Osteoarthritis Flashcards Preview

Pharmacology > Osteoarthritis > Flashcards

Flashcards in Osteoarthritis Deck (21)
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1
Q

What do chondrocytes produce

A

proteoglycans and collagen

2
Q

Proteoglycans

A

provides resiliency, form aggregates w/ hyaluronic acid

3
Q

Collagen fiber function

A

provides strength and anchor the cartilage to the bone surface

4
Q

Chondrocyte function

A

to maintain the integrity of the matrix in healthy cartilage

5
Q

Osteoarthritis most commonly affects

A

DIP, hips, knees

6
Q

Osteoarthritis risk factors

A

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

7
Q

Osteoarthritis presentation

A

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

8
Q

Heberden’s nodes

A

bony spurs on distal joints in finger

9
Q

Brouchard’s nodes

A

bony spurs cover cartilage on knuckles

10
Q

Osteoarthritis non pharm treatment

A

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

11
Q

Step 1 treatment

A

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

12
Q

Step 2 treatment

A

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

13
Q

If there is a concern for a GI bleed

A

consider Celecoxib, NSAID +GI prophylaxis

14
Q

NSAIDs with lower/ higher risk of bleeds

A

ibuprofen, diclofenac, nabumetone, higher piroxicam, ketorolac

15
Q

If concerned for CV complications use

A

naproxen

16
Q

NSAIDs monitor for

A

renal dysfunction, bleeding

17
Q

Step 3 treatment

A

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

18
Q

Hyaluronate injections

A

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

19
Q

Intra-articular steroid injections

A

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

20
Q

Opioid analgesic/tramadol

A

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

21
Q

Step 4 treatment

A

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