Treatment of osteoarthritis and Paracetamol (Acetaminophen in USA) By Josh

Treatment of osteoarthritis and Paracetamol (Acetaminophen in USA)

 

Treatment of osteoarthritis

 The guiding feature in treatment of OA is to treat the pain and symptoms, not the X-ray

 

Physical Measures – weight loss, exercise, heat, ice, NSAID gels

 

Medication – should only be used in severe cases (side effects not worth it)

                        Short course of simple analgesics

                        NSAIDS

                        Corticosteroids (only causes temporarily relief, frequent injections should be avoided)

 

Surgery – Total replacement arthroplasty (hip or knee replacement) (complications, usually joint becoming loose or blood borne infection)

Other – fusion of first MTP joint  

 

 

Paracetamol (acetaminophen in USA)

 

Pharmacodynamics not yet clear.  Weak Cox inhibiter (inhibition of prostaglandin synthesis) however unlike other Cox inhibitors (aspirin, NSAIDS) doesn’t reduce inflammation (caused by prostaglandins).

 

Reduces mild to moderate pain (simple analgesic).  Preferred over aspirin as it has less side effects ( no GI upsets)  Can cause rash or fever, overdose may lead to death by hepatic necrosis. 

 

Pharmacokinetics: usually given PO sometimes PR.  Absorbed easily (little plasma protein binding) metabolised by liver, excreted via urine. 

 

Structure – benzene ring core with a hydroxyl group and a acetamide group (acetamide is an amine)

                       

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~ by pcl4 on September 10, 2008.

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