Biologic Response, Antirheumatic, Immunosupressant Drugs

Question 1

1st line of treatment for RA

Answer 1

can’t be cured, only treated
-NSAIDs
-non-biologic DMARDs

Question 2

Abacept, Humira, Etanercept are biologics used to treat RA. Name MOA, considerations, SFX

Answer 2

-MOA: binds to TNF and blocks it’s action
-Considerations: caution for pts w/ active infections, COPD, past hepatitis and TB
-SFX: headache, dizziness, weakness, injection site reaction, infection (URIs), malignancy

Question 3

Abatacept considerations

Answer 3

-give w/ filter
-caution for patients w/ COPD, recurrent infections

Question 4

Etanercept should be given w/ caution for patients with a ______ allergy, and starts working after __-__ weeks

Answer 4

-latex allergy
-1-2 week onset

Question 5

Methotrexate, used for ___, is dosed weekly. It should be taken with what type of supplement and has how long of an onset?

Answer 5

-folic acid supplement to reduce bone marrow suppression
-6-12 week onset

Question 6

Leflunomide MOA, side effects

Answer 6

-MOA: modulates DNA formation, reducing proliferation of immune cells
-SFX: DIARRHEA!, URI, elevated liver enzymes, alopecia
-NO for pregnancy

Question 7

MOA of immunosupressants

Answer 7

Suppress T-lymphocyte cells, preventing immune response

Question 8

Nursing considerations for Immunosupressants

Answer 8

-take same time each day, w/ food, don’t skip doses
-draw kidney function/drug function labs regularly
-reduce infection risk
-take precautions in sunlight
-interactions w/ antibiotics and antifungals
-no Gfruit juice

Question 9

Cellcept has a carries a black box warning for _______. use/MOA?

Answer 9

-pregnancy
-immunosupressant
-MOA: inhibit purine synthesis –> prevent T cell proliferation

Question 10

Rapamune use, MOA

Answer 10

-immunosupressant
-MOA: mTOR inhibtor –> prevent T cell proliferation

Question 11

Cyclosporine use, MOA

Answer 11

-immunosupressant
-MOA: inhibit IL-2 –> prevent T cell proliferation

Question 12

Tacrolimus use, MOA

Answer 12

-immunosupressant
-MOA: prevent T cell activation/proliferation

Question 13

Azothioprine blocks ___-______ proliferation, and carries side effects like ____ ______ suppression, increases risk for lymphoma and _______

Answer 13

-TCell
-bone marrow suppression
-tumors (malignancies)

Question 14

Basiliximab and daclizumab are _____-_____ ________

Answer 14

short-term immunosupressants

Question 15

OKT3 is a _________ immunosuppressant. MOA/side effects?

Answer 15

-powerful
-MOA: monoclonal antibody that prevents T cell function
-SFX: cytokine release syndrome, CV disease, hypertension