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Pharmacy > Musculoskeletal > Flashcards

Musculoskeletal Flashcards

1
Q

what drugs should be given first line to patients with newly diagnosed rheumatoid arthritis?

A

DMARD (methotrexate/ leflunomide/ sulfasalazine)

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2
Q

which two antimalarials are used in rheumatic conditions?

A

chloroquine and hydroxychloroquine

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3
Q

what is the MHRA alert for hydroxychloroquine and chloroquine?

A

risk of cardiovascular events when used with macrolides

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4
Q

how should methotrexate be given?

A

once weekly, on the same day each week

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5
Q

what medication should be given alongside methotrexate?

A

folic acid

5mg once weekly, day after MTX dose

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6
Q

what are the side effects on methotrexate?

A

blood dyscrasias
hepatotoxicity
nephrotoxicity
pulmonary toxicity
GI toxicity

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7
Q

what is the reversal agent of methotrexate?

A

folinic acid (calcium folinate)

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8
Q

how do you treat an acute attack of gout?

A

1st NSAIDs (diclofenac, naproxen)
2nd colchicine

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9
Q

what is the counselling advice for colchicine?

A

do not repeat course in 3 days
max dose 500mcg 2-4 times a day
max 6mg per course

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10
Q

how do you manage gout prophylactically?

A

1st allopurinol
2nd febuxostat

started after inflammation of acute attack settled, start 1-2 weeks after acute

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11
Q

what is the side effect of allopurinol requiring discontinuation of treatment?

A

rash

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12
Q

what is the MHRA alert for febuxostat?

A

-hypersensitivity
-risk of cardiovascular death

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13
Q

what treatment is used for nocturnal leg cramps?

A

quinine sulfate

trial for 4 weeks

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14
Q

what is the MHRA alert for quinine?

A

QT prolongation

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15
Q

name the selective cox-2 inhibitors?

A

celecoxib, parecoxib, etorcoxib

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16
Q

what are NSAIDs cautioned in?

A

heart failure, renal and liver impairment, hypertension

17
Q

which of the NSAIDS have the lowest risk of cardiovascular events?

A

naproxen and low dose (<1.2g) ibuprofen

18
Q

which of the NSAIDs have the highest risk of cardiovascular events?

A

cox-2 inhibitors (coxib)
high dose ibuprofen (2.4g)
diclofenac

19
Q

which of the NSAIDs have the lowest risk of GI effects?

A

Ibuprofen

cox-2 inhibitors have the lowest risk

20
Q

which of the NSAIDS have the highest risk of GI effects?

A

piroxicam, ketoprofen

21
Q

which of the NSAIDs have an intermediate risk of GI effects?

A

indometacin, diclofenac, naproxen

22
Q

can NSAIDs be use during pregnancy?

A

should be avoided, especially in the third trimester

(delays labour, causes pulmonary hypertension in neonate, premature closure of foetal ductus arteriosus)

Pharmacy (20 decks)

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