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Endocrine/Autoimmune > Autoimmune Disease > Flashcards

Autoimmune Disease Flashcards

1
Q

What mineralcorticoid acts like ALDOSTERONE and is approved for Addison’s disease?

A

Fludrocortisone

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2
Q

What are symptoms of Cushing’s Syndrome? What is the cause?

A

Too much Cortisol!!!
-Acne
-Glaucoma
-Moonface
-Buffalohump
-Psych changes
-Pink-purple stretch marks
-Diabetes
-Infection or impaired wound healing

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3
Q

What is Addison’s disease?

A

Lack of cortisol

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4
Q

What are the short-acting systemic steroids?

A

Hydrocortisone
Cortisone

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5
Q

What are the intermediate systemic steroids?

A

Prednisone
Prednisolone
Methylprednisolone
Triamcinolone

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6
Q

What are the Long-Acting systemic steroids?

A

Betamethasone
Dexamethasone

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7
Q

Decadron SE

A

Dexamethasone
Short term
increased appetite
weight gain
emotional instability
insomnia
increased IOP
fluid retention
increased BP and BG

Long-term
Osteoporosis
Diabetes
Impaired wound healing
Psych disorders
growth retardation

Warning: Adrenal suppression, if taking longer than 14 days, taper SLOWLY

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8
Q

Deltasone

A

Prednisone

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9
Q

Millipred

A

Prednisolone

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10
Q

Orapred ODT

A

Prenisolone

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11
Q

Solu-Cortef

A

Hydrocortisone

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12
Q

Kenalog

A

Triamcinolone

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13
Q

What a patient considers immunosuppresed on systemic steroid use?

A

When using >/= 20 mg/day of prednisone equivalent dose for 2 weeks

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14
Q

non-biologic DMARDs

A

Disease Modifying Anti-rheumatic Drugs
- methotrexate
- hydroxychloroquine
- sulfalazine
- leflunomide

*slow disease progression and prevent further joint damage

JAK inhibitors:
Tofacitinib
Baricitinib
Upadacitinib
**do not use these with bioilogic DMARDs

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15
Q

What testing is more specific to rheumatoid arthrisis?

RF
CRP
CPK
ACPA

A

ACPA

**RF is positive for other immune disorders like SLE

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16
Q

What is the preferred initial therapy for rheumatoid arthritis? What situations would you NOT want to use this medication?

A

Methotrexate (Trexall)

-Pregnancy patient (teratogenic)
-breastfeeding
-Alcoholic
-Chronic liver disease
- Blood Dyscrasias

SE: hepatotoxicity! myleosuppression! mucositis!
**give with FOLATE to help with myleosuppresion and hepatic side effects

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17
Q

What can be added on to DMARD therapy when insufficent for a disease flare?

A

Low-dose systemic steroid

(</= 10 mg/day of prednisone equivalant)

18
Q

What medication is dosed once weekly in RA when it is dosed daily for other conditions?

A

Methotrexate (Trexall)
**doses daily in cancer!

MOA: irreversibly binds to dihydrofolate reductase to block folate

19
Q

JAK inhibitors

A

BUT JAK

Baricitinib
Upadacitinib
Tofacitinib

increase risk for infections, malignancy, thrombosis!

20
Q

What is the MAIN side effect with DMARD Plaquenil?

A

Hydroxychloroquine
Irreverible retinopathy
**get eye exam every 3 months!

21
Q

What non-biologic DMARD can cause yellow-orange coloration?

A

Sulfasalazine

22
Q

What non-biologic DMARDs are Contraindicated in pregnancy?

A

Trexall
Lefunomide

22
Q

What non-biologic DMARDs are Contraindicated in pregnancy?

