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Pharmacology III > DMARDs > Flashcards

DMARDs Flashcards

1
Q

TNF alpha is produced by _______ and stimulates production of_________

A

macrophages

prostaglandin

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2
Q

what are NSAIDs used for in chronic inflammatory disease?

A

tx of sx

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3
Q

DMARDs have what effect on chronic inflammatory diseases?

A

modify course of disease

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4
Q

do DMARDs have analgesic properties?

A

no

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5
Q

describe the onset of effects for DMARDs

A

generally weeks to months

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6
Q

Which DMARD?

suppress cellular immunity

causes bone marrow damage and enterocolitis

A

Gold Salts

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7
Q

This is a chelating DMARD that is effective in RA and Wilson’s disease

A

penicillamine

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8
Q

The below are the toxicities of…

  • high incidence of reaction
  • thrombocytopenia, leukopenia, agranulocytosis, aplastic anemia
  • lupus, pemphigus, goodpastures
  • nephrotic syndrome
A

penicillamine

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9
Q

This drug has antihistamine, anticholinesterase and antiprotease properties.

It stabilizes the lysosomes and reacts with nucleic acids/proteins

A

hydroxychloroquine

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10
Q

This drug:

  • inhibits prostaglandin synthesis
  • inhibits mucopolysaccharaide synthesis
  • inhibits chemotaxic responses and phagocytosis
A

hydroxychloroquine

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11
Q

The below are toxicities to which drug?

  • pruritis
  • hemolysis in G6PD
  • ototoxicity, retinopathy, peripheral neuropathy (cinchonism)
A

hydroxychloroquine

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12
Q

This is an IBD drug now used to treat RA.

it is better tolerated and as effective as older therapies…

A

sulfasalazine

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13
Q

how long must you monitor for hepatitis and marrow suppression when starting sulfasalazine?

A

2-3 weeks q 1st 3 months

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14
Q

TNF Alpha inhibitors are often combined with…

A

MTX

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15
Q

Which TNF Alpha inhibitor?

Chimeric

composed of human constant region

murine variable region

IgG1k mAb

A

infliximab

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16
Q

4 C/I for TNF alphas?

A

pregnancy, breast feeding, children, infx

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17
Q

route of admin for infliximab?

A

IV

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18
Q

infliximab is approved for…(2)

A

Chron Disease and RA

19
Q

Which TNF Alpha inhibitor?

IgG1

100% human derived

monotherapy for RA

A

adalimumab

20
Q

adalimumab is administered ________ and has a half-life of…

A

SC

8-10 days

21
Q

the below are S/Es for…

rash
flu sxs
fatigue
HA
pruritis
N/V
A

TNF-A inhibitors

esp. adalimumab

22
Q

2 “me too” drugs of adalimumab…

A

certrolizumab

golimumab

23
Q

Which TNF Alpha inhibitor?

dimeric fusion protein via recombinant DNA

acts as false TNF receptor

A

etenercept

24
Q

The below are contraindications of…

bone marrow suppression
breast feeding
children
DM
Infx
Sepsis
Vaccination
Varicella
A

etanercept

25
Q

2 inhibitors of B/T cells

A

rituxumab

abatacept

26
Q

Which T/B cell inhibitor?

chimeric mAb

IgG that binds to CD20 on B-Cells

A

Rituximab

27
Q

CD-20 is expressed on > 90% of B-Cells in _______

A

Non-Hodgkin Lymphoma

28
Q

Which T/B cell inhibitor?

fully human recombinant fusion protein

T-cell activation blocker

Competes w/ CD-28

A

Abatacept

29
Q

This drug disrupts key mechanisms of inflammation and joint destruction in RA

may also affect defenses against infx and malignancy via T cell inhibition

A

abatacept

30
Q

Inhibitor of nucleic acid synthesis…

A

leflunomide

31
Q

Which drug?

inhibits DHODH, enzyme that catalyzes de novo pyramidine synth

A

leflunomide

32
Q

Which drug?

inhibits the induction of COX-2

A

leflunomide

33
Q

route of leflunomide

A

PO

34
Q

3 C/Is for leflunomide

A

pregnancy
breast feeding

hepatic/renal failure

35
Q

Which drug?

inhibits lymphocyte purine synth by reversible inhibition of IMPDH

A

mycophenolate mofetil

36
Q

C/Is for mycophenolate mofetil… (5)

A 
Active GI disease
Diarrhea
Pregnancy
Breast Feeding
Infx
37
Q

IL-1 receptor antagonist…

A

anakinra

38
Q

mAb against IL-6 receptor.

compete w. IL-6 to bind

similar acts to other immunosuppressants

A

tocilizumab

39
Q

When should JAK inhibitors be considered?

A

severe RA w. intolerance to MTX

40
Q

Tofacitinib is what class?

A

JAK inhibitor

41
Q

tofacitinib can precipitate… (2)

A

malignancy & serious infx

42
Q

Which JAK inhibitor?

Primarily inhibits JAK1 and JAK3

A

Tofacitinib

43
Q

Which JAK inhibitor?

Primarily inhibits JAK1 and JAK2

A

Baricitinib

44
Q

This JAK inhibitor may be used as monotherapy or in combo w. MTX or other non-biologic DMARDs

A

baricitinib

Pharmacology III (15 decks)

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