DMARDs Flashcards
1
Q
Gold Salts MOA (7)
A
- SUPPRESS CELLULAR IMMUNITY - Inhibit phagocytosis - Uncouple oxidative phosphorylation and inhibit cellular respiration - Stabilize lysosomal membranes and inhibit actions of lysosomal enzymes - React with proteins - Inhibit proteolytic enzymes of leukocytes - Prevent prostaglandin synthesis
2
Q
Gold Salts SE (5)
A
- BONE MARROW DAMAGE - Dermatitis - ENTEROCOLITIS - Jaundice - Peripheral neuropathy
3
Q
Penicillamine MOA (2)
A
- unknown, resembles gold and may be as effective - Chelating drug
4
Q
Penicillamine SE (5)
A
- Pruritis, rash - Alteration in taste - Thrombocytopenia, leukopenia, agranulocytosis, aplastic anemia - Proteinurina, hypoalbumin, nephrotic syndrome - Lupus like dz, pemphigus, Goodpastures, Myasthenia gravis, polymyositis, stenosing alveolitis
5
Q
Hydroxychloroquine MOA (6)
A
- Antihistaminic, anticholinesterase, antiprotease - Inhibits prostaglandin synthesis - Inhibits biosynth of mucopolysaccharide - Inhibits response to chemotactic stimuli and phagocytosis - Stabilizes lysosomes - Reacts with nucleic acids and tissue proteins
6
Q
Hydroxychloroquine SE (5)
A
- Pruritis - Hemolysis (G6PD deficient) - Ototoxicity - Retinopathy - Peripheral neuropathy
7
Q
Sulfasalazine Tx
A
- RA - IBD
8
Q
Sulfasalazine SE (3)
A
- GI disturbances - Rash - Hepatitis and dyscrasias rare - Monitoring for hepatitis and marrow suppression rec.
9
Q
Agents acting on TNa (5)
A
- Infliximab - Adalimumab - Certrolizumab pegol - Golimumab - Etanercept
10
Q
Infliximab MOA (2)
A
- Chimeric IgG1k monoclonal antibody targeted against TNFa - Human constant and murine variable regions
11
Q
Infliximab Tx (2)
A
- Crohns - RA - Combined with methotrexate
12
Q
Infliximab Admin
A
IV
13
Q
Infliximab SE (2)
A
- HA - Infusion rxn
14
Q
Infliximab CI (4)
A
- Pregnancy - Breast feeding - Children - Infections
15
Q
Adalimumab MOA (3)
A
- Recombinant human IgG1 monoclonal antibody - Human derived heavy and light chain variable regions and human IgG1:k constant regions (100% HUMAN PEPTIDE SEQ) - Specific for TNFa
16
Q
Adalimumab Tx
A
- Monotherapy RA
17
Q
Adalimumab Admin and t 1/2
A
- SC - 8- 10days
18
Q
Adalimumab SE (6)
A
- Rash - Influenza-like s/s - Fatigue - HA - Pruritis - N/V
19
Q
Certrolizumab pegol MOA
A
- Humanized antibody neutralizer of TNFa
20
Q
Golimumab MOA
A
- Human derived monoclonal antibody with human-derived variable and constant regions TNFa
21
Q
Entanercept MOA (3)
A
- Dimeric fusion protein produced by recombinant DNA technology - Consists of extracellular ligand-binding portion of the human 75 kilodalton TNF RECEPTOR linked to the Fc portion of human IgG1 - Inhibits TNF
22
Q
Entanercept Admin
A
- SC
23
Q
Entanercept SE (3)
A
- Injection site rxn - Infections - Increased incidence of antibody formation
24
Q
Entanercept CI (8)
A
- Bone marrow suppression - Breast feeding - Children - DM - Infection - Sepsis - Vaccination - Varicella
25
Q
Inhibitors of B cell differentiation and T cell activation (2)
A
- Rituximab - Abatacept
26
Q
Rituximab MOA
A
- Genetically engineered CHIMERIC murine/human monoclonal antibody - IgG immunoglobulin containing murine light and heavy chain variable regions and human constant regions - Binds specifically to CD20 a B LYMPHOCYTE DIFFERENTIATION ANTIGEN on pre-B and mature B lymphocytes
27
Q
Rituximab Admin
A
IV
28
Q
Rituximab Tx (3)
A
- non-Hodgkin lymphoma - refractory B cell NHL - B cell malignancies like chronic lymphocytic leukemia
29
Q
Abatacept MOA (3)
A
- FULLY HUMAN recombinant fusion protein categorized as a costimulatory or second-signal blocker of T cell activation - Competes with CD28 (on T cell) for CD80 and CD86 (on APC) - Disturbs key mech of inflammation and progressive joint destruction in RA
30
Q
Abatacept Admin and t 1/2
A
- IV - 13.1 days
31
Q
Inhibitors of Nucleic acid synthesis (2)
A
- Leflunomide (pyrimidine) - Mycophenolate mofetil (purine)
32
Q
Leflunomide MOA (3)
A
- Inhibits DHODH to stop de novo PYRIMIDINE synth - 2ndary, inhibition of cytokine and growth factor receptor associated tyrosine kinase activity - INHIBITS THE INDUCTION OF COX 2
33
Q
Leflunomide Admin and t 1/2
A
- Oral - 16 hrs
34
Q
Leflunomide SE (4)
A
- Diarrhea, dyspepsia, N/V - Abd pain, anorexia, wt loss, oral ulceration - Back pain - Elevated hepatic enzymes
35
Q
Leflunomide CI (4)
A
- Pregnancy - Breast feeding - Hepatic failure - Renal failure
36
Q
Mycophenolate mofetil MOA
A
- Prodrug for the immunosuppresive agent mycophenolic acid (MPA) - INHIBITS LYMPHOCYTIC PURINE SYNTHESIS by reversible and noncompetitively inhibiting the enzyme IMPDH
37
Q
Mycophenolate mofetil Admin
A
- Oral - IV
38
Q
Mycophenolate mofetil SE
A
- D/V - GI bleed
39
Q
Mycophenolate mofetil CI
A
- Active GI bleed - Diarrhea - Pregnancy - Breast feeing - Infections
40
Q
Interleukin Receptor Antagonists (2)
A
- Anakinra - Tocilizumab
41
Q
Anakinra MOA (1)
A
- Recombinant, nonglycosylated form of human INTERLEUKIN-1 RECEPTOR ANTAGONIST
42
Q
Anakinra Admin and t 1/2
A
- SC - 4 - 6hrs
43
Q
Anakinra CI (4)
A
- Breast feeding - Children - Hypersensitivity rxn - Renal dz (eliminated renally)
44
Q
Tocilizumab MOA
A
- Humanized interleukin-6 receptor inhibiting monoclonal antibody - Competes with IL6 for binding to receptor
45
Q
Janus Kinase Inhibitors (1)
A
- Tofacitinib
46
Q
Tofacitinib MOA (1)
A
- Primarily inhibits JAK1 and JAK3
47
Q
Tofacitinib Tx
A
- Adults with mod to severe RA who have inadequate response or INTOLERANCE TO METHOTREXATE
48
Q
Tofacitinib SE
A
- SERIOUS INFECTIONS AND MALIGNANCY
49
Q
Tofacitinib Admin and t 1/2
A
- Oral - 3 hrs
50
Q
Penicillamine Tx (2)
A
- RA - WILSONS Dz
