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21 Cards in this Set

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  • Back
How do you Tx osteoarthritis?
Tylenol 4gm/daily

If on coumadin: 2gm/daily
What do you monitor with high doses of Tylenol?
INR
Which agents are effective in moderate to severe pain for treating osteoarthritis?
NSAIDS

e.g. Naproxen, Diclofenac, ASA, Ibuprofen
What is the MOA of Tramadol (Ultram)
Its an opioid like structure. Binds to mule receptors in the CNS causing inhibition of ascending pain pathways
What is the BEERS list?
BEERS list – tells us what meds are not suggested to be used on the elderly
This drug is on the BEERS list and its not recommended because it can cause hepatotoxicity and seizures in the elderly
Propyxyphene(Darvocet)
Name two intra-articular glucocorticoids
Triamcinolone
Methylprednisilone

Once a month injection: good for knee pain
Name some topical agents used for osteoarthritis
Capsaicin (Chilli pepper)
Aspirin cream
Ibuprofen
Methylsalycilate

Used as adjunct therapy to first line drugs
Most common Intrarticular Hyaluronic treatment and dose
Synvisc 25mg Intra-Articular, one shot per week for 3 weeks, to be re-done every 6 months to a year(MC)
What is the diagnostic criteria for rheumatoic arthritis?
AM stiffness more than 1 hr
Arthritis in 3 or more joints
Symmetric arthritis
Positive RF (rhematoid factor)
Can differentiate between osteo and RA
What is the Tx for RA?
NSAIDS
DMARDS (Disease modifying anti rhematoid drug)
Start with DMARDS initially – they help prevent disease progression and joint deformity
What is the first line Tx for RA?
Aspirin is gold standard
5 Grams per day (Max)
What is Misoprostol (Cytotec) used for?
Prevention of NSAID Ulcers

Give at the same time as the NSAID.
Name some DMARDs
1st line agents:
Methotrexate
Gold
Hydroxychloroquine

2nd line agents:
Sulfasalazine
Penicillamine
Azathiorprine(Imuran)
What is Methotrexate and what are its contra-indications
Anti – metabolite
CI – Pregnancy, chronic liver disease
What are the adverse effects of methotrexate
GI
Anemia
LFTS
What are the contra-indications of Gold
Renal Disease
Blood dyscrasias (Lupus etc…)
What are the adverse effects of Gold
Metallic taste, Derm
Which DMARD causes night blindness and GI effects
Hydroxycholoroquine (Plaquenil)
When do you use corticosteroids?
As bridging therapy – to assist in acute attack – give steroid on top of NSAID
What are the adverse effects of corticosteroids?
gastritis
osteoporosis
cataracts
hyperglycemia
infections