Autoimmune Flashcards
What is the goal within 3 months of a diagnosis of RA?
start the patient on a DMARD
what are the non biologic DMARDs?
MTX - Rhematrex, Trexall, Otrexup sulfasalazine-Azulfidine, Sulfazine minocycline-Minocin, Dynacin, Solodyn hydroxychloroquine-Plaquinel Leflunomide- Arava Tofacitinib- Xeljanz (Not sure may be biologic)
What are the antiTNF alfa drugs for RA?
adalimumab certolizumab etanercept golimumab infliximab
what are the nonTNF agents for RA?
abatacept rituximab and tocilizumab
methotrexate brand
Rheumatrex; Trexall, Otrexup
Otrexup
SC weekly methotrexate injection
How long can it take to see benefit from MTX?
up to 12 weeks
What are the common SEs associated with MTX?
N/V increased LFTs stomatitis alopecia photoxensitivity
What should be done at baseline when using MTX?
Hep B and C testing
What are some BB warnings with MTX?
hepatitis BMS mucositis Dermatologic conditions renal pneumonitis
What are SEs associated with Plaquenil?
N/D rashes pigmentation of skin and hair weakness vision changes
What SEs are associated with sulfasalazine?
HA anorexia dyspepsia N/V/D oligospermia rash folate deficiency
What RA drug can cause yellow/orange coloration of skin/urine?
sulfasalazine
leflunomide
Arava
What do you have to screen for prior to starting leflunomide?
Tb and pregnancy (category X)
tofacitinib
Xeljanz
What should you screen for prior to starting Xeljanz?
latent Tb should be treated prior to using
________ is a REMS drug which also has to be given once daily if given with a strong 3A4/2C19 inhibitors
Tofacitinib
renal excretion is decreased when MTX is given with what drugs
NSAIDS probenacid beta lactams aspirin
what combination should be avoided due to both concentrations increasing when coadministered?
MTX and cyclosporine
etanercept
Enbrel
Which RA drugs are only given in combo with MTX in RA?
infliximab and golimumab rituximab
adalimumab
Humira
golimumab
Simponi
Remicade
infliximab
Which drug has the possiblility of a delayed hypersensitivity reaction?
infliximab; 3 to 10days later (fever rash myalgia sore throat)
What are the BB warnings with the TNF drugs?
serious infections. lymphomas and other malignancies reactivation of latent Tb
What are the warnings with the TNF drugs?
can cause hep B reactivation, HF, hepatotoxicity, LLS
When dispensing TNF inhibitors you must give a _____
medguide
Which drugs carry the potential to cause progressive multifocal leukoencephalopathy?
rituximab(Rituxan) & natalizumab (Tysabri)
anakinra brand name &MOA
Kineret; IL1 antagonist
abatacept
Orencia
abatacept MOA
inhibits T cell activation by binding CD80 and 86