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Flashcards in Pharmacology of Arthritis Deck (28):
1

Pure analgesics such as paracetamol, have what properties?

Analgesic
Little anti-inflam activity
Anti-pyretic

2

What is co-codamol made with?

Codeine and paracetamol

3

What type of drug is amitryptiline?

Anti-depressant

4

What type of drug is Gabapentin?

Anti-convulsant

5

Give some side effects of opiod drugs?

dizzy
Nausea
vomiting
sleepy
confused

6

Give some side effects of long term opiod drug use?

constipation
itching
weight gain
lack of sex drive
reduced fertility
erectile dysfunction
irregular periods
decreased ability to fight infection

7

What is the effect of NSAID on inflammation?

Symptomatic relief of inflammation but does not decrease inflammation to where the disease actually stops

8

Give some examples of NSAIDs?

Naproxen
Ibruprofen
Diclofenac

9

List some side effects of NSAIDs.

dyspepsia and peptic ulcers
oesophagitis
gastritis
small/ large bowel ulceration
rash
wheeze (avoid in asthmatics)
fluid retention

10

What is DMARDs onset of action like?

Slow acting - weeks to months

11

What should be given over the lag phase of DMARDs?

Steroids

12

Do DMARDs show any analgesic effect?

No

13

How quickly should patients who present with RA be started on DMARDs?

Aim for within 3 months of symptom onset - patients do not present at the onset of symptoms

14

What should be given prior to starting DMARDs?

Vaccinations - flu & pneumococcal

15

Are DMARDs normally started individually?

No, normally methotrexate an sulphasalazine are started together

16

What does Methotrexate work as in the body?

folate antagonist

17

How is MTX given?

Oral
Subcutaneously if GI SE of oral MTX

18

What conditions is MTX used in?

RA
Psoriatic arthritis
CTD
Vasculitis

19

Give some side effects of MTX.

Leucopenia/ thrombocytopenia
Hepatitis/ cirrhosis
rash and mouth ulcers
pneumonitis

20

Is MTX teratogenic?

Yes, should be stopped in males and females at least 3 months before conception

21

Are there any contraindications to giving MTX?

Pre-existing pulmonary fibrosis

22

What is sulphasalazine made of?

Azo-ester of sulphapyridine and 5-aminosalicylic acid

23

What is the main worrying SE of sulphasalazine?

Neutropenia

24

When is hydroxychloroquin used?

CTD
SLE
Sjogren's syndrome
RA

25

What should HCQ be avoided in?

psoriatic arthritis

26

Why should azathioprine never be used with allopurinol?

Irreversible agranulocytosis occurs

27

In the UK, currently what is Anti-TNF licensed for?

RA
Psoriatic arthritis
ankylosing spondylitis

28

Are Anti-TNF drugs, more effective when used in combination with DMARDs or alone?

In combination with DMARDs