PHRM 825: OA Flashcards Preview

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Flashcards in PHRM 825: OA Deck (13)
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1
Q

What is the pathogenesis of OA?

A

Degenerative changes that occur in cartilage and the associated bone

2
Q

What is OA characterized by?

A

Increased destruction and subsequent proliferation of cartilage and bone; regenerated articular surfaces do not possess the same qualities and architecture as the original joint

3
Q

In what population is OA more common?

A
  • Older (85% of patients >75 years old)

- Female

4
Q

What joints are most commonly affected by OA?

A
  • Distal interphalangeal joint (DIP)
  • Hips
  • Knees
5
Q

What are risk factors for OA?

A
  • Increasing age
  • Obesity
  • Congenital/anatomical defects
  • Muscle weakness
  • Female gender
  • Repetitive stress
  • Major joint trauma
  • Heredity
6
Q

How does OA present?

A
  • Pain in joints (worse with activity)
  • AM stiffness is BRIEF
  • Crepitus
  • Asymmetric involvement
  • Muscle atrophy
  • Herberden’s nodes
  • Bouchard’s nodes
  • Instability of weight bearing joints
7
Q

Goals of treatment for OA

A
  • Relief of pain and discomfort
  • Maintain function and strength of joint
  • Prevent deformities and progressive changes
  • Can NOT reverse damage
8
Q

What is the step-wise treatment for OA?

A
Step 1: Non-pharmacologic
Step 2: Acetaminophen
Step 3: NSAIDs
Step 4: Opioid analgesics
Step 5: Surgery
9
Q

What are non-pharmacological treatment options for OA?

A
  • Psychological support
  • Education
  • Rest
  • Physical activity/exercise
  • Heat/ice
  • Physical therapy
  • Occupational therapy
  • Weight loss
10
Q

What patients are at an increased risk of nephrotoxicity with NSAIDs?

A
  • CHF
  • HTN
  • Renal dysfunction
  • Dehydration
11
Q

What is a potential benefit of COX-2 inhibitors?

A

-Lower incidence of severe GI bleeding

12
Q

What are potential risks associated with COX-2 inhibitors?

A
  • Increased risk of CV disease
  • Increased costs
  • Same impact on renal functions and INR
13
Q

How long do new joints last after surgery?

A

10-15 years