Drugs in the Management of Musculoskeletal Disorders Flashcards Preview

Medicine, Year 2, Block 12 (Neurological, Neuromuscular, and MSK Diseases) > Drugs in the Management of Musculoskeletal Disorders > Flashcards

Flashcards in Drugs in the Management of Musculoskeletal Disorders Deck (23):
1

What is an Osteoblast and Osteoclast?

Osteoblast: Cells which make bone

Osteoclast: Cells which breakdown bone

2

Describe the structure of Osteoblasts and Osteoclasts

Osteoclasts are multinucleated with up to 200 nuclei, and Osteoblasts have one nuclei

3

How do Osteoclasts break down bone?

Bind to bone surface via integrins, forming a "ceiling zone". They then breakdown bone and release calcium

4

What are three treatments doctors can offer patients to alleviate Osteoporosis?

Appropriate diet & exercise
Medications
Replacement

5

Describe the mechanism of action of Bisphosphonates

Bisphosphonates are enzyme resistant analogues of pyrophosphate, which normally inhibits mineralisation of bone

They inhibit osteoclast activity, inhibit osteoclast progenitor development and increase osteoclast apoptosis

6

Give 2 examples of drugs which are Bisphosphonates

Alenodronate
Etidronate

7

What are some side effects of Bisphosphonate therapy?

Osteonecrosis of the Jaw

8

Give 2 examples of drugs which is a SERM (Selective Estrogen Receptor Modulator)

Raloxifene
Tamoxifen

9

What is an adverse side effect of the SERM drug, Raloxifine?

Increased risk of blood clots

10

What is the role of Calcitonin when Ca2+ levels are high in plasma?

The thyroid gland releases Calcitonin, which stimulates Osteoblast activity (bone deposition) and reduces plasma calcium

11

What is the role of PTH when Ca2+ levels are low in plasma?

The parathyroid gland releases PTH, which stimulates Osteoclast activity (bone resorption) which releases Ca2+ from bone into the blood

12

What 4 classes of drugs can be used to target Rheumatoid Arthritis?

NSAIDs
Steroids
DMARDs
Antibody therapy

13

Give 4 examples of non-selective COX inhibitor NSAIDs

Aspirin
Diclofenac
Ibuprofen
Naproxen

14

Give 1 example of a COX-2 selective inhibitor NSAID used to treat Rheumatoid Arthritis

Celecoxib

(coxib suffix)

15

What is the mode of action of Steroid drugs?

Nuclear receptor, which reduce expression of inflammatory cytokines and increased expression of anti-inflammatory cytokines

16

What are two adverse effects of Steroid use?

Adrenal insufficiency
Cushing's disease

17

Give 5 examples of DMARD drugs

Gold
MTX
Sulfasalazine (SSZ)
Azathioprine
Ciclosporin

18

What conditions can Sulfasalazine be used to treat?

Rheumatoid Arthritis
Crohn's Disease
Ulcerative Colitis

19

Give 1 example of an antibody used to treat Rheumatoid Arthritis.

Infliximab

20

What does Infliximab target?

TNF-alpha

21

What does Adalimumab (Humira) target?

TNF-alpha

22

What are 2 agents of last resort when all Rheumatoid Arthritis drugs have failed?

Cyclophosphamide, Cyclosporin (global immunosupressants)

23

Which drug used to treat Rheumatoid Arthritis CANNOT be consumed with Grapefruit juice?

Cyclosporin