Anti Rheum Drugs Flashcards
symptoms, NON first line drugs
NSAIDS, glucocorticoids
DMARD principles
Slow effect Increase infection risk No change to wound healing Regular follow up Teratogenic Increase risk of malignancy (maybe) (Lymphoma)
what DMARD is safe for pregnancy
Hydrocholroquine
first drug is
methotrexate
methotrexate info
MOA unknown, low dose, give with folic acid, NO ALCH
what can you give if pt drinks alch?
Leflumonide
Sulfasalazone side effect
bone marrow issue with G6PD deficiency
Mycophenolate/cyclopentolate
SLE life threatening disease- REALLY toxic. inhibitors DNA synthesis
biologic principles
Principles All are DMARDS Not oral 2nd/3rd line Similar risks Combo with non biologics
TNF agonist MOA
MAb, bind/block TNF receptor
TNF agonist side effects
reactive TB, infection, CHF, SLE/neurologic
abataceot/.tocilizumab
decrease T cell activation
Abat: block CTLA4
TOC: IL6 receptor
Rituzimab
Man to CD20- kill B/.pre B cells- not plasma
Rituzimab side effects
Leukoencephalopathy- reactivate JC virus
Infusion
RA treatment principles
Treat early with DMARD/ biologic
Screen Hep B/C/TB and vaccinate before treatment if possible
MTX first
3 monthdrug trial
Goal: decrease activity of disease/ remission
Vaccinate when appropriate (not live vaccines!!)