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Musculoskeletal/Rheumatic > DMARDS - Treatment of Rheumatoid Arthritis > Flashcards

DMARDS - Treatment of Rheumatoid Arthritis Flashcards

1
Q

Firstline therapy for rheumatoid arthritis

A

Methotrexate (maybe with NSAID or corticosteroid)

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2
Q

MOA of methotrexate

A

Inhibition of AICAR transformylase; increased adenosine concentrations

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3
Q

Side effects of MTX

A

Myelosuppression, Cat X pregnancy, pulmonary toxicity; get CBC, LFT, renal analysis

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4
Q

MOA of sulfasalazine

A

Inhibitor of prostaglandins and leukotrienes

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5
Q

Side effects of sulfasalazine

A

Blood dyscasias; get CBC, LFT, renal analysis

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6
Q

MOA of Leflunomide

A

Inhibits dihydroorotate dehydrogenase (pyrimidine synthesis); cell cycle blocker

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7
Q

Side effects of leflunomide

A

Bone marrow dysplasia, immunodeficiency, Cat X pregnancy; need CBC, LFT, pregnancy test, serum electrolytes

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8
Q

MOA of hydroxychloroquine

A

Increase intracellular pH; reduced number of peptide-MHC II complexes

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9
Q

Side effects of hydroxychloroquine

A

Contraindicated in ocular disease - corneal opacities, keratopathy, retinopathy; CNS toxicity - ototoxicity, seizures; need CBC and opthalmalogic exam

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10
Q

Biologic DMARDS

A

Abatacept, adalimumab, anakinra, certolizumab, etanercept, golimumab, infliximab, rituximab, tocilizumab

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11
Q

Which biologic DMARDS are TNF-alpha inhibitors?

A

Adalimumab, Certolizumab, etancercept, golimumab, infliximab

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12
Q

Target of rituximab?

A

CD20 receptor on B cells

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13
Q

MOA of Abatacept

A

CTLA4 - precents T cell co-stimulation via CD28

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14
Q

Side effects of biologic DMARDS?

A

Immunosuppression (infections, URTIs, don’t give vaccines), increased risk of malignancies

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15
Q

Contraindication of infliximab?

A

CHF, hypotension/angina/dysrhythmia

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16
Q

Rare side effect of rituximab?

A

SJS/TEN

17
Q

Avoid pregnancy with this biologic…

A

Rituximab

18
Q

Blood dyscrasias in which biologics?

A

(CART) Certolizumab, Anakinra, Rituximab, Tocilimumab

19
Q

Lupus-like syndrome in which biologics?

A

(ACEI) Adalimumab, Certolizumab, Etanercept, Infliximab

Musculoskeletal/Rheumatic (6 decks)

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