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NMSP - Exam 2 > bDMARDS and tsDMARDS > Flashcards

bDMARDS and tsDMARDS Flashcards

1
Q

What is the Targeted Synthetic DMARD?

A

Tofacitinib

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2
Q

What is the tsDMARD?

A

Tofacitinib

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3
Q

What are the 7 Biologic DMARDS?

A 
Etanercept
Adalimumab
Infliximab
Rituximab
Abatacept
Tocilizumab
Anakinra
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4
Q

What are 3 TNF alpha Antagonists?

A

Etanercept
Adalimumab
Infliximab

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5
Q

What is a B cell depleter mAb?

A

Rituximab

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6
Q

What drug (-) T cell activation?

A

Abatacept

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7
Q

What is an IL-6 Receptor mAb?

A

Tocilizumab

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8
Q

What is an IL-1 Antagonist?

A

Anakinra

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9
Q

bDMARDS should NEVER be combined with?

A

Each other!

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10
Q

Generally what is good and bad about bDMARDS?

A

Faster and stronger response

More expensive and risk of more severe adverse effects

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11
Q

What are the adverse effects of TNF alpha Antagonists (2)?

A

Severe allergic reactions

Serious infections like TB

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12
Q

What TNF alpha Antagonist involves 2 p75 TNF receptors bound to Fc portion of IgG?

A

Etanercept

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13
Q

How is Etanercept given?

A

1x/week via SubQ

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14
Q

What TNF alpha Antagonist is a chimeric mAb?

A

Infliximab

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15
Q

How is Infliximab given?

A

1x/ every 8 weeks via IV

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16
Q

What TNF alpha Antagonist is a human mAb?

A

Adalimumab

17
Q

How is Adalimumab given?

A

1x/ every 2 weeks via SubQ

18
Q

Which TNF alpha Antagonist has a lower risk of anti-drug antibody formation?

A

Adalimumab

19
Q

What is the MOA for Rituximab?

A

Antibody that targets CD20 on pre-B cell surface so that CD20 is lost as B cells differentiate into plasma cells

20
Q

If what things are present, will there be a greater likelihood of response to Rituximab?

A

Rheumatoid factor

Anti-cyclic Citrullinated Peptide antibodies

21
Q

What is a possible adverse effect with Rituximab?

A

Infusion hypersensitivity reactions

22
Q

What is the MOA for Abatacept?

A

Prevents CD28 from binding to CD80/CD86

= (-) T cell activation

23
Q

What is the possible adverse effect of Abatacept?

A

Serious infections

24
Q

Tocilizumab is an Anti-IL-6 Receptor Antibody. What forms does it target?

A

Membrane bound and soluble IL-6 receptors

25
Q

What is the effective result of Tocilizumab targeting IL-6 Receptors?

A

Limits hepatic acute phase response and activation of T/B cells, macrophages and osteoclasts

26
Q

What are 2 possible adverse effects of Tocilizumab?

A

Upper respiratory tract infections

Life threatening infections

27
Q

Anakinra is an IL-1 Antagonist. How often is it used?

A

Rarely used - less efficacious

28
Q

What are 2 possible adverse effects of Anakinra?

A

Serious infections

Hypersensitivity reactions

29
Q

How do tsDMARDs differ from bDMARDS?

A

Small molecules, NOT proteins

30
Q

How is Tofacitinib given that is generally different from most DMARDS?

A

ORALLY

31
Q

What is the MOA for Tofacitinib and the effect it causes?

A

JAK3 Antagonist

==> (-) production of IL-17, IFNgamma and CD4 T cells

32
Q

What are the adverse effects associated with Tofacitinib?

A

Serious infections with opportunistic pathogens
Increased malignancies
Cardiovascular warnings

33
Q

What are the adverse effects associated with Tofacitinib?

A

Serious infections with opportunistic pathogens
Increased malignancies
Cardiovascular warnings

34
Q

Once Methotrexate has been tried, what bDMARD should be added?

A

TNF alpha Antagonists

35
Q

Tofacitinib can be used with or without Methotrexate. It is a first choice after what?

A

csDMARDS

36
Q

Once Methotrexate + TNF alpha Antagonists have been tried and they were not successful, what should then be tried?

A

Methotrexate + NON-TNF bDMARD or tsDMARD

NMSP - Exam 2 (29 decks)

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