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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
Q

Uses of adalimumab

A

RA
Ankylosing spondylitis
Psoriatic arthritis
Juvenile idiopathic arthritis

26
Q

Human anti-TNF-alpha monoclonal antibody with a PEG variable region

A

Certolizumab

27
Q

Drugs that neutralize both membrane-bound and soluble TNF-alpha

A

Certolizumab
Golimumab

28
Q

Recombinant human IL-1 receptor antagonist

A

Anakinra

29
Q

Action of IL-1 in RA

A

Cartilage degradation and bone resorption

30
Q

Drug that inhibits T cell activation by binding to cell surface markers on leukocytes

A

Abatacept

31
Q

Human anti-IL-6 receptor monoclonal antibody that acts as a IL-6 receptor antagonist

A

Tocilizumab

32
Q

Uses of Tocilizumab

A

RA
Juvenile idiopathic arthritis
Polymyalgia rheumatic

33
Q

Function of PDE4

A

Primarily on immune cells
Specific for breaking down cAMP

34
Q

Drug that inhibits PDE4 to increase cAMP, resulting in decreased expression of pro-inflammatory cytokines

A

Apremilast

35
Q

Anti-CD20 antibody that is used in autoimmune disease when the pt also has thrombocytopenia

A

Rituximab

36
Q

Treatments for fibromyalgia

A

Amitriptyline
Duloxetine
Pregabalin
Gabapentin
Venlafaxine
Milnacipran

37
Q

Side effects of amitriptyline

A

Anticholinergic
Alpha blocking effects
Sedation

38
Q

Mechanism of pregabalin

A

Binds to alpha-2-delta CNS Ca channels to inhibit excitatory NT release

39
Q

Mechanism of amitriptyline and duloxetine

A

Blocks reuptake of norepinephrine and serotonin

40
Q

Treatment for infectious arthritis caused by group B strep

A

Combination of penicillin and either gentamicin or later gen cephalosporin

41
Q

Treatment for infectious arthritis caused by MRSA or MSSA

A

Dalbavancin

42
Q

Treatment for gonococcal infectious arthritis

A

Azithromycin and doxycycline

43
Q

Treatment for coagulase negative S aureus infectious arthritis

A

Rifampin

44
Q

Treatment for infectious arthritis caused by Lyme disease

A

Doxycycline for >8 yo
Amoxicillin of cefuroxime for younger children and pregnant/breastfeeding

45
Q

Drugs that treat gout by inhibiting xanthine oxidase

A

Allopurinol
Febuxostat

46
Q

Drugs that provide a recombinant uricase enzyme to convert uric acid to allantoin to be secreted

A

Pegloticase
Rasburicase

47
Q

Drugs that inhibit the renal tubular reabsorption of uric acid

A

Probenecid
Lesinurad
High-dose salicylates

48
Q

Drugs that inhibit the renal tubular secretion of uric acid

A

Diuretics
Low-dose salicylates

49
Q

Drug that selectively inhibits microtubule assembly to reduce leukocyte migration and phagocytosis in gout

A

Colchicine

50
Q

Adverse effects of colchicine

A

Significant GI disturbance
Liver and kidney damage

51
Q

Use for colchicine other than gout

A

Familial mediterranean fever

52
Q

Mechanism of Probenecid

A

Competitively binds to OAT in kidney, blocking uric acid reabsorption

53
Q

Drug interactions of uricosurics

A

Inhibits secretion of other weak acids
Effect can be interfered with by salicylates
Avoid co-administration with colchicine or indomethacin

54
Q

Drug that is metabolized into an irreversible, suicide inhibitor of xanthine oxidase

A

Allopurinol

55
Q

Drugs that can cause gout exacerbation in early therapy

A

Allopurinol
Uricosurics

56
Q

Drug that is more selective and more effective than allopurinol

A

Febuxostat

57
Q

Drug that inhibits URAT1 and OAT4 to decrease uric acid reabsorption

A

Lesinurad

58
Q

Recombinant uricase that catalyzes the oxidation of uric acid to allantoin so it can be excreted

A

Pegloticase

59
Q

Adverse effect of pegloticase

A

Life-threatening allergy

60
Q
A

MSK II (16 decks)

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