NSG 533 ADVANCED PHARMACOLOGY EXAM QUESTIONS
AND ANSWERS LATEST UPDATE
What is the typical presentation of Osteoarthritis and the overall goals of
therapy?
Patients are usually more than 50 years old. May be asymptomatic to severe joint pain
and stiffness. Joint involvement is asymmetric. Inflammation is absent or mild. Cardinal
s/s are use-related joint pain (deep and aching), joint stiffness (abates with motion,
recurs with rest), weight bearing joints unstable, joint stiffness lasts fewer than 30
minutes. One or more joints can be involved but most common are distal finger joints,
proximal finger joints, first carpometacarpal joint, knees, hips, cervicolumbar spine, and
joint of the great toe. Examination of the joint may reveal tenderness, crepitus, muscle
atrophy, and limited ROM.
Osteoarthritis (OA) treatment goals
Educate the patient and caregivers o Relieve pain o Maintain or restore mobility o
Minimize functional impairment and associated adverse outcomes (like falls) o Preserve
joint integrity o Improve quality of life
Osteoarthritis (OA)
progressive, degenerative joint disease with loss of articular cartilage and hypertrophy
of bone (formation of osteophytes, or bone spurs) at articular surfaces
Provide a stepwise approach to the treatment of osteoarthritis, including non-
pharmacological interventions (figure 58-2).
1) non pharm, 2) pharm (Tylenol APAP/nsaids + glucosamine), then 3) injections,
opioids, surgery *If NSAIDS are contraindicated, then utilize glucocorticoid injections
What is meant by adequate dose / duration and ATC dosing when determining
APAPs effectiveness
APAP: first line therapy for mild to moderate osteoarthritis Apap should be tried
initially at an adequate dose and duration before considering an NSAID* Insufficient
acetaminophen dose or duration are common reasons for inadequte response. APAP
should be given on a PRN basis in divided doses up to 4 g daily. Single doses should
not exceed 1 g. Trial for 4 to 6 weeks. Use 2.5g max for pts who consume 2 to 3
AND ANSWERS LATEST UPDATE
What is the typical presentation of Osteoarthritis and the overall goals of
therapy?
Patients are usually more than 50 years old. May be asymptomatic to severe joint pain
and stiffness. Joint involvement is asymmetric. Inflammation is absent or mild. Cardinal
s/s are use-related joint pain (deep and aching), joint stiffness (abates with motion,
recurs with rest), weight bearing joints unstable, joint stiffness lasts fewer than 30
minutes. One or more joints can be involved but most common are distal finger joints,
proximal finger joints, first carpometacarpal joint, knees, hips, cervicolumbar spine, and
joint of the great toe. Examination of the joint may reveal tenderness, crepitus, muscle
atrophy, and limited ROM.
Osteoarthritis (OA) treatment goals
Educate the patient and caregivers o Relieve pain o Maintain or restore mobility o
Minimize functional impairment and associated adverse outcomes (like falls) o Preserve
joint integrity o Improve quality of life
Osteoarthritis (OA)
progressive, degenerative joint disease with loss of articular cartilage and hypertrophy
of bone (formation of osteophytes, or bone spurs) at articular surfaces
Provide a stepwise approach to the treatment of osteoarthritis, including non-
pharmacological interventions (figure 58-2).
1) non pharm, 2) pharm (Tylenol APAP/nsaids + glucosamine), then 3) injections,
opioids, surgery *If NSAIDS are contraindicated, then utilize glucocorticoid injections
What is meant by adequate dose / duration and ATC dosing when determining
APAPs effectiveness
APAP: first line therapy for mild to moderate osteoarthritis Apap should be tried
initially at an adequate dose and duration before considering an NSAID* Insufficient
acetaminophen dose or duration are common reasons for inadequte response. APAP
should be given on a PRN basis in divided doses up to 4 g daily. Single doses should
not exceed 1 g. Trial for 4 to 6 weeks. Use 2.5g max for pts who consume 2 to 3
