3014034
Description
Flashcards by esther.westwood, updated more than 1 year ago
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Created by esther.westwood
almost 9 years ago
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| Question | Answer |
| What are the general management aims of rheumatological diseases? | Patient education Pain relief Optimise function +/- process modifications +/- 'cure' |
| What are the broad categories of pain relief drugs? | Simple analgesics (i.e. paracetamol) Stronger/combination analgesics Oral NSAIDs Topical (NSAIDs, capsaicin, rubefacients) Local injection (corticosteroid, radiocolloids, hyaluronic acid) Antidepressants (low dose amitriptyline) |
| How long do the DMARDs take to take effect? | Weeks/months |
| How do the DMARDs work? | They have no direct symptomatic benefit But they may reduce the acute phase response, inflammatory clinical signs and may modify the outcome by reducing tissue damage |
| What are the indications for DMARDs? | Persistent synovitis Extra-articular disease Drug-sparing effects (NSAIDs, corticosteroids) |
| What are the first line DMARDs? | Methotrexate Hydroxychloroquine |
| What are some other DMARDs? | Salazopyrin Gold Penicillamine Azathioprine Cyclophosphamide Cyclosporin Biological agents - anti-TNF |
| What are the benefits of oral corticosteroid therapy in RA? | Works quickly to reduce inflammation Low doses may reduce early joint damage of RA |
| What are some disadvantages of oral corticosteroid therapy in RA? | High incidence of side effects (e.g. osteoporosis, muscle atrophy, altered fat distribution, skin bruising, hypertension, cataract, enhanced GI gut toxicity from NSAIDs, iatrogenic Addison's) |
| What is the place of oral corticosteroid therapy in RA? | The cornerstone of early treatment Often used for the first few months to gain short-term control of inflammation while awaiting benefit from slow-acting drugs |
| What are the 2 'curable' major rheumatic diseases? How are they cured? | Septic arthritis/osteomyelitis - parenteral antibiotics Gout - hypouricaemic agents to hold the serum uric acid in the lower half of the normal range |
| What percentage of gout patients are treated correctly and therefore cured? | 10% |
| What surgical options are there for rheumatic disease? | Joint surgery for persistent severe pain/disability (joint replacement is the only cure for OA) Reconstructive surgery (for e.g. ruptured tendons) Removal of inflamed synovium to prevent damage |
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