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Rheumatoid Arthritis:
An autoimmune, inflammatory disorder
Joints are destroyed by autoimmune process
Immune system attacks synovial tissue
Goals of Treatment for Rheumatoid Arthritis:
1. Relieve symptoms
2. Maintain joint function
3. Minimize systemic involvement
4. Delay disease progression
Treatment Types for Rheumatoid Arthritis:
Non-drug Measures:
-Physical therapy, exercise, surgery
Drug Therapy:
-Nonsteroidal anti-inflammatory drugs
-Glucocorticoids
-Disease-modifying antirheumatic drugs
NSAIDS (Non-steroidal anti-inflammatory drugs)
for Rheumatoid Arthritis
rapid relief of symtpoms
does not prevent joint damage
do not slow disease progression
safer then others
DMARDs (Disease-modifying antirheumatic drugs)
for Rheumatoid Arthritis:
Provide rapid relief of symptoms
Slows the progression
Close monitoring required to prevent toxicity
Short courses of drugs rather long terms
DMARDs are subdivided:
Nonbiologic- Small molecules/traditional chemical techniques
Biologic- Large molecules/ recombinant DNA technology
-very expensive
What do DMARDs do for Rheumatoid Arthritis:
Decrease inflammation
Immunosuppressant
Risk of serious infections!
Glucocorticoids for Rheumatoid Arthritis:
Powerful anti-inflammatory
May slow progression of RA
Long term use can cause toxicity
Osteoporosis
Gastric Ulceration
Adrenal suppression
Treatment for Rheumatoid Arthritis:
DMARDs within three months
NSAIDs are needed until DMARDs take effect
Glucocorticoids- short courses if needed until DMARDs take effect
**If joint destruction continues during treatment
:
a second DMARD may be added or substituted
Gout:
Recurrent inflammatory disorder (severe pain)
Hyperuricemia
Sodium urate crystalizes in synovial space
-this sets off inflammatory response
Treatment for Gout:
NSAIDs most common
-Glucocorticoids are acceptable
Drugs for Hyperuricemia
:
-Drugs that decrease production
-Drugs that increase secretion
Hyperuricemia=
Uric Acid- above 7 in men, above 6 in women
Drugs For Hyperuricemia:
Used on patients with frequent attacks (3 or more/yr)
Allopurinol and Febuxostat
Probenecid and Sulfinpyrazone
Allopurinol and Febuxostat:
Decrease production of uric acid
Probenecid and Sulfinpyrazone:
Increase excretion of uric acid
Goal of both drugs:
(Allopurinol and Febuxostat vs. Probenecid and Sulfinpyrazone)
To obtain uric acid level of 7 or below ion men and 6 or below in women
What regulates Calcium
Parathyroid hormone
Vitamin D
Calcitonin
Bisphosphonates:
Fosamax
Actonel
Boniva
Used to treat Osteoporosis, Glucocorticoid-induced osteo and Paget's disease
They suppress/stop resorption of bone
Not absorbed well orally (Don't take with FOOD!!)
Raloxifene-Evista
Selective estrogen receptor modulators (SERMs)
Exerts estrogenic effects
Preserves BMD (Bone Mineral Density)
Lowers cholesterhol
Helps to prevent breast and endometrium cancers (used as a prophylactic drug)
Teriparatide- Forteo
A form of parathyroid hormone
Only drug for osteoporosis that
INCREASES BONE FORMATION
All others decrease bone resorption
Author
emilybabs
ID
40791
Card Set
Pharmacology
Description
Bones and Joints
Updated
2010-10-09T03:54:37Z
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