Study Notes >> Revision Questions >> Musculoskeletal (Preview)
Revision Questions: Musculoskeletal (Preview)
- Celecoxib should not be taken by patients allergic to ........................
- Glucosamine should not be taken by patients allergic to .......................
- True or false: COX-2 inhibitors are associated with a lower GI upset risk than non-selective agents.
- True or false: Rectal NSAID formulations reduce the GI ulceration risk where as enteric coated NSAID tablets have no effect on GI ulceration.
- A patient takes meloxicam 15 mg daily, pantoprazole 40 mg daily and methotrexate 22.5 mg weekly on the same day. Do you have any concerns?
- False. Neither enteric coated or rectal NSAID formulations reduce the risk of GI ulceration.
- Important findings and recommendations:
- Coadministration of meloxicam and methotrexate may increase the risk of methotrexate toxicity via a reduction of renal function and methotrexate excretion (especially when the dose is >20 mg/week). Also, meloxicam may contribute to fluid retention, cardiovascular complications, and gastrointestinal irritation when used on a long-term basis. Recommend replacement of meloxicam with paracetamol 500mg 2 qid for pain relief.
- Pantoprazole may be drug-induced therapy associated with meloxicam. Coadministration of pantoprazole and methotrexate increases the risk of methotrexate toxicity. Review the need for pantoprazole after ceasing meloxicam. Cease pantoprazole if no longer needed.
- Review the need for high-dose methotrexate treatment. Reduce dose if possible to minimise risk of adverse effects.
The full version has many more questions with answers included.