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Advanced Pharm Exam 4 > biologics > Flashcards

biologics Flashcards

1
Q

hydrocortisone glucocorticoid/mineralocorticoid activity

duration

A

high glucocorticoid, some mineralocorticoid

short-acting

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2
Q

dexamethasone glucocorticoid/mineralocorticoid activity

duration

A

some gluco, no mineralo

long acting

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3
Q

fludrocortisone glucocorticoid/mineralocorticoid activity

duration

A

no gluco, very high mineralo

long-acting

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4
Q

prednisone/methylprednisolone gluco/mineral

duration

A

moderate, moderate

intermediate-acting

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5
Q

glucocorticoid AEs

A

poorly tolerated

hyperglycemia
leukocytosis
HPA axis insufficiency
neuropsych effects
osteopenia
myopathy
fluid retention
gastritis
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6
Q

conventional synthetic DMARD examples & uses

A

methotrexate, leflunomide, sulfasalazine, hydroxychloroquine

RA

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7
Q

methotrexate uses

A

RA - first line, once weekly

IBD

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8
Q

conventional synthetic DMARDS AE

A

ALL - folic acid deficiency, bone marrow suppression, infection, hepatitis, teratogenic

methotrexate - stomatitis **folic acid supplementation reduces toxicity

lefluonomide - alopecia ** loooong half life

sulfasalazine - rash, SJS **avoid in pt w sulfa allergy

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9
Q

hydroxychloroquine use

A

used in RA for pt that are pregnant

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10
Q

hydroxychloroquine AE

A

ocular toxicitieies, increased skin pigmentation, QT PROLONGATION

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11
Q

JAK inhibitor AEs

A

infection, malignancy, THROMBOSIS, HLD

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12
Q

jak inhibitors examples

A

tofacitinib
baracitinib
upadacitinib

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13
Q

biologic meds characteristics

A 
produced by living cell cultures
large, complex, heavy molecules
complex structures
potentially immunogenic
unstable and sensitive to external conditions
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14
Q

-mab medications

A

monoclonal antibodies

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15
Q

-cept medications

A

soluble receptor antagonist

etanercept

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16
Q

biologics rule of thumb

A

update immunizations and screen before tx
avoid live vaccines
injectables (not oral!)
do not combine biologics

injection site rxn
IV infusion rxn
antidrug antibody formation

17
Q

TNF-a inhibitors

A 
etanercept
infliximab
adalimumab
golimumab
certolizumab pegol
18
Q

infliximab admin

A

give w methotrexate in RA

give w azathioprine or 6-mercantopurine in IBD

19
Q

golimumab admin

A

give w methotrexate in RA

20
Q

certolizumab pegol admin

A

give w polyethylene glycol to prolong half life and reduce immunogenicity

21
Q

TNF-a inhibitor AEs

A

HEART FAILURE!!!

malignancy, infection, anti-drug antibody formation (immunogenicity)

22
Q

CD20 monoclonal antibodies AEs

A

infusion/injection site rxn - premedicate w antihistamine/APAP/glucocorticoid

malignancy
infection (leukoencephalopathy)

23
Q

fumaric acids indications

24
Q

fumaric acids AE

A

gi upset/flushing

infections, pymphopenia

25
Q

S1PR modulators use

26
Q

S1PR AEs

A 
QT prolongation
bradyarrhythmia
HTN
macular edema
infection

CI in pt w hx of severe cardiac problem in past 6 mos

27
Q

S1PR modulators examples

A

fingolimod - higher incidence of QTprolong/brady - admin in clinc

siponimod
ozanimod

28
Q

induction immunosuppressants

A

glucocorticoids
basiliximab
antithymocyte immune globulin
alemtuzumab

29
Q

maintenance immunosuppression

A

calcineurin inhibitor, antiproliferative, glucocorticoid

tacro > cyclosporine
mycophenolate > azathioprine
prednisone

30
Q

cyclosporine/tacro AEs

A

nephrotox, tremor, HTN, HLD, hyperglc, gingival hyperplasia, hirsutism

tacro - hyperuricemia

titrated, many interax

31
Q

mycophenolate/azathioprine AE

A

bone marrow suppression

myco - diarrhea

azathioprine - hepatotox - varied metabolism TMPT

32
Q

RA mgmt

A

methotrexate
contraindication to methotrexate - leflunomide, sulfasalazine

short term glucocorticoids when initiating/changing csDMARDs

try another DMAD, then use bDMARD or tsDMARD

33
Q

types of MS

A

relapse-remitting - clearly defined relapses w full recovery or residual deficit upon recovery
secondary progressive - RRMS w steady deterioration of function
primary progressive - occasional plateaus w steady decline

34
Q

MS therapy efficacy

A

infusion therapy
oral therapy
injection therapy

35
Q

relapse remitting tx

A

any meds

poor prognosis - natalizumab, ocrelizumab, alemtuzumab

36
Q

secondary progressive MS tx

A

siponimod

or any DMT

37
Q

PPMS tx

A

oreclizumab

Advanced Pharm Exam 4 (13 decks)

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