine
Paracetamol
• Ceiling effect: higher doses will not increase analgesic benefit
• Used alone or as an adjunct to NSAIDS
first line therapy in most cases
NSAIDS
• Inhibit production of prostaglandins and thromboxanes which cause pain
• Risk of serious complications. GI bleeding, real failure
• Aspirin, ibuprofen, indomethacin, diclofenac
• NSAIDs, COX-2 selective inhibitors
relieve inflammation
steroids
- Corticosteroids valuable for synovial inflammation
* Steroids can be given topically (cream or ointment), by mouth, or by injection
hyaluronic acid
substance that is naturally present in the human body. It is found in the highest concentrations in fluids in the eyes and joints
• Normal component of the joint for lubrication and nutrition
treatment of rheumatoid arthritis
- Treatment aims to supress inflammation and prevent joint destruction
corticosteroids, NSAIDS, DMARDS,
Corticosteroids
prednisone
reduce inflammation
e.g. Betamethasone or methylprednisolone
disease modifying anti rheumatic drugs
• Often an alternative for the patient who has used low-dose steroids without relief for several months
e.g. gold salts, gold, antimalarials, penicillamine, cyclosporine, azathioprine, methotrexate, sulasalazine, TNN
what is tendonitis
inflammation of tendon sheath
pain and reduced mobility
what is bursitis
o Irritation of subcutaneous tissue and inflammation of underlying bursae
pain on movement
Tx of gout
combination of pharmacotherapy and lifestyle adjustments
- Foods high in purine to be avoided or limited
o Meat, offal, sardines, anchovies, seafood, lentils, spinach, peas
NSAIDS
Corticosteroids
colchicine - anti-inflammatory
uricorsuric acid: enhances excretion of uric acid
