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CSP Inflammatory > Inflammatory > Flashcards

Inflammatory Flashcards

1
Q

anakinra brand name

A

kineret

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2
Q

brodalumab brand name

A

Siliq

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3
Q

canakinumab brand name

A

ilaris

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4
Q

dupilumab brand name

A

dupixent

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5
Q

guselkumab brand name

A

Tremfya

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6
Q

ixekizumab brand name

A

taltz

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7
Q

rilonacept brand name

A

arcalyst

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8
Q

risankizumab brand name

A

skyrizi

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9
Q

sarilumab brand name

A

kevzara

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10
Q

secukinumab brand name

A

cosentyx

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11
Q

tildrakizumab brand name

A

ilumya

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12
Q

tocilizumab brand name

A

actemra

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13
Q

tralokinumab brand name

A

adbry

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14
Q

ustekinumab brand name

A

stelara

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15
Q

adalibumab brand name

A

humira

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16
Q

certolizumab brand name

A

cimzia

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17
Q

etanercept brand name

A

Enbrel

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18
Q

golimumab brand name

A

simponi

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19
Q

infliximab brand name

A

remicade

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20
Q

belimumab brand name

A

benlysta

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21
Q

rituximab brand name

A

rituxan

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22
Q

abatacept brand name

A

orencia

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23
Q

oegloticase brand name

A

krystexxa

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24
Q

natalizumab brand name

A

tysarbi

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25
Q

omalizumab brand name

A

xolair

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26
Q

vedolizumab brand name

A

entyvio

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27
Q

abufrolumab brand name

A

saphnelo

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28
Q

apremilast brand name

A

otezla

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29
Q

baricitinib brand name

A

olumiant

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30
Q

tofacitinib brand name

A

xeljanz

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31
Q

upadacitinib brand name

A

rinvoq

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32
Q

abrocitinib brand name

A

cibinqo

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33
Q

ruxolitinib brand name

A

opzelura

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34
Q

ozanimod brand name

A

zeposia

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35
Q

teduglutide brand name

A

gattex

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36
Q

voclosporin brand name

A

lupkynis

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37
Q

avaocopan brand name

A

tavneos

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38
Q

TNF Inhibitor drugs

A

SERCH- Simponi, Enbrel, Remicade, Cimzia, Humira

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39
Q

B-Cell Inhibitor Drugs

A

Stop Ben’s in a Tux: Benlysta, Rituxan

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40
Q

T cell Inhibitor Drugs

A

Orencia

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41
Q

PDE-4 Inhibitor Drugs

A

Otezla

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42
Q

JAK Inhibitor Drugs

A

JACK CROOX’ed: Cibinqo, Rinvoq, Oluminant, Opzelura, Xeljanz

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43
Q

S1P Receptor Modulator Drugs

A

Zeposia

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44
Q

GLP-2 Analog Drugs

A

Gattex

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45
Q

Calcineurin Inhibitor Drugs

A

Lupkynis

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46
Q

C5a Receptor Inhibitor Drugs

A

Tavneos

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47
Q

BBW for TNF inhibitors

A

malignancies, serious infections (TB)

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48
Q

AEs TNF Inhibitors

A

CHF, demyelinating diseases, HBV reactivation, infections, headache, nausea, ISR, cytopenia, lupus like syndrome

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49
Q

Stability of Humira

A

room temp for single period of <14 days

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50
Q

Latex in Humira

A

yes in needle cover, CF is also latex free

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51
Q

Baseline labs for TNFs

A

CBC with diff, TB, HBV, CMP

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52
Q

Monitoring for TNFs

A

CBC with diff, TB, CMP

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53
Q

What indications of Humira do not need loading dose? What is dose?

A

RA, PsA, AS: 40mg every other week

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54
Q

What is dose of Humira for uveitis and PP?

A

80mg initially then 40mg every other week (1 week after initial dose)

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55
Q

what is dose of Humira for HS?

A

160mg on day 1, then 80 mg every other week starting day 15 (or 40 mg every week)

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56
Q

what is CD/UC dose of Humira?

