Ch 16 3 Pharm

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Ch 16 3 Pharm
2015-06-10 12:37:38
16 Pharm

Ch 16 3 Pharm
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  1. Combination Therapy DMARDs Dietary implications
    • High fish oil and certain fatty acid diet better
    • Foods with antioxidant properties (fruits, vegetables)
    • Bad
    • ----Meat/ protein
  2. Osteoarthritis
    • Most common joint disease
    • Caused by defect in joint cartilage (not autoimmune)
    • Slow deterioration of articular cartilage, degenerative change in bone, thickening of subchrondral cone, creation of subchrondral bone cysts, formation of large bony protrusions (osteophytes)
    • Occurs in large weight bearing joints
    • Drugs help manage pain and maintain active lifestyle
  3. DMOADs
    • Viscosupplementation
    • Glucosamine and chondroitin sulfate
    • Acetaminophen
    • NSAIDs
  4. Viscosupplementation
    • Improve viscosity and function of synovial fluid
    • Injected into arthritic joint
    • Reduces stresses, limits progression of disease
    • Reduces pain 6mo – yr after injections
  5. Glucosamine and chondroitin sulfate
    • Protect articular cartilage and halt/reverse degeneration of OA
    • Key ingredients in production of components of articular cartilage and synovial fluid
    • Function
    • ----Repair joint tissue
    • ----Improve viscosity
    • ----Help restore joint function
  6. Acetaminophen
    • Often first drug used to treat OA
    • ---- Safe for long term use
    • Controls pain and doesn’t have GI side effect
  7. NSAIDs
    • Used for symptomatic treatment of pain in OA, don’t alter course of disease
    • Used for analgesics effects
    • Anti-inflammatory effect can help control mild Synovitis in advances OA (due to joint destruction)
    • COX-2 cause less GI disorders but increase risk of CV disease
  8. Therapist Considerations
    • Decreased pain and inflammation allowing more active and vigorous exercise and functional activities
    • Some medications halt the destruction of the disease allowing for the restoration of muscle strength and joint function rather than just maintenance of disease
    • Impact of meds on therapy sessions
    • ---Joint pain and swelling may occur due to medications
    • --------Methotrexate