Which drugs provide symptom relief in inflammatory arthritis?
Paracetamol
NSAIDs
Opiates
Atypical analgesics
Which two groups of drugs are classed as disease-modifying drugs in rheumatology?
DMARDs
Biologics
Give examples of DMARDS
Methotrexate
Sulphasalazine
Hydroxychloroquine
Give examples of biologics
Anti-TNF
Ritixumab
List some analgesic drugs
Co-codamol
Tramadol
Amitryptilline
Gabapentin
List some NSAIDs
Ibuprofen
Diclofenac
Celecoxib
Naproxen
DMARDs are fast-acting drugs. True/False?
False
Slow to act - weeks to months
What effect do DMARDs have?
Anti-inflammatory but NO DIRECT ANALGESIA
Reduce rate of joint damage
What is the “window of opportunity” for DMARDs and arthritic patients?
Start DMARD within 3 months of symptom onset
What are the 2 DMARDs of choice?
Methotrexate
Sulfasalazine
What is the supposed mode of action of methotrexate?
Folate antagonist
Methotrexate is teratogenic. What implication does this have?
Male and females must stop drug 3 months prior to conception of child
Does hydroxychloroquine have effect on joint damage?
No
What is the main anti-TNF drug?
Infliximab
Are anti-TNF drugs more effective than DMARDs?
Yes
What is the strict criteria for allowing use of anti-TNF?
Unresponsive to DMARDs
Scoring: count tender joints + rate activity of disease + check CRP
People on anti-TNF drugs must show response to allow continuation of the drug. True/False?
True
What drugs are given in acute gout?
Colchicine (diarrhoea, vomiting)
NSAID
Steroid
What is the main drug for gout treatment given following an acute attack?
Allopurinol
Which enzyme does allopurinol inhibit?
Xanthine oxidase to prevent uric acid production
Allopurinol should be prescribed in acute gout attack. True/False?
False
Can flareup acute gout
What is the alternative to allopurinol?
Febuxostat
