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My2 MSK > pharmacology of arthritis > Flashcards

pharmacology of arthritis Flashcards

1
Q

what is the first line pain management

A

non-opioid +/- adjuvant eg aspirin, paracetemol, NSAIDs

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2
Q

what is second line pain management

A

weak opioid eg codeine +/-non-opioid +/- adjuvant

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3
Q

what is 3rd line pain management

A

strong opioid eg morphine +/- non-opioid +/- adjuvant

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4
Q

what is the purpose of NSAIDs

A

anti-inflam and analgesic

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5
Q

give 2 examples of MSK NSAIDs

A

ibuprofen and naproxen

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6
Q

when are NSAIDs used in MSK

A

inflammatory arthritis/ diseases, mechanical pain, pleuritic pain

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7
Q

what are some side effects of NSAIDs (7)

A

dyspepsia, oesophagitis, gastritis, peptic ulcers, renal + CVD risk, fluid retention

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8
Q

what are the purpose of DMARDs

A

for inflam arthritis, reduce the rate of disease advancement, more effective started earlier and no analgesic affects

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9
Q

name 4 DMARDs

A

Methotrexate, sulphasalazine, leflunomide, hydroxychloroquine

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10
Q

what is usually first line DMARD in inflam MSK diseases

A

methotrexate

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11
Q

what type of drug is methotrexate

A

folate antagonist

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12
Q

what diseases is methotrexate used in

A

RA, psoriatic arthritis, connective tissue disease, vasculitis

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13
Q

what are the side effects of methotrexate

A

leucopoenia, thromboctyopenia, hepatitis. cirrhosis, pneumonitis, mouth ulcers, GI upset

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14
Q

what is monitored regularly with DMARDs

A

FBC and LFTs

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15
Q

when is methotrexate contraindicated

A

lung disease, renal disease, immunosuppressed, women getting pregnant

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16
Q

what DMARD is leflunomide similar to

A

methotrexate - same efficacy and side effects

17
Q

what is a downside to leflunomide

A

long half life so requires wash out

18
Q

what is 2nd line DMARD

A

sulfasalazine

19
Q

what are side effects of sulfasalazine

A

nausea, mouth ulcers, neutropenia, hepatitis, oligozoospermia (low sperm count)

20
Q

when is hydroxycholoroquine used

A

connective tissue disease eg SLE, sjorgen (not joints)

21
Q

what is a rare side effect of hydroxychloroquine

A

retinopathy

22
Q

what DMARD is used in combination with methotrexate in early disease

A

sulphasalzine

23
Q

what DMARDs are teratogenic

A

methotrexate and luflunomide

24
Q

what are some biologic targets in inflam arthritis

A

TNFa, B cells, interleukins

25
Q

what diseases are anti-TNFa used in

A

RA, psoriatic arthritis, AnkSpondy

26
Q

how are biologics given

A

injections

27
Q

give 2 examples of anti-TNFa drugs

A

etanercept, infliximab, -mab

28
Q

what are side effects/ contraindications of anti-TNF

A

TB, contraindicated in pulm fibrosis and HF

29
Q

what is more effective DMARDs or biologics

A

biologics more effective but strict criteria, best on combination

30
Q

what 3 drugs are given in acute gout

A

NSAIDs, steroids, colchicine

31
Q

what is a common side effect of colchicine

A

diarrhoea

32
Q

name 2 xanthine oxidase inhibitors used in gout prophylaxis

A

allopurinol, febuxostat

33
Q

when do prophylactic gout drugs need to be stared and with what drugs

A

2-4 weeks after acute gout, with NSAIDs

34
Q

what can allopurinol trigger and why

A

rapid reduction of uric acid to cause gout

35
Q

what is a side effect and drug reaction of allopurinol

A

vasculitis - azathioprine

36
Q

what are contraindications to febuxostat

A

renal impairment, ischaemic heart disease

37
Q

what are steroids side effects

A

weight gain, muscle wasting/ skin atrophy, osteoporosis, diabetes, hypertension, immunosuppression

My2 MSK (29 decks)

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