Drugs for Osteoarthritis, Joint Disease - Fitz Flashcards Preview

MSK 2 > Drugs for Osteoarthritis, Joint Disease - Fitz > Flashcards

Flashcards in Drugs for Osteoarthritis, Joint Disease - Fitz Deck (13)
1

Easy drug for analgesia (PAIN CONTROL) in osteoarthritis?

Powerful ones?

Acetaminophen

Tramadol (narcotic)
Codeine (narcotic)

2

Oral drugs for ANTI-INFLAMMATION in osteoarthritis?

IF NSAIDs FAIL, drug for anti-inflammation of joint?

MoA?

NSAIDs, Coxib

Triamcinolone (steroid injection)

Represses COX-2 transcription and translation, thus can't be turned on

3

Patient presents to ER w/ emesis, jaundice, altered mental status. Recently been depressed/despondent. Has severe osteoarthritis.

What is found in blood?

What does this molecule do?

Acetaminophen OD (hepatic centrolobular necrosis)

Elevated NAPQI (metabolite)

Binds glutathione, uses it up, then does damage in liver

4

How long does it take for acetaminophen toxicity to see full toxicity/toxic effects?

Will first see symptoms when?

3 days

Within the 1st day

5

Treatment for acetaminophen toxicity

Does what?

N-acetylcysteine

Replenishes glutathione

6

Mild OA, minimal inflammation...drug?

Takes it for 2 weeks, only gets worse...drug?

Acetaminophen

NSAID

7

Giving an NSAID for OA. Be cautious of what?

- GI risk profile
- CV risk profile
- Hypersensitivity (sulfa)

8

Best NSAIDs to give for short term OA relief (4)

Ibuprofen
Naproxen
Diclofenac
Celecoxib

9

Best NSAIDs to give for longer term OA relief - 1x per day (2)

Piroxicam
Nabumetone

10

Can multiple NSAIDs be taken at the same time? Why?

NO - will compete for absorption and increase risk for GI bleeding/ulcer

11

Way to avoid GI bleeding/ulcer risk when taking NSAID?

Taking w/ Misoprostol (PGE1) or PPI (Omeprazole)

12

Narcotics for pain

MoA?

Toxicity?

Cure?

Morphine, Codeine, Tramadol

Mu-receptor agonists (analgesia)

Pupil constriction, respiratory depression

Naloxone/Naltrexone

13

Patient presents w/ pupillary constriction and respiratory depression. Current med history of severe osteoarthritis. Dx?

Treatment?

Patient returns 24 hours later. Why? What should you have done?

Narcotic overdose

Naloxone/Naltrexone

Acetaminophen overdose (combo drug w/ narcotic)

Given N-acetylcysteine when first presented