Topic 9 - Drugs that affect the musculoskeletal system

Question 1

Discuss why DMARDs such as methotrexate are use din the treatment of rheumatoid arthritis

Answer 1

• Inhibition of neutrophil adhesion to endothelial cells which ↓ cell migration
• T cell deactivation
• ↑ intracellular adenosine and potentiate stimulation of α 2 receptors
• Patient must be supplemented with folic acid with MTX use
• Early diagnosis and treatment relieves pain, reduces inflammation and helps limit joint damage
• Because irreversible damage takes place in the first 2 years of RA, early intervention is crucial

Question 2

Discuss the role of bisphosphonates and pulsatile parathyroid hormone in the treatment of osteoporosis

Answer 2

Osteoblasts create bone and osteoclasts destroy bone. Bisphosphonates encourages osteoclasts to undergo apoptosis, therefore slowing the role of bone loss.