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MSK II > Drugs for arthritis and gout > Flashcards

Drugs for arthritis and gout Flashcards

1
Q

Mechanism of corticosteroids

A

Form lipocortin, a protein that inhibits phospholipase A2 activity. Inhibits the release of arachidonic acid and formation of prostaglandins

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2
Q

Drug that inhibits AICAR transformylase, dihydrofolate reductase, and thymidylate synthetase

A

Methotrexate

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3
Q

Side effects of methotrexate

A

Elevated LFTs
Cytopenia
Somatitis
GI ulcerations
Alopecia
Contraindicated in pregnancy

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4
Q

Drugs that increase methotrexate levels

A

Probenecid
Aspirin

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5
Q

Drug that adds to the inhibition DHFR and depresses bone marrow when taken with methotrexate

A

Trimethoprim

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6
Q

Purine antimetabolite used for RA

A

Azathioprine

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7
Q

Adverse effects of azathioprine

A

Bone marrow suppression
GI disturbances
Increased infection risk

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8
Q

Risk of using azathioprine long-term

A

Lymphoma

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9
Q

Drug that selectively inhibits T lymphocyte proliferation, IL-2, and other cytokine production

A

Cyclosporine

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10
Q

Adverse effects of cyclosporine

A

Nephrotoxic
Impairs liver function
Hirsutism
Gum hyperplasia
Increase BP
Precipitation of diabetes

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11
Q

5-amino salicylic acid with an antibacterial drug for RA

A

Sulfasalazine

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12
Q

Other uses for sulfasalazine

A

UC and Crohn’s

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13
Q

Drug that suppresses T cell responses to mitogens, reduces chemotaxis and phagocytosis of polymorphonuclear leukocytes, and decreases the production of superoxide radicals

A

Hydroxychloroquine

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14
Q

Adverse effects of hydroxychloroquine

A

Blurred vision
Scotomas
Night blindness

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15
Q

Drug that inhibits DHODH to result in decreases DNA replication

A

Leflunomide

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16
Q

Other use of leflunomide

A

MS

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17
Q

Adverse effects of leflunomide

A

Diarrhea
Hepatotoxicity
Alopecia
Terotegenic

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18
Q

Alternative to methotrexate for first-line management of RA

A

Leflunomide

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19
Q

Adverse effects of TNF-alpha inhibitors

A

Infection
Reactivation of hep B or latent TB
Lymphomas
Legionella and listeria

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20
Q

Blackbox warning for TNF-alpha inhibitors

A

Legionalla pneumonia and listeria infection risk

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21
Q

Drug formed by recombining human soluble TNF-alpha receptors with Fc fragmants of human IgG1

A

Etanercept

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22
Q

Chimeric IgG1 monoclonal antibody TNF-alpha inhibitor

A

Infiximab

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23
Q

Fully human IgG1 anti-TNF monoclonal antibody

A

Adalimumab

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24
Q

Drug that complexes with soluble TNF-alpha and prevents its interaction with p55

A

Adalimumab

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25
Uses of adalimumab
RA Ankylosing spondylitis Psoriatic arthritis Juvenile idiopathic arthritis
26
Human anti-TNF-alpha monoclonal antibody with a PEG variable region
Certolizumab
27
Drugs that neutralize both membrane-bound and soluble TNF-alpha
Certolizumab Golimumab
28
Recombinant human IL-1 receptor antagonist
Anakinra
29
Action of IL-1 in RA
Cartilage degradation and bone resorption
30
Drug that inhibits T cell activation by binding to cell surface markers on leukocytes
Abatacept
31
Human anti-IL-6 receptor monoclonal antibody that acts as a IL-6 receptor antagonist
Tocilizumab
32
Uses of Tocilizumab
RA Juvenile idiopathic arthritis Polymyalgia rheumatic
33
Function of PDE4
Primarily on immune cells Specific for breaking down cAMP
34
Drug that inhibits PDE4 to increase cAMP, resulting in decreased expression of pro-inflammatory cytokines
Apremilast
35
Anti-CD20 antibody that is used in autoimmune disease when the pt also has thrombocytopenia
Rituximab
36
Treatments for fibromyalgia
Amitriptyline Duloxetine Pregabalin Gabapentin Venlafaxine Milnacipran
37
Side effects of amitriptyline
Anticholinergic Alpha blocking effects Sedation
38
Mechanism of pregabalin
Binds to alpha-2-delta CNS Ca channels to inhibit excitatory NT release
39
Mechanism of amitriptyline and duloxetine
Blocks reuptake of norepinephrine and serotonin
40
Treatment for infectious arthritis caused by group B strep
Combination of penicillin and either gentamicin or later gen cephalosporin
41
Treatment for infectious arthritis caused by MRSA or MSSA
Dalbavancin
42
Treatment for gonococcal infectious arthritis
Azithromycin and doxycycline
43
Treatment for coagulase negative S aureus infectious arthritis
Rifampin
44
Treatment for infectious arthritis caused by Lyme disease
Doxycycline for >8 yo Amoxicillin of cefuroxime for younger children and pregnant/breastfeeding
45
Drugs that treat gout by inhibiting xanthine oxidase
Allopurinol Febuxostat
46
Drugs that provide a recombinant uricase enzyme to convert uric acid to allantoin to be secreted
Pegloticase Rasburicase
47
Drugs that inhibit the renal tubular reabsorption of uric acid
Probenecid Lesinurad High-dose salicylates
48
Drugs that inhibit the renal tubular secretion of uric acid
Diuretics Low-dose salicylates
49
Drug that selectively inhibits microtubule assembly to reduce leukocyte migration and phagocytosis in gout
Colchicine
50
Adverse effects of colchicine
Significant GI disturbance Liver and kidney damage
51
Use for colchicine other than gout
Familial mediterranean fever
52
Mechanism of Probenecid
Competitively binds to OAT in kidney, blocking uric acid reabsorption
53
Drug interactions of uricosurics
Inhibits secretion of other weak acids Effect can be interfered with by salicylates Avoid co-administration with colchicine or indomethacin
54
Drug that is metabolized into an irreversible, suicide inhibitor of xanthine oxidase
Allopurinol
55
Drugs that can cause gout exacerbation in early therapy
Allopurinol Uricosurics
56
Drug that is more selective and more effective than allopurinol
Febuxostat
57
Drug that inhibits URAT1 and OAT4 to decrease uric acid reabsorption
Lesinurad
58
Recombinant uricase that catalyzes the oxidation of uric acid to allantoin so it can be excreted
Pegloticase
59
Adverse effect of pegloticase
Life-threatening allergy
60

MSK II (16 decks)

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