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Pharmacology > DMARDs > Flashcards

DMARDs Flashcards

1
Q

What are glucocorticoids usually used for in RA

A

Bridge agent while other DMARDs become effective

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2
Q

What is the most popular DMARD

A

Methotrexate

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3
Q

Pharmakokineteics of Methotrexate

A

Oral, or injection once per week (possible hepatotoxicity)

May take 4-6 weeks to become effective.

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4
Q

Methotrexate MOAs (3)

A
  1. “anti-metabolite” to inhibit purine synthesis (folate), side effects
  2. Inhibits AICAR transformylase leading to increased adenosine release which is anti-inflammatory
  3. Inhibits pyrimidine synthesis which inhibits proliferation of inflammatory cells
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5
Q

Major side effect of Methotrexate

A

Hepatotoxicity

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6
Q

Least effective of the DMARDs

A

Hydroxychloroquine

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7
Q

Possible mechanism of hydroxychloroquine anti-inflammatory effects

A

altering cellular pH

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8
Q

Pharmacokinetics of Hydroxychloroquine

A

Oral, once daily. Long half life (45 days)

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9
Q

Clinical use of Hydroxychloroquine

A

often combined with other DMARDs

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10
Q

Side effects of Hydroxychloroquine

A

Short term: GI and skin problems

Long term: retinal damage and decrease blood glucose.

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11
Q

Which DMARDs can be used in pregnant patients

A

hydroxycholorquine

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12
Q

Which DMARD is metabolized to a salicylate

A

Sulfasalazine

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13
Q

What are the two metabolites of Sulfasalazine

A

salicylate and slufapyridine

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14
Q

Which DMARD has a chance of blood dyscrasias, which can be fatal

A

Sulfasalazine

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15
Q

What three drugs are part of triple drug therapy

A

Methotrexate, Hydroxychloroquine, Slufasalazine

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16
Q

General properties of Leflunomide

A

inhibits pyrimidine synthesis, tyrosine kinases

inhibits T-cell proliferation and auto-antibody formation

17
Q

Which DMARD requires wash out before pregnancy

A

Leflunomine

18
Q

Which DMARD inhibits matrix metalloproteinases, including collagenase

A

Minocycline

19
Q

Biologic DMARD that is a subunit of the TNF receptor

A

Entercept

20
Q

Biologic DMARD that is a partially humanized mouse antibody against TNF

A

Infliximab

21
Q

Biologic DMARD that is a fully humanized antibody against TNF

A

Adalimumab

22
Q

What are the two biologic DMARDs that target immune cells directly and what are their targets

A

Abatacept targets T-cell activation

Rituximab is an antibody that inhibits B cell activation

23
Q

Which DMARD is most likely to cause eye damage

A

hydroxychloroquine

24
Q

Which DMARD can cause liver damage

A

Methotrexate

Pharmacology (35 decks)

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