Anti Rheum Drugs

Question 1

symptoms, NON first line drugs

Answer 1

NSAIDS, glucocorticoids

Question 2

DMARD principles

Answer 2

Slow effect
Increase infection risk
No change to wound healing 
Regular follow up
Teratogenic
Increase risk of malignancy (maybe) (Lymphoma)

Question 3

what DMARD is safe for pregnancy

Answer 3

Hydrocholroquine

Question 4

first drug is

Answer 4

methotrexate

Question 5

methotrexate info

Answer 5

MOA unknown, low dose, give with folic acid, NO ALCH

Question 6

what can you give if pt drinks alch?

Answer 6

Leflumonide

Question 7

Sulfasalazone side effect

Answer 7

bone marrow issue with G6PD deficiency

Question 8

Mycophenolate/cyclopentolate

Answer 8

SLE life threatening disease- REALLY toxic. inhibitors DNA synthesis

Question 9

biologic principles

Answer 9

Principles
All are DMARDS
Not oral
2nd/3rd line
Similar risks
Combo with non biologics

Question 10

TNF agonist MOA

Answer 10

MAb, bind/block TNF receptor

Question 11

TNF agonist side effects

Answer 11

reactive TB, infection, CHF, SLE/neurologic

Question 12

abataceot/.tocilizumab

Answer 12

decrease T cell activation

Abat: block CTLA4

TOC: IL6 receptor

Question 13

Rituzimab

Answer 13

Man to CD20- kill B/.pre B cells- not plasma

Question 14

Rituzimab side effects

Answer 14

Leukoencephalopathy- reactivate JC virus

Infusion

Question 15

RA treatment principles

Answer 15

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!!)

Question 16

Biological side effects

Answer 16

Allergy, cost, injected, infections, Chf, neurological disease,

Large»> not cleared by kidney, renal function ok