Connective Tissue [RA, Gout, OA]

Question 1

colchinine is for

Answer 1

gout/gouty arthritis

Question 2

colchinine

MOA

Answer 2

treats inflammation

Question 3

**colchinine

Tx

Answer 3

for ACUTE ATTACKS

-often along w NSAIDs

Question 4

colchinine

AE

Answer 4

• GI toxicity
• NVD
• rhabdomyolysis
• thrombocytopenia
• bone marrow suppression

Question 5

colchinine

CI

Answer 5

I

Question 6

**colchinine

RN

Answer 6

DONT DRINK GRAPEFRUIT JUICE
DO INCR FLUIDS

• take w food
• monitor for pink/red urine
• monitor for muscle pain
• report bruising or sore throat

Question 7

CHRONIC gout meds

Answer 7

allopurinol
febuxostat
probenecid

Question 8

allopurinol, febuxostat, probenecid

MOA

Answer 8

• treats hyperURICEMIA

- protects kidneys

Question 9

*allopurinol, febuxostat, probenecid

Tx

Answer 9

CHRONIC GOUT

-before chemo

Question 10

allopurinol

AE

Answer 10

• hypersensitivity rxn
• kidney injury
• hepatitis
• NV

Question 11

probenecid

AE

Answer 11

• renal calculi
• NV
• reaction

Question 12

allopurinol

RN/teaching

Answer 12

patient may experience increase attacks during 1st month

-notify physician

Question 13

probenecid

RN/teaching

Answer 13

dont take ASA
dont take w/in 3 weeks of acute attack
take med w meals

Question 14

*allopurinol, febuxostat, probenecid

RN/teaching

Answer 14

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

Question 15

fibromyalgia

drugs

Answer 15

duloxetine, pregabalin, gabapentin

Question 16

duloxetine, pregabalin, gabapentin

MOA

Answer 16

INCR GABA (inhibitory neurotransmitter)

Question 17

***duloxetine, pregabalin, gabapentin

Tx

Answer 17

fibromyalgia
PERIPHERAL NEUROPATHY
Psych

Question 18

duloxetine, pregabalin, gabapentin

AE

Answer 18

• drowsiness,
• dizzy,
• serotonin syndrome,
• WD,
• sex dysfunction,
• anorgasmic,
• anorexia

pregabalin, gabapentin: DROWSINESS, dizzy, consti[ation, ab pain, wt gain, angioedema, rhabdo, ED

Question 19

pregabalin, gabapentin

AE

Answer 19

• DROWSINESS
• dizzy
• constipation
• ab pain
• wt gain
• angioedema
• rhabdo
• ED

Question 20

duloxetine, pregabalin, gabapentin

CI

Answer 20

SNRI - MAO/I

caution w SSRIs

Question 21

duloxetine, pregabalin, gabapentin

RN

Answer 21

• SNRI- monitor for suicidal ideation

- taper off

Question 22

DMARDS stands for

Answer 22

Disease-modifying antirheumatic drugs

Question 23

DMARDS

Tx

Answer 23

**rheumatoid arthritis

other uses: chemo + transplants

Question 24

most DMARDs takes ___ to start working

Answer 24

3-6wk

Question 25

DMARD I | drugs

Answer 25

* methotrexate [MTX] * hydroxychloroquine sulfasalazine minocycline

Question 26

methotrexate [MTX]

Answer 26

- immunosuppressant - for RA [DMARD I] - 1st line med

Question 27

methotrexate [MTX] | AE

Answer 27

- HEPATIC FIBROSIS (NO ETOH!!!) - bone marros suppression - category X - stomatitis - oral/GI ulcers - mild alopecia

Question 28

if rheumatoid arthritis patient is taking MTX and is experiencing mild alopecia, you can give them ____

Answer 28

folic acid supplements

Question 29

methotrexate [MTX] | RN/teaching

Answer 29

- takes 8 wks to work - bloodwork Qmonthly - leucovorin - drink 2L water per day

Question 30

hydroxychloroquine

Answer 30

anti-malarial | -for RA [DMARD I]

Question 31

hydroxychloroquine | AE

Answer 31

blindness | photosensitivity

Question 32

hydroxychloroquine | PT

Answer 32

baseline eye exam then Q6mo

Question 33

sulfasalazine

Answer 33

anti-inflammatory | -for RA [DMARD I]

Question 34

sulfasalazine | AE

Answer 34

bone marrow suppression | hepatotoxic

Question 35

sulfasalazine | CI

Answer 35

sulfa allergy

Question 36

minocycline

Answer 36

tetracycline | -for RA [DMARD I]

Question 37

types of DMARDS

Answer 37

DMARD I - nonBIOLOGIC DMARD II - BIOLOGIC DMARD III

Question 38

DMARD II | drugs

Answer 38

``` 1 adalimumab 2 etanercept 3 infliximab 4 rituximab 5 IL-1vanakinra, IL-2 ```

Question 39

adalimumab, etanercept, infliximab

Answer 39

TNF antagonist | -for RA [DMARD II]

Question 40

adalimumab, etanercept, infliximab | AE

Answer 40

- pancytopenia - HF - SJS - anaphylaxis - infection - CA - TB reactivation

Question 41

adalimumab, etanercept, infliximab | RN/teaching

Answer 41

-need TB test prior bc TB reactivation infliximab is IV - sharp teaching adalimumab is SQ

Question 42

rituximab

Answer 42

B lympocyte depletor | -for RA [DMARD II]

Question 43

DMARD III drug

Answer 43

cyclosporine

Question 44

cyclosporine

Answer 44

``` immunosuppressant -for RA [DMARD III] *used as last resort bc big toxicities -frequently used in transplant patients ***EYEDROPS FOR MORE TEARS CATEGORY X!!! ```

Question 45

cyclosporine | AE

Answer 45

``` NEPHROTOXIC HEPATOTOXIC GINGIVAL HYPERPLASIA hirsutism CATEGORY X!!!! ```

Question 46

cyclosporine | CI

Answer 46

category X no grapefruit juice no recent live vaccines

Question 47

DMARDs are often paired with...

Answer 47

NSAIDs + steroids bc DMARD's long onset also given folic acid + leucovorin prophylactically