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4. Pharm III > 2- DMARDs > Flashcards

2- DMARDs Flashcards

1
Q

What is the MOA for gold salts?

A

Inhibit phagocytosis, prevent PG synthesis

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2
Q

What is the use for gold salts?

A

Supress cellular immunity

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3
Q

What are the SEs of gold salts?

A

BM damage, enterocolitis

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4
Q

What is the caution with use of Penicillamine?

A

HIGH incidence of SEs

(hematologic, renal, AI, ↑ risk > 65 yo)

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5
Q

What is the use for Penicillamine?

A

Wilson’s disease, RA

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6
Q

What type of properties does Hydroxychloroquine (Plaquenil) have?

A

Antihistaminic, anticholinesterase, antiprotease

(inhibits PG synthesis, stabilize lysosomes)

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7
Q

What are the SEs for Hydroxychloroquine (Plaquenil)?

A

Hemolysis (G6PD def), ototoxicity

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8
Q

What is the use for Sulfasalazine?

A

RA, better tolerated and less toxic

(but still not well tolerated)

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9
Q

What are general contraindications to use of DMARD agents?

A

Breastfeeding, children, renal disease +/- infections

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10
Q

What mediators of chronic inflammation are specifically identifed as DMARDs? (4)

A

Gold salts, Penicillamine, Hydroxychloroquine (Plaquenil), Sulfasalazine

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11
Q

What mediators of chronic inflammation are identifed as agents acting on TNF-alpha? (5)

A

Infliximab (Remicade)

Adalimumab (Humira)

Certolizumab Pegol (Cimiza)

Golimumab (Simponi)

Etanercept (Enbrel)

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12
Q

Which drug is a chimeric IgG1k monoclonal Ab targeting TNFa and is combined with Methotrexate?

A

Infliximab (Remicade)

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13
Q

What is the use for Infliximab (Remicade)?

(TNF-alpha agent)

A

RA, Crohn’s Disease

(given IV)

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14
Q

Which drug is a 100% HUMAN IgG1 monoclonal Ab targeting TNF-alpha?

A

Adalimumab (Humira)

(given subcutaneously)

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15
Q

What is the use for Adalimumab (Humira)?

A

RA (monotherapy)

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16
Q

Which drugs are humanized Abs targeting TNF-alpha?

A

Certolizumab Pegol (Cimiza)

Golimumab (Simponi)

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17
Q

What drug is considered a “fake TNFa receptor” and is a dimeric fusion protein?

A

Etanercept (Enbrel)

(given subcutaneously)

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18
Q

What are the contraindications to Etanercept (Enbrel)?

A

BM suppression, breastfeeding, children, DM, infection/ sepsis, live vaccines, current varicella infection

19
Q

What are the SEs of Infliximab (Remicade)?

A

HA, infusion reactions

20
Q

What are the SEs of Adalimumab (Humira)?

A

Rash, flu-like sxs, fatigue, HA

21
Q

What is a SE of Etanercept (Enbrel) aside from injection site rxn and infections?

A

Increased incidence of antibody formation

22
Q

What mediators of chronic inflammation are inhibitors of beta-cell differentiation and T-cell activation?

A

Rituximab

Abatacept

23
Q

What mediators of chronic inflammation are inhibitors of nucleic acid synthesis?

A

Leflunomide

Micophenolate Mofetil

24
Q

What mediators of chronic inflammation are interleukin receptor antagonists?

A

Anakinra

Tocilizumab

25
Q

What mediators of chronic inflammation are JAK inhibitors?

A

Tofacitinib

Baricitinib

26
Q

What drug is a genetically engineered chimeric antibody, specifically binds CD20 and is a B-lymphocyte differentiation antigen on B cells?

A

Rituximab (Rituxan)

(given IV)

27
Q

What is the use for Rituximab (Rituxan)?

A

RA, relapsed/ refractory B-cell Non-Hodgkin Lymphoma (NHL)

28
Q

What drug is a fully human recombinant fusion protein that blocks T cell activation to disturb key mechanisms of inflammation and progressive joint destruction?

A

Abatacept (Orencia)

(given IV, long half life)

29
Q

What is the use for Abatacept (Orencia)?

A

RA

30
Q

What drug inhibits DHODH and inhibits induction of COX-2?

A

Leflunomide (Arava)

(oral admin, long half life)

31
Q

What are the SEs of Leflunomide (Arava)?

A

GI, immune suppression

32
Q

What are the contraindications of Leflunomide (Arava)?

A

Pregnancy, breastfeeding, hepatic failure, renal failure

33
Q

What drug inhibits lymphocyte purine synthesis and is a prodrug for the immunosuppressive agent MPA?

A

Mycophenolate Mofetil (Cellcept)

(given oral or IV)

34
Q

Whare are the SEs of Mycophenolate Mofetil (Cellcept)?

A

Diarrhea, vomiting, GI bleeding

35
Q

What are the contraindications to Mycophenolate Mofetil (Cellcept)?

A

Active GI disease, diarrhea, pregnancy, breast feeding, infections

36
Q

What is the use for Mycophenolate Mofetil (Cellcept)?

A

RA, esp if resistant to Methotrexate

37
Q

What drug is a human interleukin-1 receptor antagonist (IL-1Ra) and takes 4-13 weeks to have an effect?

A

Anakinra (Kineret)

(given subcutaneoulsy, eliminated renally)

38
Q

What is the use for Anakinra (Kineret)?

A

RA- improve swollen/ painful joints

39
Q

What drug is human interleukin-6 receptor antagonist (IL-6)?

A

Tocilizumab (Actemra)

40
Q

What drug inhibits JAK1 and JAK 3 and is used in pts with mod-sev active RA who are intolerant to or have not had an adequate response to methotrexate?

A

Tofacitinib (Xeljanz)

(given orally)

41
Q

What are the SEs of Tofacitinib (Xeljanz)?

A

Serious infections/ malignancy

42
Q

What drug inhibits JAK1 and JAK2 and is used for the tx of mod-sev RA?

A

Baricitinib (Olumiant)

(mono or combo therapy)

43
Q

What are the SEs of Baricitinib (Olumiant)?

A

Serious infection/ malignancy, thrombosis

4. Pharm III (16 decks)

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