Biologic Response Modifying Drugs and Antirheumatic Drugs

Question 1

What is the most common monoclonal antibody drug

Answer 1

Belimumab

Question 2

Belimumab purpose, route of administration and length of administration

Answer 2

This drug is specifically for systemic lupus. It is administered via IV infusion and given slowly over one hour

Question 3

Adverse effects and complications of belimumab

Answer 3

Anaphylaxis is the main one. Diarrhea, fever, nausea. No live vaccines for 30 days

Question 4

What do DMARDs do?

Answer 4

Slow progression and relieve manifestations of rheumatoid arthritis

Question 5

What drugs are given for rheumatoid arthritis?

Answer 5

Methotrexate, adalimumab, gold salts, glucocorticoids, NSAIDs

Question 6

What is the most common glucocorticoid?

Answer 6

Prednisone

Question 7

What are glucocorticoids given for?

Answer 7

Provide relief for inflammation and pain and can also delay the progression of the disease. They are usually used short-term

Question 8

Complications of glucocorticoids

Answer 8

Risk for infection, osteoporosis, adrenal suppression, fluid retention, GI discomfort, hyperglycemia, hypokalemia

Question 9

Why are NSAIDs used and what is the most common one?

Answer 9

Anti inflammatory, analgesic, antipyretic and platelet inhibition. Aspirin

Question 10

Methotrexate

Answer 10

Folic acid antagonist, reduces folic acid and is an immunosuppressive.

Question 11

Adverse effects of methotrexate

Answer 11

Hepatotoxicity, bone marrow suppression

Question 12

Contraindication of methotrexate

Answer 12

Do not take during pregnancy as it can cause fetal death

Question 13

Erythropoietic drugs

Answer 13

Epoetin and Darbepoetin

Question 14

Epoetin adverse effects and what should a patient be expected to take with epoetin

Answer 14

Most patients receiving this will also receive iron. Hypertension, fever, headache, rash, arthralgia, injection site reaction.

Question 15

Effect of epoetin

Answer 15

Increases RBC production from bone marrow

Question 16

What needs to be monitored when giving epoetin

Answer 16

Blood pressure, iron levels, hemoglobin and hematocrit

Question 17

Filgrastim purpose

Answer 17

Stimulates bone marrow to make more neutrophils and decreases risk of infection for clients with cancer

Question 18

Complications of filgrastim

Answer 18

bone pain, leukocytosis (high level of WBCs), splenomegaly

Question 19

What needs to be monitored when giving filgrastim

Answer 19

Complete blood count twice per week, and absence of infection is how to monitor effectiveness

Question 20

Sargramostim purpose

Answer 20

Increases production of WBCs

Question 21

Sargramostim complications

Answer 21

Tachycardia, leukocytosis, diaphoresis (excessive sweating)

Question 22

What needs to be monitored when giving sargramostim

Answer 22

Monitor CBC, differential and platelet count. IV infusion can cause dyspnea. Effectiveness measure is same as filgrastim (absence of infection)

Question 23

What is the oral form of iron

Answer 23

Ferrous salts (specifically ferrous sulfate)

Question 24

What is the IV form of iron

Answer 24

Ferrous dextran

Question 25

When is iron given

Answer 25

Deficiency, iron-deficient anemia, when RBCs are needed due to blood loss.

Question 26

Complications of iron

Answer 26

Taken with a straw to avoid teeth staining. Anaphylaxis needs to be monitored especially for IV so monitor with a test dose.

Question 27

Folic acid

Answer 27

Essential for erythropoiesis (production of RBCs).

Question 28

When is folic acid used

Answer 28

When folic acid deficiency or given during pregnancy to avoid neural tube defects

Question 29

What drugs should be avoided when taking folic acid

Answer 29

Methotrexate and sulfonamides