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Aging Beautifully: Visions & Realities Part I: Osteoarthritis
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By Christine Hortillosa Pharm.D. 2013 Candidate University of Texas at Austin College of Pharmacy 4. 9. 2013
The Vision of Joint Health
If I aged beautifully, I would…
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If I aged beautifully, I would…
If I aged beautifully, I would…
…without pain.
The Reality of Joint Health
OSTEOARTHRITIS
27 MM $65 MM
PAIN
STIFFNESS
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Education on OA
Diet and Exercise
Medications
Management http://www.clipartguide.com/_named_clipart_images/0511-0905-2016-1540_Old_Man_Walking_with_a_Cane_clipart_image.jpg
Surgery
Medications
NSAIDS APAP
Topical Analgesics
PPI
Opioids
(types)
Medications
Recommendations for High-Risk Patients
PPI
If GI Safety is paramount
COX-2
inhibitor
PPI
If CV Safety is paramount
Naproxen
If Renal Safety
is paramount
APAP
If all else fails, use an OPIOID cautiously.
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Pharmacists are critical in effective osteoarthritis management.
With your help, I can…
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With your help, I can…
With your help, I can…
…without pain.
REFERENCES
1. Hunter DJ. Insights from imaging on the epidemiology and pathophysiology of osteoarthritis. Radiol Clin North Am 2009; 47:539–551. 2. Zhang Y. Jordan JM. Epidemiology of osteoarthritis. Clin Geriatr Med 2010; 26: 355-369. 3. Harvey WF. Hunter DJ. Pharmacologic intervention for osteoarthritis in older adults. Clin Geriatr Med 2010; 26: 503-515. 4. Zhang W. Moskowitz RW. Nuki G, et al. OARSI recommendations for the management of hip and knee osteoarthritis, part II: OARSI evidence-based, expert consensus guidelines. Osteoarthritis Cartilage 2008; 16:137–162. 5. American College of Rheumatology Subcommittee on Osteoarthritis Guidelines. Recommendations for the medical management of osteoarthritis of the hip and knee: 2000 update. Arthritis Rheum 2000; 43:1905–1915. 6. Rostom A. Moayyedi P. Hunt R. Canadian Association of Gastroenterology Consensus Group. Canadian consensus guidelines on long-term nonsteroidal anti-inflammatory drug therapy and the need for gastroprotection: Benefits versus risks. Aliment Pharmacol Ther 2009; 29:481–496. 7. Buys LM. Elliott ME. Chapter 101. Osteoarthritis. In: Talbert RL, DiPiro JT, Matzke GR, Posey LM, Wells BG, Yee GC, eds. Pharmacotherapy: A Pathophysiologic Approach. 8th ed. New York: McGraw-Hill; 2011. http://www.accesspharmacy.com/content.aspx?aID=7997482. Accessed April 9, 2013. 8. Pictures throughout the slide deck: see bottom of individual slide.