Biologics

Question 1

conventional DMARDS

Answer 1

methorexate
leflunomide
hydroxychloroquine
sulfasalazine
azathioprine

Question 2

first line RA treatment

Answer 2

methotrexate

Question 3

inhibition of dihydrofolate

Answer 3

methotrexate

Question 4

give folic acid with

Answer 4

methotrexate

Question 5

mechanism: methotrexate

Answer 5

increases adenosine release from cell walls

Question 6

administration: methotrexate

Answer 6

oral or subcutaneous weekly does

Question 7

adverse effects: methotrexate

Answer 7

oral ulcers, GI, cytopenia, liver toxicity, teratogen

Question 8

inhibition of dihydroorotate dehydrogenase

Answer 8

leflunomide

Question 9

prodrug, enterohepatocyte circulation gives longer half life

Answer 9

leflunomide

Question 10

administation: leflunomide

Answer 10

oral

Question 11

adverse effects: leflunomide

Answer 11

diarrhea, cytopenias, hepatotoxicity, teratogen

Question 12

inhibits TLRs
inhibits acidification of lysosomes

Answer 12

hydroxychloroquine

Question 13

administration: hydroxychloroquine

Answer 13

oral

Question 14

adverse effects: hydroxychloroquine

Answer 14

rare retinal toxicity

Question 15

sulfapyridine is active moiety

Answer 15

sulfasalazine

Question 16

administration: sulfasalazine

Answer 16

oral

Question 17

adverse effects: sulfasalazine

Answer 17

rash, GI upset, hepatotoxicity, cytopenias

Question 18

purine synthesis inhibitor

Answer 18

azathioprine

Question 19

administration: azathioprine

Answer 19

oral

Question 20

adverse effects: azathioprine

Answer 20

cytopenias, rash GI upset, pancreatitis

Question 21

TNF inhibitors

Answer 21

biologics

reduce joint inflammation and damage to joints

Question 22

administration: etanercept

Answer 22

subcutaneous

Question 23

mechanism: etanercept

Answer 23

binds TNF and blocks its interaction with cell surface receptors

Question 24

administration: adalimumab

Answer 24

subcutaneous

Question 25

mechanism: adalimumab

Answer 25

human monoclonal antibody directed to TNF

Question 26

administration: certolizumab

Answer 26

subcutaneous

Question 27

mechanism: certolizumab

Answer 27

Fab fragment of humanized monoclonal antibody directed at TNF

Question 28

mechanism: golimumab

Answer 28

human monoclonal antibody directed to TNF

Question 29

administration: golimumab

Answer 29

subcutaneous

Question 30

mechanism: infliximab

Answer 30

chimeric monoclonal antibody against TNF

Question 31

administration: remicade

Answer 31

infusion

Question 32

humanized monoclonal antibody targeting IL-6

Answer 32

tocilizumab

Question 33

administration: tocilizumab

Answer 33

subq or IV

Question 34

antagonist of IL-1 receptor

Answer 34

anakinra **not terribly effective against RA

Question 35

binds CD80/86 on APCs blocking the interaction of CD28

Answer 35

abatacept

Question 36

t cells cannot be activated

Answer 36

abatacept

Question 37

administration: abatacept

Answer 37

subq or IV

Question 38

monoclonal antibody directed against CD20

Answer 38

rituximab

Question 39

result is depletion of B cells, but not plasma cells

Answer 39

rituximab

Question 40

administration: rituximab

Answer 40

IV

Question 41

Tofacitinib, Baricitinib, Upadacitinib mechanism

Answer 41

JAK inhib

Question 42

administration: Tofacitinib, Baricitinib, Upadacitinib

Answer 42

oral

Question 43

treat to target

Answer 43

utilize disease activity scores to adjust therapy

Question 44

triple therapy

Answer 44

methotrexate, sulfasalazine, hydroxychloroquine

Question 45

methotrexate leflunomide tocilizumab sarilumab abatacept rituximab Jak inhibs

Answer 45

all teratogens

Question 46

cheaper

Answer 46

DMARDS methotrexate leflunomide hydroxychloroquine sulfasalazine