anti-RA drugs Flashcards

1. Describe the limitations to the use of non-steroidal anti-inflammatory drugs in the treatment of rheumatoid arthritis. 2. Explain why the use of corticosteroids is controversial in the treatment of rheumatoid arthritis. 3. List the prototype “synthetic” disease modifying anti-rheumatic drugs, describe their mechanism of action and clinical uses, and list their major adverse effects. 4. List the prototype “biologic” disease modifying anti-rheumatic drugs, describe their mechanism of action

1
Q

problem with using NSAIDS for RA

A

do not prevent the irreversable damage to the joints

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

problems with using corticosteroids for RA

A

too many side effects with long term use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

current use of steroids in RA

A

bridge therapy until long-term drugs kick in

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

synthetic RA DMARDs

A

methotrexate, hydrocychloriquine, sulfalazine, lefunomide, gold salts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

biological RA DMARDS

A

TNF inhibitors, IL-1 inhibitors, IL-6 inhinitors, B/T cell inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

SE of methotrexte

A

hepatotox

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

SE of sulfasalazine

A

hepatotox

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

SE of antimalarial drugs

A

retinopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

MOA of methotrexate

A

antimetaboliite (inhibits DHF)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

MOA of sulfasalazine

A

anti-inflammatory and antimicrobial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

MOA f cyclosporin

A

T-cell avtivation inhibitor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

SE of cyclosporin

A

kidney tox

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

use of sulfasalzine

A

RA, juvinile chronic arthritis, ankylosing spondy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

typically added to pts taking methotrexate

A

leflunomide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

may increase hypertension

A

leflunomide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

TNF inhibors

A

etanercept, xxx-mab (NOT tocilizumab/rituximab)

17
Q

increases risk of infection, ESPECIALLY TB

A

TNF inhibitors

18
Q

can cause MS-like illness

A

TNF inhibitors

19
Q

black box warning about cancer risk

A

TNF inhibitors

20
Q

must screen for TB before using

A

TNF inhibitors

21
Q

chimeric human/mouse monoclonal anti0TNF anibody

A

infliximab

22
Q

T/B cell inhibitors

A

anakinra, tocilizumab, abatacept, , rituximab, tofiacitnib,

23
Q

anti IL-6 drug

A

tocilizumab

24
Q

used when other DMARBs fail

A

tocilizumab, rituximab

25
Q

cannot be used with TNF-inhibitors

A

tocilizumab, abatacept, ritiximab, tofacitinab

26
Q

prevents T-cell activation

A

abacept

27
Q

binds to CD20 on B cells to cause depletion

A

rituximab

28
Q

inhibitor of JAX

A

tofacitnib

29
Q

contraindications tofacitinib

A

pregnancy, liver disease or hematologic abnormalities

30
Q

last resort drug not to be used in kids

A

cyclophosphamide

31
Q

nephrotixic last resort drug

A

cyclosporine

32
Q

immunosuppressive purine analige

A

azathippurine

33
Q

last resport drug causing hepatotixicty, GI tox, bone marrow supression

A

azathiopurine

34
Q

general combo therapies (2)

A

DMARD + NSAID or steroid (gradulally wd NSAID/steroid)

in non responders add lefulonomide or TNF inhibitor to methotrexate

35
Q

drugs to use in combo therapy if TNF inhibitors fail

A

IL-1/6 or B’/t cell inhibotors

36
Q

drug to remove with gold salts/last resort agents

A

methotrexate