Osteoarthritis Flashcards Preview

Pharmacology > Osteoarthritis > Flashcards

Flashcards in Osteoarthritis Deck (21):
1

What do chondrocytes produce

proteoglycans and collagen

2

Proteoglycans

provides resiliency, form aggregates w/ hyaluronic acid

3

Collagen fiber function

provides strength and anchor the cartilage to the bone surface

4

Chondrocyte function

to maintain the integrity of the matrix in healthy cartilage

5

Osteoarthritis most commonly affects

DIP, hips, knees

6

Osteoarthritis risk factors

age, congenital/ anatomical defects, female, major joint trauma, obesity, muscle weakness, repetitive stress, genetics

7

Osteoarthritis presentation

joint pain, worse w/ activity, pain at rest, morning joint stiffness, crepitus, inflammation, asymmetric involvement, muscle atrophy, falls

8

Heberden's nodes

bony spurs on distal joints in finger

9

Brouchard's nodes

bony spurs cover cartilage on knuckles

10

Osteoarthritis non pharm treatment

education, rest, exercise, PT/OT, wt loss, heat, ice

11

Step 1 treatment

APAP, use regularly, monitor LFTs, or capsaicin cream, glucosamine/chondroitin, other OTC

12

Step 2 treatment

NSAIDs, should use lower recommended dose, best results with regular dose, caution in gi bleeds, ulcers, antiacoagulants, glucocorticoids, CHF, renal, HTN

13

If there is a concern for a GI bleed

consider Celecoxib, NSAID +GI prophylaxis

14

NSAIDs with lower/ higher risk of bleeds

ibuprofen, diclofenac, nabumetone, higher piroxicam, ketorolac

15

If concerned for CV complications use

naproxen

16

NSAIDs monitor for

renal dysfunction, bleeding

17

Step 3 treatment

Hyaluronate injections, intra-articular steroid injections, opioid analgesics/tramadol

18

Hyaluronate injections

replaces fluids, weekly injections x3-5 weeks, lasts 8-12 weeks, $$$

19

Intra-articular steroid injections

Methylprednisolone (Depo medrol), injected 3-4 months or longer, risk of infection (fungal), more frequent

20

Opioid analgesic/tramadol

added for persistent breakthrough pain, used at bedtime to help sleep, monitor for sedation, constipation, resp depression, watch APAP

21

Step 4 treatment

Joint replacement therapy, consider for severe pain at rest, newer products/ joints last longer, timing is important