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21 Cards in this Set
- Front
- Back
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How do you Tx osteoarthritis?
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Tylenol 4gm/daily
If on coumadin: 2gm/daily |
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What do you monitor with high doses of Tylenol?
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INR
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Which agents are effective in moderate to severe pain for treating osteoarthritis?
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NSAIDS
e.g. Naproxen, Diclofenac, ASA, Ibuprofen |
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What is the MOA of Tramadol (Ultram)
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Its an opioid like structure. Binds to mule receptors in the CNS causing inhibition of ascending pain pathways
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What is the BEERS list?
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BEERS list – tells us what meds are not suggested to be used on the elderly
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This drug is on the BEERS list and its not recommended because it can cause hepatotoxicity and seizures in the elderly
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Propyxyphene(Darvocet)
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Name two intra-articular glucocorticoids
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Triamcinolone
Methylprednisilone Once a month injection: good for knee pain |
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Name some topical agents used for osteoarthritis
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Capsaicin (Chilli pepper)
Aspirin cream Ibuprofen Methylsalycilate Used as adjunct therapy to first line drugs |
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Most common Intrarticular Hyaluronic treatment and dose
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Synvisc 25mg Intra-Articular, one shot per week for 3 weeks, to be re-done every 6 months to a year(MC)
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What is the diagnostic criteria for rheumatoic arthritis?
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AM stiffness more than 1 hr
Arthritis in 3 or more joints Symmetric arthritis Positive RF (rhematoid factor) Can differentiate between osteo and RA |
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What is the Tx for RA?
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NSAIDS
DMARDS (Disease modifying anti rhematoid drug) Start with DMARDS initially – they help prevent disease progression and joint deformity |
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What is the first line Tx for RA?
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Aspirin is gold standard
5 Grams per day (Max) |
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What is Misoprostol (Cytotec) used for?
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Prevention of NSAID Ulcers
Give at the same time as the NSAID. |
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Name some DMARDs
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1st line agents:
Methotrexate Gold Hydroxychloroquine 2nd line agents: Sulfasalazine Penicillamine Azathiorprine(Imuran) |
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What is Methotrexate and what are its contra-indications
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Anti – metabolite
CI – Pregnancy, chronic liver disease |
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What are the adverse effects of methotrexate
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GI
Anemia LFTS |
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What are the contra-indications of Gold
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Renal Disease
Blood dyscrasias (Lupus etc…) |
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What are the adverse effects of Gold
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Metallic taste, Derm
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Which DMARD causes night blindness and GI effects
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Hydroxycholoroquine (Plaquenil)
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When do you use corticosteroids?
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As bridging therapy – to assist in acute attack – give steroid on top of NSAID
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What are the adverse effects of corticosteroids?
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gastritis
osteoporosis cataracts hyperglycemia infections |
