Approach/Therapeutics Flashcards
Most vision threatening condition in rheumatoid arthritis
Scleral melt
Most common ocular condition in rheumatoid arthritis
Keratoconjunctivitis sicca (dry eyes)
Most of the anti-inflammatory and analgesic effects of NSAIDs is through reduction of this prostaglandin
Prostaglandin E2
The benefit of methotrexate in rheumatic diseases is related to this mechanism
Ability to raise extracellular adenosine levels
The only NSAID that appears to reduce cardiovascular risk
Naproxen
This drug combines the dual actions of engaging opiate receptors and raising serotonin and norepinephrine levels; more potent than acetaminophen; low potential for abuse
Tramadol
Dose and duration of corticosteroid therapy at which bisphosphonates are indicated to prevent osteoporosis
=>7.5 mg/d for more than 3 months
Most important toxicity of hydroxychloroquine
Visual loss from retinal pigment deposition
Mechanism of action of leflunomide
Blocks pyrimidine biosynthesis
targets lymphocytes, which lack pyrimidine salvage pathways
Drug given to remove leflunomide from the body in the event that the drug must be withdrawn
Cholestyramine (tid x 8 days)
Enzyme that metabolizes azathioprine
Thiopurine methyltransferase
Drugs that should be avoided in patients taking azathioprine
Allopurinol or febuxostat
active azathioprine metabolites are also degraded by xanthine oxidase
Mechanism of action of mycophenolate mofetil
Inhibits inosine monophosphate dehydrogenase (in the purine synthetic pathway)
Active metabolite of mycophenolate mofetil
Mycophenolic acid
Methotrexate should be discontinued for this duration prior to pregnancy
3 months
Monoclonal antibody that targets IL-12/IL-23 used in patients with psoriatic arthritis or IBD
Ustekinumab
Biologic agent composed of a fusion protein of CTLA4 and Fc portion of IgG; binds to antigen-presenting cells and blocks costimulatory signals to T lymphocytes
Abatacept
A chimeric (mouse-human) monoclonal antibody with specificity for the IL-6 receptor; used in patients with rheumatoid arthritis
Tocilizumab
Blockade of this interleukin by ustekinumab attenuates the maturation and activation of Th1 lineage of T cells
IL-12
Blockade of this interleukin by ustekinumab attenuates the maturation and survival of Th17 cells, a subset of T cells implicated in Crohn’s disease, psoriatic arthritis, and RA
IL-23
Monoclonal antibody with specificity for B cell activating factor (BAFF), also referred to as B-lymphocyte stimulator (BLyS)
Belimumab
IL-1 beta receptor antagonist that have proved beneficial in the treatment of adult-onset Still disease
Anakinra
IL-1 beta inhibitors that have proved beneficial in the treatment of cryopyrin-associated periodic fever syndromes (2)
Rilonacept and canakinumab
Renal tubule transporter inhibited by probenecid to block retention of urate
URAT1
