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PA30245 Infection and Immunity > Dampening the inflammatory response > Flashcards

Dampening the inflammatory response Flashcards

1
Q

The presence of what facilitates response to self antigen in joints?

A

Tissue damage
APCs
Cytokines

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2
Q

What is 1st line treatment for RA?

A

NSAIDs

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3
Q

What is 2nd line treatment for RA?

A

DMARDS

Disease modifying anti rheumatic drugs

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4
Q

Name some examples of DMARDS

A 
Methotrexate
Sulfasalazine
Gold
Penicillamine
Hydroxychloroquine
Leflunomide
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5
Q

Are DMARDs slow or quick acting?

A

Slow

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6
Q

When are DMARDs recommended?

A

Early in disease process

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7
Q

What is methotrexate?

A

Folate antagonist

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8
Q

How does methotrexate work?

A

Anti-proliferative effect via inhiition of drihydrofolate reductase

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9
Q

What was methotrexate originally introduced as?

A

Anti-tumour agent

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10
Q

Is methotrextae effective in RA in high or low doses?

A

Low

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11
Q

Can resistance to methotrexate develop?

A

Yes

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12
Q

What are the side effects of methotrexate

A

Depression of bone marrow.

GI tract damage.

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13
Q

What is sulphasalazine used to treat?

A

RA

IBD

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14
Q

What does penicillamine cause?

A

Decreased joint swelling, RF and concentration of APP

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15
Q

What does penicillamine prevent maturation of?

A

Newly synthesised collagen

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16
Q

What are the side effects of penicillamine?

A

Taste disturbances, rashes, thrombocytopenia, autoimmune disease

17
Q

What is hydroxychloroquine used mainly to treat?

A

Malaria

18
Q

What does hydroxychloroquine do?

A

Induce remission but doesnt retard progression of bone damage.
Reduces joint swelling and decreases RF.

19
Q

What does leflunomide do?

A

Inhibits orotate dehydrogenase

20
Q

What is it thought DMARDs do?

A

Inhibit macrophage activation.
Inhibit cell proliferation.
Decrease release of pro-inflammatory cytokines and reactive oxygen species.

21
Q

What is 3rd line treatment for RA?

A

Steroids

22
Q

When do we use steroids in RA?

A

During flare upas

23
Q

What is 3rd/4th line treatment for RA?

A

Biologicals

24
Q

Name 2 biologicals used in RA

A

Infliximab

Adalimumab

25
Q

When is Adalimumab advised to be given?

A

When pts have failed to respond to DMARD and other a-TNF

PA30245 Infection and Immunity (30 decks)

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