MSK Drugs (Not including anti-inflammatories) Flashcards Preview

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Flashcards in MSK Drugs (Not including anti-inflammatories) Deck (25)
1

Name the bisphosphonates

alendronate, other "-dronates"

2

Mechanism of bisphosphonates

pyrophosphate analogs
bind hydroxyapatite in bone, inhibiting osteoclast activity

3

Use of bisphosphonates

osteoporosis
hypercalcemia
Paget disease of bone

4

Toxicity of bisphosphonates

corrosive esophagitis (pts advised to take with water and remain upright for 30 minutes)
osteonecrosis of jaw

5

Mechanism of teriparatide

recombinant PTH analog given subcutaneously daily --> increased osteoblastic activity

6

Use of teriparatide

osteoporosis
causes increased bone growth compared to antiresportive therapies (bisphosphonates)

7

Toxicity of teriparatide

transient hypercalcemia
may increase risk of osteosarcoma

8

Name the acute gout drugs

NSAIDs (naproxen, indomethacin)
Glucocorticoids (oral and intra-articular)
Colchicine

9

Mechanism of colchicine

binds and stabilizes tubulin to inhibit MT polymerization, impairing neutrophil chemotaxis and degranulation

10

Use of colchicine

acute and prophylactic value for gout

11

Toxicity of colchicine

GI side effects

12

Why not give salicylates in gout?

all doses but the HIGHEST dose depress uric acid clearance
even highest doses have only minor uricosuric activity

13

Name the chronic gout drugs (preventative

allopurinol, febuxostat, pegloticase, probenecid

14

Mechanism of allopurinol

inhibits xanthine oxidase after being converted to alloxanthine
decreases conversion of xanthine to uric acid

15

Use of allopurinol

gout prevention/chronic tx

16

Use of allopurinol in leukemia and lymphoma

to prevent tumor lysis-associated urate nephropathy

17

Mechanism of febuxostat

inhibits xanthine oxidase

18

Name the two antimetabolite drugs that need to be careful of dosing when using allopurinol/febuxostat

azathioprine and 6-mercaptopurine (6-MP)
because normally metabolized by xanthine oxidase

19

Mechanism of pegloticase

recombinant uricase that catalyzes metabolism of uric acid to allantoin (more water soluble product)

20

Mechanism of probenecid

inhibits reabsorption of uric acid in proximal convoluted tubule (also inhibits secretion of penicillin)
can precipitate uric acid calculi
NEED TO HAVE PRISTINE KIDNEYS TO USE

21

What do need to check before starting TNF-alpha inhibitor?

TB status because using TNF-alpha inhibitors could predispose to infection by reactivating latent TB

TNF-alpha is important in granuloma formation and stabilization

22

Mechanism of etanercept

fusion protein (receptor for TNF-alpha and IgG1 Fc receptor), produced by recombinant DNA

23

Use of etanercept

RA
psoriasis
ankylosing spondylitis

24

Mechanism of infliximab/adalimumab

anti-TNF-alpha monoclonal antibodies

25

Use of infliximab/adalimumab

IBD
RA
ankylosing spondylitis
psoriasis