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DMARDS + Gout Flashcards

1
Q

DMARDS take effect after ____ how many weeks/months of treatment

A

6 weeks to 6 months

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2
Q

___ inhibits AICAR transformylase AND thymidilate synthetase

A

Methotrexate

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3
Q

___ has a secondary effect on polymorphonuclear chemotaxis;

play a role in Wegener granulomatosis, Giant cell arteritis, vasculitis, dermatomyositis

A

Methotrexate

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4
Q

What is the DMARD of first choice in RA?

A

methotrexate

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5
Q

What is the rescue agent of methotrexate?

A

Leucovorin

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6
Q

Cite examples of TNF alpha inhibitors

A
  1. Adalimumab
  2. Certolizumab
  3. Etanercept
  4. Golimumab
  5. Infliximab
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7
Q

TNF alpha inhibitors are used in what diseases?

A

Crohn’s

RA

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8
Q

___ is a DMARD that forms 6-thioguanine, suppressing inosinic acid synthesis, Bcell and T cell function, Ig production, and IL2 secretion

A

Azathioprine

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9
Q

What antigout treatment is contraindicated with concommitant azathioprine therapy?

A

Allopurinol

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10
Q

When Azathioprine and Allopurinol are given simultaneously, what by product is bound to increase?

A

6 thioguanine nucleotides

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11
Q

A DMARD that suppresses Tlymphocytes to mitogens, decrease leukocyte chemotaxis, stabilize lysosomal enzymes, inhibit DNA and RNA synthesis, and trap free radicals

A

Chlorquine

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12
Q

Aside from malaria, Chlorquine/Hydrochlorquine is used in what diseases?

A

RA
SLE
Sjogren Syndrome

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13
Q

___ is a cancer chemotherapeutic drug that forms phosphoramide mustard leading to cross-linking of DNA to prevent cell replication

A

Cyclophosphamide

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14
Q

What is the rescue agent of cyclophosphamide?

A

MESNA

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15
Q

___ inhibits IL1 and IL2 receptor production AND secondarily inhibits macrophage Tcell interaction and T cell responsiveness

A

cyclosporine

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16
Q

What is the active product of mycophenolate mofetil?

A

Mycophenolic acid

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17
Q

___ inhibits inosine monophosphate dehydrogenase

A

mycophenolic acid

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18
Q

What is the enzyme that plays a role in guanine nucleotide synthesis?

A

Monophosphate dehydrogenase

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19
Q

This DMARD causes reversible myelosuppresion (neutropenia)

A

mycophenolate mofetil

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20
Q

What is the active metabolite of sulfasalazine?

A

sulfapyridine

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21
Q

The active metabolite of this drug inhibits the release of inflammatory cytokines

A

Sulfasalazine

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22
Q

What autoantibody is formed in sulfasalazine therapy?

A

anti-dsDNA

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23
Q

This DMARD causes reversible infertility in men

A

Sulfasalazine

24
Q

____ is a co-stimulator modulator. Inhibits the activation of Tcells by binding to CD80 and 86 of the APC

A

Abatacepts

Concomitant use of TNF alpha blocker is not recommended due to increased risk of infection

25
Q

___ is a non-biologic DMARD that inhibits dihydroorotate dehydrogenase leading to arrest of stimulated cells in the G1 phase of cell growth

A

Leflunomide

26
Q

What is the active metabolite of leflunomide which is converted in the intestines?

27
Q

This non-biologic DMARD is considered as effective as Methotrexate in treating RA

A

Leflunomide

28
Q

A monoclonal antibody that deplete B cells by cell-mediated and complement dependent cytotoxicity and stimulation of cell apoptosis

29
Q

This can be used in moderate to severe RA (with MTX) in patients with INADEQUATE response to TNF alpha

30
Q

This MAB binds to IL6 to d decrease Tcell activation acnd inflammatory process

A

Tocilizumab

31
Q

Prior to giving tocilizumab, patient should be screened for what disease entity?

A

Tuberculosis

32
Q

This MAB is not advised for patients with what disease of the large intestine?

A

diverticulitis

33
Q

___ inhibits macrophage function, inhibits macrophage function, decreases IL-1, decreases rheumatoid factor and prevents collagen from cross-linking

A

Penicillamine

34
Q

Wha is the JAK inhibitor used to treat RA

A

Tofacitinib

35
Q

___ is a sphingosine-1-phosphate receptor modulator used for multiple sclerosis

A

Fingolimod

36
Q

__ is a MAB against IL17 used for psoriasis and ankylosing spondylitis

A

Secukinumab

37
Q

__ is a MAB against IL2 used to prevent organ transplant rejection

A

Basiliximab

38
Q

___ ius a MAB against IL12 and IL23; used for crohns and psoriasis

A

Utsekinumab

39
Q

____antigout treatment that inhibits microtubule assembly and LTB4 production

A

Colchicine

40
Q

What is the drug of choice for familial mediterranean fever?

A

colchicine

41
Q

Gout treatment that can cause aplastic anenia, peripheral neuritis, and myopathy

A

Colchicine

42
Q

What NSAIDs also inhibit urate crystal phagocytosis?

A

indomethacin

43
Q

Antigout drug that is uricospric

A

Probenecid

44
Q

Probenecid competes with uric acid reabsorption in which part of the nephron?

A

proximal tubules

45
Q

Uricosoric and antigout agent that can cause nephrotic syndrome

A

probenecid

46
Q

Probenecid is advantageous in prolonging the therapeutic effect of this antibiotic by inhibiting its renal tubular secretion

A

penicillin

47
Q

what is the minimum GFR prior to starting probenecid

48
Q

Cite examples of urocosuric drugs

A
  1. Fenofibrate
  2. Losartan
  3. Probenecid
49
Q

What metabolite of allopurinol that irreversibly inhibits xanthine oxidase?

A

Alloxanthine

50
Q

Allopurinol cant be given with this antichemo drug

A

Azathioprine

51
Q

___ is a nonpurine reversible inhibitor of xanthine oxidase

A

febuxostat

52
Q

What is the first line treatment for chronic gout?

A

allopurinol

53
Q

What is the treatment for allopurinol intolerance?

A

febuxostat

54
Q

___ is derived from mamalian urate oxidse enzyme which converts uric acid to allantoid

A

Pegloticase

55
Q

Cite examples of IL-1 pathway inhibitors that are used for acute gout in patients with contraindication or refractory to traditional therapies

A
  1. Anakinra
  2. Canakinumab
  3. Rilonacept

Pharmacology (35 decks)

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