Connective Tissue [RA, Gout, OA] Flashcards
RA, OA, Gout
colchinine is for
gout/gouty arthritis
colchinine
MOA
treats inflammation
**colchinine
Tx
for ACUTE ATTACKS
-often along w NSAIDs
colchinine
AE
- GI toxicity
- NVD
- rhabdomyolysis
- thrombocytopenia
- bone marrow suppression
colchinine
CI
I
**colchinine
RN
DONT DRINK GRAPEFRUIT JUICE
DO INCR FLUIDS
- take w food
- monitor for pink/red urine
- monitor for muscle pain
- report bruising or sore throat
CHRONIC gout meds
allopurinol
febuxostat
probenecid
allopurinol, febuxostat, probenecid
MOA
- treats hyperURICEMIA
- protects kidneys
*allopurinol, febuxostat, probenecid
Tx
CHRONIC GOUT
-before chemo
allopurinol
AE
- hypersensitivity rxn
- kidney injury
- hepatitis
- NV
probenecid
AE
- renal calculi
- NV
- reaction
allopurinol
RN/teaching
patient may experience increase attacks during 1st month
-notify physician
probenecid
RN/teaching
dont take ASA
dont take w/in 3 weeks of acute attack
take med w meals
*allopurinol, febuxostat, probenecid
RN/teaching
AVOID HIGH PURINE FOODS [ETOH, red meats]
allopurinol: may experience increase attacks during 1st month
- notify physician
probenecid: DONT take w ASA, DONT take w/in 3 weeks of acute attack, DO take w meals
fibromyalgia
drugs
duloxetine, pregabalin, gabapentin
duloxetine, pregabalin, gabapentin
MOA
INCR GABA (inhibitory neurotransmitter)
***duloxetine, pregabalin, gabapentin
Tx
fibromyalgia
PERIPHERAL NEUROPATHY
Psych
duloxetine, pregabalin, gabapentin
AE
- drowsiness,
- dizzy,
- serotonin syndrome,
- WD,
- sex dysfunction,
- anorgasmic,
- anorexia
pregabalin, gabapentin: DROWSINESS, dizzy, consti[ation, ab pain, wt gain, angioedema, rhabdo, ED
pregabalin, gabapentin
AE
- DROWSINESS
- dizzy
- constipation
- ab pain
- wt gain
- angioedema
- rhabdo
- ED
duloxetine, pregabalin, gabapentin
CI
SNRI - MAO/I
caution w SSRIs
duloxetine, pregabalin, gabapentin
RN
- SNRI- monitor for suicidal ideation
- taper off
DMARDS stands for
Disease-modifying antirheumatic drugs
DMARDS
Tx
**rheumatoid arthritis
other uses: chemo + transplants
most DMARDs takes ___ to start working
3-6wk
DMARD I
drugs
- methotrexate [MTX]
- hydroxychloroquine
sulfasalazine
minocycline
methotrexate [MTX]
- immunosuppressant
- for RA [DMARD I]
- 1st line med
methotrexate [MTX]
AE
- HEPATIC FIBROSIS (NO ETOH!!!)
- bone marros suppression
- category X
- stomatitis
- oral/GI ulcers
- mild alopecia
if rheumatoid arthritis patient is taking MTX and is experiencing mild alopecia, you can give them ____
folic acid supplements
methotrexate [MTX]
RN/teaching
- takes 8 wks to work
- bloodwork Qmonthly
- leucovorin
- drink 2L water per day
hydroxychloroquine
anti-malarial
-for RA [DMARD I]
hydroxychloroquine
AE
blindness
photosensitivity
hydroxychloroquine
PT
baseline eye exam then Q6mo
sulfasalazine
anti-inflammatory
-for RA [DMARD I]
sulfasalazine
AE
bone marrow suppression
hepatotoxic
sulfasalazine
CI
sulfa allergy
minocycline
tetracycline
-for RA [DMARD I]
types of DMARDS
DMARD I - nonBIOLOGIC
DMARD II - BIOLOGIC
DMARD III
DMARD II
drugs
1 adalimumab 2 etanercept 3 infliximab 4 rituximab 5 IL-1vanakinra, IL-2
adalimumab, etanercept, infliximab
TNF antagonist
-for RA [DMARD II]
adalimumab, etanercept, infliximab
AE
- pancytopenia
- HF
- SJS
- anaphylaxis
- infection
- CA
- TB reactivation
adalimumab, etanercept, infliximab
RN/teaching
-need TB test prior bc TB reactivation
infliximab is IV - sharp teaching
adalimumab is SQ
rituximab
B lympocyte depletor
-for RA [DMARD II]
DMARD III drug
cyclosporine
cyclosporine
immunosuppressant -for RA [DMARD III] *used as last resort bc big toxicities -frequently used in transplant patients ***EYEDROPS FOR MORE TEARS CATEGORY X!!!
cyclosporine
AE
NEPHROTOXIC HEPATOTOXIC GINGIVAL HYPERPLASIA hirsutism CATEGORY X!!!!
cyclosporine
CI
category X
no grapefruit juice
no recent live vaccines
DMARDs are often paired with…
NSAIDs + steroids bc DMARD’s long onset
also given folic acid + leucovorin prophylactically
