aspirin
Potent inhibitor of Both COX -1 and 2
aspirin is effective for the treatment of? (5)
mild to mod pain/inflammation, fever in adults, help prevent heart attacks, TIAs, and strokes
Other Common NSAIDs (5)
celebrex, voltaren (topical), toradol, meloxicam/mobic, naproxen/naprosyn
Other considerations with Glucocorticoids injections (2)
massive increase in blood sugar (caution with DM) and increased cortisol with long term use
glucocorticoids (4)
decrease joint inflammation/pain, can supplement effects of DMARDs, inhibit production of pro-inflammatory substances, best used for SHORT-TERM control of symptoms
effects of glucocorticoids (3)
immunosuppression, affects renal function (impairs kidneys ability to excrete water), alter CNS function (behavior/mood)
glucocorticoid side effects (5)
Cushing syndrome, breakdown of supporting tissues, peptic ulcers, increased susceptibility to infection, mood changes/psychoses
Glucocorticoids: special consideration for Rehab (6)
monitor for tissue fragility (avoid excessive loading/stretching), incorporate gradual strengthening and WB, watch for HTN, mood changes, infection
DMARDs are used to (2)
control synovitis and erosive changes during the active stages of RA
categories of DMARDs (3)
Traditional (nonbiological), Biological, Combinations
Traditional (Nonbiological) DMARDs include (4)
antimalarial drugs, gold compounds, methotrexate, penicillamine
Antimalarial drugs (3)
chloroquine, azathioprine, cyclosporine
gold compounds (2)
auranofin, gold sodium thomalate (both GI distress)
Methotrexate
most common DMARD used for RA
Biological DMARDs (2)
Tumor necrosis factor (TNF-alpha) inhibit the action of a small protein (cytokine) involved in the inflammatory response
TNF-alpha examples (3)
Humira, Remicade, and Enbrel
most common adverse effect of biological DMARDs? (2)
increased susceptibility of infections (sepsis) thus cannot be taken by patients with infections
biological DMARDs are often combined with?
Methotrexate
disadvantage of DMARD combination therapy?
potential for increased toxicity and drug interactions
NSAIDs for OA are primarily used for (3)
symptomatic treatment of pain, helps control mild synovitis, provides better pain relief for people with mod to severe OA
viscosupplementation schedule (2)
3-5 weekly injections, may decrease sx for 6 months up to 1 year
effectiveness of dietary supplements (2)
protect articular cartilage and halt joint degeneration (INCONCLUSIVE EVIDENCE of effectiveness)
common side effects of NSAIDs (2)
GI and CV issues
side effects of NSAIDs that may interfere with PT? (4)
nausea, tiredness, dizziness, CV effects
