Drugs

Question 1

methotrexate

Answer 1

DMARD 2.5 mg tab, max 10 tab.

Question 2

sulfasalazine

Answer 2

DMARD azulfidine

0.5g-1g PO divided daily, max 4g daily

Question 3

plaquenil

Answer 3

DMARD hydroxychloroquine
200mg tabs daily
max 400mg daily

Question 4

arava

Answer 4

DMARD leflunomide

max 20 mg daily

Question 5

imuran

Answer 5

DMARD azathioprine
1mg/kg daily (can divide BID)
max 2.5mg daily

Question 6

enbrel

Answer 6

TNF Inhibitor
Etanercept
SQ weekly

Question 7

Humira

Answer 7

TNF Inhibitor
Adalimumab
SQ every 2 weeks
can increase to weekly

Question 8

Simponi

Answer 8

TNF Inhibitor
Golimumab
SQ monthly

Question 9

Simponi Aria

Answer 9

TNF Inhibitor
Golumumab
- RA indication only
IV 2mg/kg at 0, 4, then every 8 weeks (first one, one month later, then every 2 months)

Question 10

Cimzia

Answer 10

TNF Inhibitor

Certolizumab pegol

Question 11

Remicade

Answer 11

TNF Inhibitor
Infliximab
IV 3mg/kg at 0,2,6 weeks then every 4-8 weeks,
max 10mg/kg every 4-8 weeks

Question 12

Actemra

Answer 12

Tocilizumab
IL - 6 antagonist
IV 8mg/kg q4 weeks
Start: IV 4mg/kg with max 800mg or SQ 162 mg weekly
if weight <100kg start q 2 weeks.

Question 13

kinaret

Answer 13

anakinra
IL 1 antagonist
SQ 100mg daily

Question 14

Ritxan

Answer 14

Rituximab
B cell antagonist
IV 1000mg every 2 weeks in 2 doses, repeat every 16-24 weeks.
give with solumedrol and zyrtec to combat infusion rxn.

Question 15

Zeljanz

Answer 15

tofacitinib
JAK antagonist
5mg BID PO or 11mg daily

Question 16

Orencia

Answer 16

abatacept
decreases immature T cell activation
weight based dosing
-IV <60kg: 500mg on weeks 0, 2, 4; then every 4 weeks
-IV 60-100kg: 750mg on weeks 0, 2, 4; then every 4 weeks
-IV 100kg: 1000mg on weeks 0, 2, 4; then every 4 weeks
-SQ 125mg weekly after loading dose according to the above IV guidelines

Question 17

Fosamax

Answer 17

alendronate
inhibits osteoclast bone resorption
70mg weekly PO

Question 18

Actonel

Answer 18

Risedronate
inhibits osteoclast bone resorption
35mg weekly PO

Question 19

Boniva

Answer 19

Ibandronate
Inhibits osteoclast bone resorption
150mg monthly PO

Question 20

Evista

Answer 20

Raloxifene
SERM = estrogen agonist, prevents bone loss
60mg daily PO

Question 21

Prolia

Answer 21

denosumab
Binds to RANKL to prevent osteoclast formation
SQ 60mg every 6 months

Question 22

gabapentin

Answer 22

neurontin
binds to alpha2 delta 1 subunit on calcium channels in the brain to decrease excitatory neurotransmitter responsible for pain perception (nocioception)
PO 300-1200 TID, max 3600 daily
taper for d/c

Question 23

lyrica

Answer 23

pregabalin
PO 75mg BID
max 450mg

Question 24

topamax

Answer 24

topiramate
blocks sodium channels, glutamate, and cabonic anhydrase. enhances GABA,
25mg BID PO
max 100mg BID

Question 25

cymbalta

Answer 25

duloxetine SNRI, mild inhibits DOPA reuptake, 30mg daily x 1 week, then max 60mg daily taper for d/c

Question 26

savella

Answer 26

milnacipran potent SNRI for only fibro 12.5mg x 1 day, 12.5 BID x 2 days then 25 mg BID x 4 days, 50 mg BID. Max 200mg

Question 27

flexeril

Answer 27

cyclobenzaprine | 5-10mg TID PO

Question 28

robaxin

Answer 28

methocarbamol 1000mg QID, max 8000mg daily

Question 29

Skelaxin

Answer 29

metaxalone | 800mg PO TID/QID

Question 30

Zanaflex

Answer 30

tizanidine 2mg q6-8hrs PRN max 36mg

Question 31

meloxicam

Answer 31

mobic PO 7.5mg daily max 15

Question 32

feldene

Answer 32

piroxicam | 20 mg daily

Question 33

clinoril

Answer 33

sulindac | 150-200mg BID, max 400mg

Question 34

Lodine

Answer 34

etodolac | 300-500mg BID, max 1000

Question 35

ketoprofen

Answer 35

PO 75mg TID, max 300mg daily

Question 36

advil

Answer 36

ibuprofen 300-800mg TID/QID max 3200

Question 37

nalfon

Answer 37

fenoprofen 300-800mg TID/QID max 3200

Question 38

nabumetone

Answer 38

1000-2000mg daily or BID, max 2000mg

Question 39

celebrex

Answer 39

celecoxib | inhibits cox 2

Question 40

arthrotec

Answer 40

diclofenac/misoprostol diclofenac-inhibits cox 1+2 misoprostol - synthetic prostaglandin E1 analog replaces the protective prostaglandis consumed by DMARDS

Question 41

RA and PsA TNF inhibitors

Answer 41

``` Enbrel-etanercept Humira-adalimumab cimzia-certolizumab pegol remicade-infliximab simponi-golimumab ```

Question 42

otezla

Answer 42

``` PsA - apremilast PDE4 antagonist start 10mg 1 in am x 1 day, 10mg BID x 1 day, 10mg qam, 20mg qpm x 1 day, 20mg BID x 1 day, 20mg qam, 30mg BID ```

Question 43

cosentyx

Answer 43

``` PsA, psoriasis, AS - secukinamab IL 17 antagonist SQ every 4 weeks, if plaque psoriasis - 300weekly with or without loading dose ```

Question 44

stelara

Answer 44

ustekinumab IL23 antagonist SQ 45mg 0,4 then every 12 weeks (3 mos)

Question 45

Lupus meds

Answer 45

PLQ, MTX imuran-azathioprine atabrine-quinacrine Benlysta-Belimumab

Question 46

atabrine

Answer 46

quinacrine anti-protozoal 25mg up to 100mg

Question 47

benlysta

Answer 47

Belimumab | IV

Question 48

aleve

Answer 48

naproxen

Question 49

colcrys

Answer 49

colchicine | mitigare

Question 50

zylprim

Answer 50

allopurinol

Question 51

uloric

Answer 51

febuxostat

Question 52

probenicid

Answer 52

promotes uric acid excretion

Question 53

krystexxa

Answer 53

pegloticase