Pharmacy Exam Points (to remember)... Set 21

1. Paracetamol is advantageous over NSAIDs because it is the first choice analgesic for majority of osteoarthritis patients, it can be given safely to all age groups from infants to elderly, and it is safe in pregnant or breast-feeding women.
2. Nefopam is a centrally-acting non-opioid analgesic which does not inhibit prostaglandin synthesis. Its mechanism of action is largely unknown, but may involve inhibition of serotonin, noradrenaline and dopamine reuptake, that is acting as an SNDRI. It is used for the relief of acute and chronic pain.
3. Topical NSAID preparations elicit symptomatic relief in soft tissue rheumatism mainly by a strong placebo effect.
4. Ibuprofen is the anti-inflammatory analgesic that has been approved for pediatric use.
5. Prednisolone is a reserve drug but not a disease-modifying drug in rheumatoid arthritis.
6. Gold sodium thiomalate (or Sodium aurothiomalate, a gold compuund) in rheumatoid arthritis is used only in severe cases when other DMARDs have failed. This gold compound is given IM and is used for its immuno-suppressive anti-rheumatic effects.
7. Auranofin is an orally-active gold compound.
8. Auranofin is used to treat rheumatoid arthritis and is usually given when other medications have been tried without successful treatment of symptoms.
9. Because gold salts used in treatment of RA can cause serious kidney and bone marrow problems, all patients require monitoring with regular testing of blood and urine.
10. In the treatment of RA, gold salts also are called second-line drugs because they often are considered when arthritis persists in spite of the use of antiinflammatory drugs (NSAIDs and corticosteroids) and DMARDs.