Chapter 73 - Drugs for Rheumatoid Arthritis

Question 1

What does RA stand for, in regards to pharmacology and drug type?

Answer 1

Rheumatoid Arthritis

Question 2

What are the 4 goals of RA drug therapy?

Answer 2

1. Relief of symptoms
2. Maintaining function of joints
3. Minimizing systemic involvement
4. Delaying progression

Question 3

What are some Non-pharmacological therapies used to treat RA? (3)

Answer 3

1. Physical Therapy
2. Exercise
3. Surgery

Question 4

What occurs when an NSAID is taken to treat/relieve RA? (5)

Answer 4

1. Provide rapid relief of symptoms only
2. Does not prevent joint damage
3. Does not slow disease progression
4. Safer than glucocorticoids and DMARDs (Disease-Modifying Antirheumatic drgs)
5. Often combined with DMARD

Question 5

What occurs when a Glucocorticoid is taken to treat/relieve RA? (5)

Answer 5

1. Provides rapid relief of symptoms
2. Slows disease progression
3. Causes toxicity with long term use
4. Used primarily for short term use or temporary relief
5. Include prednisone and prednisolone

Question 6

What does DMARDs stand for?

Answer 6

Disease-Modifying Antirheumatic drugs

Question 7

Does a DMARD work faster or more slow than NSAIDs and Glucocorticoids? Are they more harmful?

Answer 7

DMARDs work more slowly and are potentially more harmful than NSAIDs and Glucocorticoids

Question 8

Which Nonbiologic or Biologic DMARDs is more expensive?

Answer 8

Nonbiologic

Question 9

Which is the fastest-acting DMARD? is it Non-biologic or Biologic?

Answer 9

Methotrexate - Non-biologic

Question 10

How long does it take for the DMARD Methotrexate to work to relieve RA?

What is Methotrexate Contraindicated with?

Answer 10

Works in about 3-6 weeks

Methotrexate is contraindicated with pregnancy

Question 11

What are the adverse effects of taking Methotrexate to relieve RA? (3)

Answer 11

1. Liver damage
2. Bone marrow presupposition
3. Gastric Ulcers including perforation

Question 12

What can occur with continued use of Methotrexate?

Answer 12

Continued use may lead to decreased life expectancy due to cardiovascular disease, possible infection, and cancer

Question 13

Which DMARD was originally used to treat inflammatory bowel disease?

Answer 13

Sulfasalazine

Question 14

Which DMARD has a slow progression of joint deterioration?

Answer 14

Sulfasalazine

Question 15

What are the adverse effects of the DMARD Sulfasalazine? (6)

Answer 15

1. N/V
2. Diarrhea
3. Pruritus
4. Rash
5. Urticaria
6. Hepatitis
7. Bone Marrow Supression

Question 16

What are the nursing considerations used while prescribing a patient with the DMARD Sulfasalazine? (3)

Answer 16

1. Enteric coated tablets should be used with GI upset
2. Doses can be divided with GI upset
3. Monitor for hepatitis and bone marrow suppression

Question 17

What occurs when the DMARD Etanercept is taken to relieve RA? (2)

Answer 17

1. Reduces RA Symptoms

2. Slows disease progression

Question 18

Which DMARD is administered subcutaneously, once a week?

Answer 18

Etanercept

Question 19

Which DMARD is contraindicated in patients with CNS disorders, heart failure, active infections, TB, HBV

Answer 19

Etanercept

Question 20

What are possible/potential adverse effects when taking the DMARD Etanercept to relieve RA? (9)

Answer 20

1. Infection
2. TB
3. Stevens-Johnson Syndrome (SIS)
4. Toxic Epidermal Necrolysis (TEN)
5. Heart failure
6. Cancer
7. Liver disease
8. CNS disorders (multiple sclerosis MS)
9. Usually used in combination with Methotrexate