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pharmacology y1 > summary of drugs used in MSK conditions > Flashcards

summary of drugs used in MSK conditions Flashcards

1
Q

what drugs are used for acute flare ups of gout?

A

NSAIDs and colchicine

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2
Q

what drug is used for chronic prevention of gout

A

allopurinol

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3
Q

dose of NSAIDs for gout

A

usually high dose for a few weeks
ibuprofen 400-800mg
naproxen - 750mg stat then 250mg tds for 7 days

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4
Q

efficacy of NSAIDs for gout

A

moderate to good

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5
Q

safety of NSAIDs for gout

A

short term ok
can cause GI bleed, renal or heart failure if high dose for long term taken

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6
Q

suitability of NSAIDs for gout

A

inexpensive
easy to take
contraindications with GI or cardiac disease

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7
Q

efficacy of colchicine for gout

A

very good

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8
Q

safety of colchicine for gout

A

nausea and diarrhoea very common
bone marrow suppression and renal failure over longer term

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9
Q

suitability of colchicine for gout

A

good option if cannot taken NSAIDs
similar efficacy to naproxen but 2x greater risk of diarrhoea

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10
Q

dose of colchicine for gout

A

0.5 mg ds for 3-4 days
stop if D/V
should not exceed 6mg in one course

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11
Q

mechanism of colchicine

A

depolarisation of microtubules to inhibit granulocyte migration and lymphocyte migration and division
tubulin disruptor

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12
Q

which corticosteroids are used for gout

A

local injection if only a single joint is affected
systemic (tablets) oral prednisolone if severe

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13
Q

suitability of corticosteroids for gout

A

great for those who cannot have NSAIDs or colchicine
usually elderly with comorbidities

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14
Q

mechanism of allopurinol

A

xanthine oxidase inhibitor

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15
Q

efficacy of allopurinol for gout

A

very good

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16
Q

interactions of allopurinol

A

purine analogues, theophylline

17
Q

dosage of allopurinol for gout

A

100mg daily unitially
check uric acid levels after a few weeks
up-titrate to desired level

18
Q

mechanism of febuxostat

A

non-purine xanthine oxidase inhibitor

19
Q

how do bisphosphonates work for osteoporosis

A

analogues of pyrophosphate
attach to bone crystals and inhibit osteoclast breakdown of bone

20
Q

safety of bisphosphonates

A

GI upset is main problem

21
Q

how does denosumab work for osteoporosis

A

monoclonal antibody - RANK ligand inhibitor
reduces osteoclast activation, differentiation, and survival

22
Q

suitability of denosumab for osteoporosis

A

recommended by NICE if patient cannot have bisphosphonate
only needs 1 subcut injection every 6 months

23
Q

other drugs for osteoporosis

A

raloxifene - oestrogen like molecule
teriparatide - recombinant PTH, intermittent use activates osteoblasts to deposit bone

24
Q

older DMARDs for RA

A

sulfasalazine
methotrexate
leflunomide
gold

25
Q

how does methotrexate work

A

anti IL-2 agent
folic acid antagonist

26
Q

side effects of methotrexate

A

immunosuppression
liver toxicity
lung damage

27
Q

mechanism of infliximab

A

human mouse monoclonal antibody
TNF alpha blocking agent

28
Q

mechanism of etanercept

A

recombinant DNA human TNF alpha receptor p75 fusion protein
binds to TNF to stop its activity

29
Q

mechanism of adalimubab

A

human monoclonal antibdoy
TNF alpha blocking agent

30
Q

main drugs for ankylosing spondylitis

A

adalimubab or etanercept

31
Q

main drugs for psoriatic arthritis

A

adalimubab
etanercept
infliximab

32
Q

main drug for juvenile idiopathic arthiritis

A

etanercept

33
Q

whihc steroids are given via local injection in rheumatology

A

triamcinolone
methylprednisolone

34
Q

whicih steroid is taken orally in rheumatology

A

prednisolone

35
Q

which steroids are taken via IV in rheumatology

A

hydrocortisone
methylprednisolone

36
Q

side effects of too many steroids

A

Cushings disease
- osteoporosis
- obeisty
- moon face
- hypertension
- hy[erglycaemia
- striae
- hypokalaemia-
- myopathy
- psychiatric symptoms

37
Q

side effects of too little steroids

A

addisons disease
- nausea/vomiting
- headache
- joint pain
- fever
- hypoglycaemia
- hypotension
- hyperkalaemia

pharmacology y1 (10 decks)

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