A

Trexall
Lefunomide

23
Q

Lefunomide

A

non-biologic DMARD

***avoid in pregnancy, wait 2 years after treatment to get pregnant OR use the accelerated drug elimination for 11 days
- Cholestyramine
- Activated Charcoal

SE: hepatotoxicity

24
Q

biologic DMARDs

A

Anti-TNF Biologics:
Adalimumab (Humira)
Etanercept (Enbrel)
Infliximab (Remicade)
Certolizumab (Cimzia)
Golimumab (Simponi)

CD20 Biologic
Rituximab (Rituxan)

25
Q

Anti-TNF Biologics

A

“Go InCert Humira and Enbrel to avoid a Tumor Necrosis Factor”

Golimumab (Simponi)
Infliximab (Remicade)
Certolizumab (Cimzia)
Adalimumab (Humira)
Etanercept (Enbrel)

BW: serious infections
**do not use with other biologics or JAK inhibitors, malignances

Warning: causes demyelinating, hep B reactivation, HF, Hepatotoxicity, lupus-like syndrome

**do not use with LIVE vaccines!!!!

***these are usually add-on therapy to MTX

26
Q

CD20 biologic DMARD

A

Rituximab (Rituxan)

**HBV reactivation
**premedicate with steroid, APAP, antihistamine due to serious infusion related reactions

27
Q

Counseling points for Enbrel and Humira

A

Weekly SC injections
Cause: HF, liver damage, infection

Store in fridge, can be stored at room temp for a MAX of 14 days

Humira - inject into ab or thigh
Enbrel - inject into ab, thigh, or upper arm

28
Q

Which drugs are DILE drugs?

A

My Pretty Malar Mark Probably Has A TransIent Quality

Minocycline
Proylthiouracil (hyperthroidism)
Methimazole (hyperthyroidism)
Methyldopa (alpha 2 agonist)
Procainamide (Class 1a)
Hydralazine
Anti-TNF (Humira, Simponi, Enbrel, Remicade)
Terbinafine
Isoniazid
Quinidine

29
Q

What are the common treatments of SLE?

A

Hydroxychloroquine (Plaquenil)
Cyclophosphamide (antimetabolite)

Transplant meds:
Azathioprine
Mycophenolate mofetil
Cyclosporine

***may take up to 6 months to see improvement!

30
Q

What are common labratory findings for Lupus?

A

Antinuclear Antibodies (ANA)
anti-ssDNA
anti-dsDNA

31
Q

What is a biologic DMARD that is approved for SLE?

A

Belimumab (Benlysta)

32
Q

What are the signs and symptoms of multiple sclerosis?

A

fatigue
numbness
blurred vision
deterioration of cogn
muscle spasms
pain
incontinence

33
Q

What are the mainstay treatments for multiple sclerosis?

A

Glatiramir Acetate (Copaxone)
and
Interferon beta

34
Q

What multiple sclerosis therapy is preferred in pregnancy?

A

glatiramir acetate (Copaxone)

warning: chest pain

35
Q

Pyrimidine synthesis inhibitors and there uses

A

lefunomide use in RA
teriflunomide use in MS

**both have hepatotoxicty and CI in pregnancy!

36
Q

Interfern beta

A

Warning: psych, hepatotoxicity, thyroid dysfunction

**do not expel air bubble due to loss of drug!!!!!

37
Q

What monoclonal antibody is approved for MS that is also approved for IBD?

A

Natalizumab (Tysabri)

**PML —– need REMS

38
Q

What is the DOC for Reynaud’s Phenomenon (cyanosis and cold extremities)?

A

Nifedipine (Procardia)

39
Q

What is myasthenia gravis?

A

autoimmune disease affecting nerves and muscles that control the face and eyes
-vision loss
-ptosis (dropping eyelid)
-problems chewing or swallowing

Tx: pyridostigmine (anticholinergic)

40
Q

What drugs worsen myasthenia gravis?

A

AG or Quinolones
BB or CCB
Magnesium
Muscle relaxants

41
Q

Sjogren’s Syndrome is?

A

autoimmune disease marked by DRY eyes and DRY mouth

Tx: eye drops
-Cyclosporine (Restasis)

oral med for dry mouth
pilocarpine (cholinergic)

Endocrine/Autoimmune (6 decks)

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