Pharmacology notes

Apr 15th, 2015
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Pharmacology notes

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1.OSTEOARTHRITIS2. OSTEOMYELITISEU MBCHB VIDR D M KILLINGOOsteoarthritisCommonest articular disease world wideDegenerative bone disease is a misnomerAffects entire joint organ includingsunchondral bone & synoviumIdiopathic(10) the most common form20-pathologically indistinguishable but there isan attributable cause.EPIDEMIOLOGY Among elderly in developing countriesknee OA is the leading cause of chronicdisability. In < 55 yrs M:F affected similar > 55 yrs more in women Racial differences also occur e.g. hipO.A. much less common in blacks thanwhites in the same population.EPIDEMIOLOGYAGE IS THE MOST POWERFUL RISKFACTOROTHER RISK FACTORSFemale, race, geneticsMajor joint trauma, repetitive stressObesitycongenital/developmental defectsPrior inflammatory joint dx.Metabolic/endocrine disorders.NOTE:In obesity - loss of only 5 kg reduces by 50%the odds of developing symptomatic kneeO.A.Pain & disability dont correspond topathologic findings.Risk factors for pain & disability in affectedindividuals are poorly understood.Psychosocial factors proved most importantdeterminants of pain.PATHOGENESISPATHOGENESISCartilage mainly consists of proteoglycan andcollagen.Collagen provides tensile strengthThe breakdown products of cartilage induce a chronicinflammatory response in the synovium.There is synovial macrophage production ofcytokines such as interleukin 1 (IL-1), a tumornecrosis factor (TNF) alpha, and meta

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