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iTx III > Gout; OA; RA/ pool/med chem > Flashcards

Gout; OA; RA/ pool/med chem Flashcards

1
Q

List 2 important transported for Uric acid reabsorption

A

URAT-1 and GLUT 9

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2
Q

Which part of kidney is important for uric acid reabsorption?

A

proximal convoluted tube (PCT)

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3
Q

What 2 compounds inhibit uric acid reabsorption?

A

Probenecid & Benzbromarone

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4
Q

What is the function of Uricase (Pegloticase)?

A

Convert UA to Allantoin

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5
Q

What is the product of the oxidation of uric acid catalyzed by uricase?

A

Allantoin

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6
Q

Which form, UA or urate, id predominant at pH 7.4?

A

urate

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7
Q

Describe the association between gout and uric acid

A

increase in UA levels –> form insoluble crystals –> increased inflammation –> gout

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8
Q

List 2 XO inhibitors

A

Allopurinol
Febuxostat

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9
Q

Understand the relationships among Xanthine, Hypoxanthine, uric acid and Allantoin

A
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10
Q

List 3 uric-acid-lowering therapies

A

UA synthesis inhibitors
UA reabsorption
UA elimination

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11
Q

What re the primary drugs recommended as first-line treatment for hyperuricemia?

A

XO inhibitor

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12
Q

What 2 bases in nucleic acid are purine?

A

Adenine and Guanine

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13
Q

What is the function of Xanthine oxidase?

A

uric acid synthesis

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14
Q

Uric acid is a weak acid because…

A

it can release a proton

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15
Q

First-line rate-lowering therapy

A

Xanthine Oxidase inhibitors

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16
Q

XO inhibitor MOA

A

inhibit uric acid synthesis

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17
Q

second-line urate lowering inhibitors

A

Benzbromarone
Probenecid
Pegloticase

18
Q

Benzbromarone MOA

A

increase renal urate excretion

19
Q

Probenecid MOA

A

increase renal urate excretion

20
Q

Pegloticase MOA

A

UA degradation

21
Q

which XO inhibitor is non-purine-like? Allopurinol or Febuxostat

A

Febuxostat

22
Q

Allopurinol is excreted…

A

by the kidney

23
Q

Febuxostat is metabolized…

A

in the liver

24
Q

How many oxygen atoms are in UA?

A

3

25
Q

Which metal atom is the active site of XO?

A

molybdopterin (MO)

26
Q

What is NOT a good treatment of hyperuricemia?

A

inhibiting UA oxidation

27
Q

Which compound is NOT an XO inhibitor?
-Febuxostat
-Allopurinol
-Oxypurinol
-Allantoin

A

Allantoin

28
Q

Which compound is an analogous of hypoxanthine and xanthine?
-febuxostat
-allopurinol
-benzbromarone
-probenacid

A

Allopurinol

29
Q

Which medication has multiple significant drug interactions with commonly used drugs like NSAIDs?

A

Probenecid

30
Q

Which transporters do Probenecid inhibit?

A

URAT 1 and GLUT 9

31
Q

Name the non-selective COX inhibitors

A

Diclofenac
Flurbiprofen
Ibuprofen
Indomethacin
Naproxen
Nabumetone

32
Q

T/F
The COX pathway of arachidonate metabolism produces prostaglandins

A

true

33
Q

Which COX isoform is induced during inflammation and tends to facilitate the inflammatory response? COX-1 or COX-2

A

COX-2

34
Q

Name an NSAID that is ketone prodrug and is metabolized to the acidic active drug?

A

Nabumetone

35
Q

biologic DMARDs
- Tumor Necrosis factor Inhibitors -

A

Etanercept (Enbrel, Erelzi)
Infliximab (Remicade)
Adalimumab (Humira)
Golimumab (Simponi and Simponi ARIA)
Certolizumab pegol (Cimzia)

36
Q

What do TNF inhibitors (TNFi) block?

A

both forms of TNF-a

37
Q

AE of TNF-a-blocking agents

A
  • TNF-a blocking agents increase the risk of bacterial infections and macrophage-dependent infections (including tuberculosis, fungal, and other opportunistic infections) are increased
  • associated w/ rick of HBV reactivation
  • increase the risk of skin cancers- including melanoma
  • Rare cases of leukopenia, neutropenia, thrombocytopenia, and pancytopenia
38
Q

Rituximab (RTX) MOA

A

chimeric monoclonal antibody that targets CD20 B-lymphocytes through cell-mediated and complement-dependent cytotoxicity and stimulation of cell apoptosis

39
Q

Rituximab AE

A
  • assoc with reactivation of Hep B
  • about 30% of pts develop rash with the first RTX dose
39
Q
A
40
Q
A

iTx III (3 decks)

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