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Aging
Beautifully:
Visions & Realities
Part I: Osteoarthritis
By Christine Hortillosa
Pharm.D. 2013 Candidate
University of Texas at Austin College of Pharmacy
4. 9. 2013




        http://www.goodlifeguide.net/wp-content/uploads/2012/09/beach-seniors-X-license.jpg
The Vision
of Joint Health
If I aged beautifully, I would…




                            http://www.grandcamp.com/blog/wp-content/uploads/2012/01/at-play-with-grandkids.jpg
If I aged beautifully, I would…




                          http://lightenupsystems.com/wp-content/uploads/2011/04/Senior-couple-on-the-Beach-Medium.jpg
If I aged beautifully, I would…
…without pain.
The Reality
of Joint Health
27 MM $65 MM
 OSTEOARTHRITIS
PAIN


                        STIFFNESS




http://www.accesspharmacy.com.ezproxy.lib.utexas.edu/popup.aspx?aID=7997492
Education
                                                                    on OA                                                        Medications
                                                                                                                      Diet and
                                                                                                                      Exercise




                                                                                                                                      Surgery




http://www.clipartguide.com/_named_clipart_images/0511-0905-2016-1540_Old_Man_Walking_with_a_Cane_clipart_image.jpg
                                                                                                                      Management
Medications
                                       Opioids


                          Topical
                          Analgesics

APAP
        NSAIDS
          (types)




                    PPI
Medications
Recommendations for High-Risk Patients




  If GI Safety            If CV Safety          If Renal Safety
  is paramount            is paramount          is paramount


              COX-2
             inhibitor               Naproxen
                                                    APAP
       PPI                     PPI




If all else fails, use an OPIOID cautiously.
Pharmacists
         are critical in
         effective
         osteoarthritis
         management.




http://www.toledoblade.com/image/2012/01/22/800x_b1_cCM_z_cT/pharmacist-bryan-01-23-2012.jpg
With your help, I can…




                         http://www.grandcamp.com/blog/wp-content/uploads/2012/01/at-play-with-grandkids.jpg
With your help, I can…




                         http://lightenupsystems.com/wp-content/uploads/2011/04/Senior-couple-on-the-Beach-Medium.jpg
With your help, I can…
…without pain.
Aging Beautifully Part 1: Osteoarthritis
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.

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Aging Beautifully Part 1: Osteoarthritis

  • 2. Aging Beautifully: Visions & Realities Part I: Osteoarthritis By Christine Hortillosa Pharm.D. 2013 Candidate University of Texas at Austin College of Pharmacy 4. 9. 2013 http://www.goodlifeguide.net/wp-content/uploads/2012/09/beach-seniors-X-license.jpg
  • 4. If I aged beautifully, I would… http://www.grandcamp.com/blog/wp-content/uploads/2012/01/at-play-with-grandkids.jpg
  • 5. If I aged beautifully, I would… http://lightenupsystems.com/wp-content/uploads/2011/04/Senior-couple-on-the-Beach-Medium.jpg
  • 6. If I aged beautifully, I would…
  • 9. 27 MM $65 MM OSTEOARTHRITIS
  • 10. PAIN STIFFNESS http://www.accesspharmacy.com.ezproxy.lib.utexas.edu/popup.aspx?aID=7997492
  • 11. Education on OA Medications Diet and Exercise Surgery http://www.clipartguide.com/_named_clipart_images/0511-0905-2016-1540_Old_Man_Walking_with_a_Cane_clipart_image.jpg Management
  • 12. Medications Opioids Topical Analgesics APAP NSAIDS (types) PPI
  • 13. Medications Recommendations for High-Risk Patients If GI Safety If CV Safety If Renal Safety is paramount is paramount is paramount COX-2 inhibitor Naproxen APAP PPI PPI If all else fails, use an OPIOID cautiously.
  • 14. Pharmacists are critical in effective osteoarthritis management. http://www.toledoblade.com/image/2012/01/22/800x_b1_cCM_z_cT/pharmacist-bryan-01-23-2012.jpg
  • 15. With your help, I can… http://www.grandcamp.com/blog/wp-content/uploads/2012/01/at-play-with-grandkids.jpg
  • 16. With your help, I can… http://lightenupsystems.com/wp-content/uploads/2011/04/Senior-couple-on-the-Beach-Medium.jpg
  • 17. With your help, I can…
  • 20. 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.