NR 565 Pharmacology Week 4 Exam
with Complete Solutions
Most common inflammatory form of arthritis - correct Answer-Gout
Characteristics: RA - correct Answer-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 - correct Answer-Pain
Swelling
Warmth
Stiffness
Adverse reactions: Colchicine - correct Answer-Rhabdomyolysis
Increased risk in patients who take statins
Discuss potential risk of muscle injury
Mechanism of action: Urate-lowering drugs/xanthine oxidase inhibitors - correct Answer-
Treat underlying cause of gout flare-ups
Initial Febuxostat therapy - correct Answer-Decrease production of uric acid = prevent
gout attacks
In the beginning, symptoms may flare
Colchicine or NSAIDs are given for up to 6 months to prevent flares
Uricosuric agents - correct Answer-Probenecid
Benzbromarone
Sulfinpyrazone
Lesinurad
Probenecid - correct Answer-Used for chronic gout
Can exacerbate acute episodes
, Delay treatment until acute attack subsides
Allopurinol and Warfarin - correct Answer-Allopurinol may delay metabolism of warfarin
Warfarin dose should be decreased when allopurinol is added
Osteoporosis - correct Answer-Decreased bone mineral density and bone mass
Changes in quality or structure of bones
Increased risk of osteoporotic fractures
Osteoporosis treatment goals - correct Answer-Slow or stop bone loss
Prevent fractures
Osteoporosis: Postmenopausal women - correct Answer-Inadequate intake of dietary
calcium
Requires supplementation
Osteoporosis: CPGs - correct Answer-Men and PM women > 50 should be considered
for treatment if:
Hip or vertebral fracture
T-score of -2.5 or less @ femoral neck or spine
Low bone mass
Medication therapy: Osteoporosis - correct Answer-Bisphosphonates
Denosumab (RANKL inhibitor)
Raloxifene
Medications for osteoporosis: Bisphosphonates - correct Answer-Alendronate
Ibandronate
Zoledronic acid
Bisphosphonate treatment rank - correct Answer-1st line for PM women with prior hip or
vertebral fracture
DXA T-score of -2.5 or less
Mechanism of action: Bisphosphonates - correct Answer-Inhibits osteoclast activity =
decreased bone resorption
Mediations for osteoporosis: Denosumab (RANKL Inhibitor) - correct Answer-Prolia
Xgeva
Denosumab (RANKL Inhibitor) treatment rank - correct Answer-Alternative initial
treatment for PM women with osteoporosis and increased risk of fractures
Mechanism of action: Denosumab (RANKL Inhibitor) - correct Answer-Binds to RANKL
> decreased osteoclast formation, maintenance and survival = decreased bone
resorption
with Complete Solutions
Most common inflammatory form of arthritis - correct Answer-Gout
Characteristics: RA - correct Answer-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 - correct Answer-Pain
Swelling
Warmth
Stiffness
Adverse reactions: Colchicine - correct Answer-Rhabdomyolysis
Increased risk in patients who take statins
Discuss potential risk of muscle injury
Mechanism of action: Urate-lowering drugs/xanthine oxidase inhibitors - correct Answer-
Treat underlying cause of gout flare-ups
Initial Febuxostat therapy - correct Answer-Decrease production of uric acid = prevent
gout attacks
In the beginning, symptoms may flare
Colchicine or NSAIDs are given for up to 6 months to prevent flares
Uricosuric agents - correct Answer-Probenecid
Benzbromarone
Sulfinpyrazone
Lesinurad
Probenecid - correct Answer-Used for chronic gout
Can exacerbate acute episodes
, Delay treatment until acute attack subsides
Allopurinol and Warfarin - correct Answer-Allopurinol may delay metabolism of warfarin
Warfarin dose should be decreased when allopurinol is added
Osteoporosis - correct Answer-Decreased bone mineral density and bone mass
Changes in quality or structure of bones
Increased risk of osteoporotic fractures
Osteoporosis treatment goals - correct Answer-Slow or stop bone loss
Prevent fractures
Osteoporosis: Postmenopausal women - correct Answer-Inadequate intake of dietary
calcium
Requires supplementation
Osteoporosis: CPGs - correct Answer-Men and PM women > 50 should be considered
for treatment if:
Hip or vertebral fracture
T-score of -2.5 or less @ femoral neck or spine
Low bone mass
Medication therapy: Osteoporosis - correct Answer-Bisphosphonates
Denosumab (RANKL inhibitor)
Raloxifene
Medications for osteoporosis: Bisphosphonates - correct Answer-Alendronate
Ibandronate
Zoledronic acid
Bisphosphonate treatment rank - correct Answer-1st line for PM women with prior hip or
vertebral fracture
DXA T-score of -2.5 or less
Mechanism of action: Bisphosphonates - correct Answer-Inhibits osteoclast activity =
decreased bone resorption
Mediations for osteoporosis: Denosumab (RANKL Inhibitor) - correct Answer-Prolia
Xgeva
Denosumab (RANKL Inhibitor) treatment rank - correct Answer-Alternative initial
treatment for PM women with osteoporosis and increased risk of fractures
Mechanism of action: Denosumab (RANKL Inhibitor) - correct Answer-Binds to RANKL
> decreased osteoclast formation, maintenance and survival = decreased bone
resorption
