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565 Advanced Pharmacology
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Most common inflammatory form of arthritis - Gout
Characteristics: RA - Rapid onset
3:1 in women/men
Age 35-50 years at onset
Affects hands and feet
local and systemic inflammation
60 mins morning joint stiffness
Symmetric
Elevated ESR
Leukocytosis
Systemic symptoms
RA symptoms - Pain
Swelling
Warmth
Stiffness
Characteristics: Osteoarthritis - Slow onset (years)
1:1 in men/women
, Age > 50 years at onset
Affects hands, hips, knees
Mild or local inflammation
< 30 min morning joint stiffness
symmetric or asymmetric pattern
ESR normal
Mild leukocytosis
No systemic symptoms
Symptoms: Osteoarthritis - Pain
Bone enlargement
Treatment goals: RA - Relieve symptoms
Maintain joint function and ROM
Decrease systemic involvement
Delay disease progression
Medications: RA - NSAIDS
Glucocorticoids
Conventional DMARDS
Biologic DMARDS
Mechanism of action: Conventional DMARDs - Immunosuppressant
Inhibits dihydrofolate reductase
Inhibits lymphocyte proliferation
Folate antagonist
Mechanism of action: Bioloic DMARDs - Inhibits JAK 1,2,3 = disruption of cytokine and growth factor
signaling pathways