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Parker Musculoskeletal Pharm > Biological DMARDs > Flashcards

Biological DMARDs Flashcards

1
Q

What are you worried about in giving any biological DMARD?

A

Infections! These drugs are immunosuppressors. Dont give them with active infections, and worry about getting infections or reactivating old ones (TB!)

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2
Q

What are the TNF-alpha blockers? What is their ADE?

A
  1. Adalimumab
  2. Etanercept
  3. Infliximab
  4. Golimumab
  5. Certolizumab pegol
    ADE: Malignancies
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3
Q

Adalimumab MOA?

A

TNF-alpha mAb. Binds TNF-alpha and blocks interaction with p55 and p75

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4
Q

Adalimumab ADE?

A

Lupus like symptoms (arthralgia, myalgia, fatigue, skin rash), CHF

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5
Q

Etanercept structure?

A

TNF-alpha receptor/Ab fusion protein.. p75 bound to IgG1

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6
Q

Etanercept ADE

A

Lupus-like symptoms

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7
Q

Infliximab structure/MOA

A

Chimeric TNF-alpha mAb; binds soluble and transmembrane TNF-alpha

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8
Q

Infliximab ADE

A

CHF, Lupus like symptoms, LFTs

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9
Q

Golimumab structure/MOA

A

Human derived mAb to TNF-alpha, has variable and constant regions; binds soluble and transmembrane TNF-alpha

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10
Q

Golimumab ADE

A

Blood dyscrasia, Lupus like symptoms

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11
Q

Certolizumab pegol structure/MOA

A

Fab fragment of humanized TNF-alpha Ab; binds soluble and transmembrane TNF-alpha

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12
Q

Certolizumab pegol ADE

A

Blood dyscrasia, Lupus-like symptoms

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13
Q

Abatacept structure/MOA

A

CTLA4/IgG1 fusion protein; blocks CD28 from activating T cells

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14
Q

Abatacept ADE

A

Contains maltose which can mess w/ blood glucose test

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15
Q

Rituximab structure/MOA

A

Chimeric CD20/IgG1k mAb. Kills B cells. Sensitization to cytotoxic tx in B-cell lymphoma

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16
Q

Rituximab ADE

A

CHF, Blood dyscrasia, toxic epidermal necrolysis, Steven Johnson, Contraindicated in pregnancy

17
Q

Anakinra structure/MOA

A

Recombinant IL-1 receptor antagonist –> decreases inflammatory response

18
Q

Anakinra ADE

A

Blood dyscrasia

19
Q

Tocilizumab structure/MOA

A

IL-6 receptor antagonist; binds to soluble and membrane bound IL-6 receptors –> decreases immune response regulator production

20
Q

Tocilizumab ADE

A

Blood dyscrasia, LFTs (get serum lipids too)

21
Q

Which biological DMARDs are administered SC?

A

Abatacept, Adalimumab, Anakinra, Certolizumab, Etancercpet, Bolimumab

22
Q

Which bio DMARDs are IV?

A

Abatacept, Infliximab, Rituximab, Tocilizumab

Parker Musculoskeletal Pharm (3 decks)

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