A

160mg on day 1, 80 mg on day 15, then 40mg every other week

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57
Q

what are the approved pediatric doses of Humira?

A

CD, UC, HS, Uveitis

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58
Q

What are the approved indications for Enbrel?

A

RA, PsA, AS, PP, JIA, PP (peds)

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59
Q

What adult indication of Enbrel has different dosing than the rest? and what is it?

A

PP: 50mg BID x 3 months then QW

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60
Q

what is the only TNF inhibitor that doesn’t have a gastro indication?

A

enbrel

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61
Q

what is enbrels stability ?

A

room temp for single period of <14 days

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62
Q

what indication of cimzia doesn’t need a load and what are the directions?

A

PP- 400mg q2w

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63
Q

what is dose for CD for cimzia

A

400mg at 0,2,4 wks then 400 q4w

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64
Q

what is dose for RA/AS/PsA/nr-axSpA for cimzia

A

400mg at 0, 2, 4 wks then 400 q4w or 200mg q2w

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65
Q

storage for cimzia (PFS vs vials)

A

PFS: RT for <7 days; unopened vials: RT <6 months; reconstituted vials: RT <2 hr or in fridge < 24 hours

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66
Q

what are approved indications of simponi

A

RA, PsA, AS, UC

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67
Q

what simponi indication has a load? what is it?

A

UC: 200mg wk 0, 100mg wk 2, then 100mg q4w

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68
Q

what is dosing for simponi in RA, PsA, AS if SQ?

A

50mg q4w

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69
Q

what is dosing for simponi in RA, PsA, AS if IV?

A

2mg/kg at wk 0 & 4 then q8w

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70
Q

what indication of simponi does not have IV dosing?

A

UC

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71
Q

what is the only TNF inhibitor that has both SQ and IV dosing

A

simponi

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72
Q

what is the only TNF inhibitor that only has IV dosing

A

remicade

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73
Q

what is stability of simponi

A

SQ <30 days RT; vials <4 hours reconstituted

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74
Q

what amount of time is simponi aria infused over

A

30 mins

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75
Q

what TNF inhibitor needs to be protected from light?

A

simponi

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76
Q

what is the only TNF inhibitor you need to premedicate with and what is the regimen?

A

Remicade, benadryl/APAP/and/or steroids

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77
Q

what is RA dosing for remicade

A

3mg/kg at 0, 2, and 6 weeks then q8w

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78
Q

what is CD, UC, PP, PsA dosing for remicade

A

5mg/kg at 0, 2, and 6 weeks then q8w

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79
Q

what is AS dosing for remicade

A

5mg/kg at 0, 2, and 6 weeks then q6w

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80
Q

within what time range should remicade be infused after preparation?

A

3 hour

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81
Q

how is remicade billed?

A

by units; 1 vial= 100mg= 10 units

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82
Q

in what condition is the dose modified for remicade?

A

mod-severe CHF

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83
Q

how long is remicade infused over?

A

> 2 hours

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84
Q

What are the IL-1 inhibitor drugs?

A

Kineret, Arcalyst, Ilaris (one big KAIL leaf)

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85
Q

What are the IL-4 inhibitor drugs?

A

DIL-4 PICKLE - Dupixent

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86
Q

what are the indications for dupixent?

A

nasal polyps, AD, EoE

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87
Q

what indication of dupixent needs a load and what is it?

A

AD: 600mg on day 1 then 300mg qow

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88
Q

How is dupixent dosed for EoE?

A

300mg QW

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89
Q

stability of dupixent

A

<14 days at RT

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90
Q

missed dosing for dupixent?

A

admin within 7 days then resume schedule; if not within 7 days, then wait for next dose,

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91
Q

what should always be monitored with dupixent?

A

ocular changes

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92
Q

AEs with dupixent

A

conjunctivitis, blepharitis, dry eyes, ISR, HSV,

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93
Q

Approved Indications for Kineret

A

RA, NOMID

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94
Q

dose for Kineret in RA

A

100mg QD (subq)

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95
Q

when does kineret dosing need to be adjusted? and what is it

A

CrCl <30ml/min down to QOD dosing

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96
Q

Approved Indications for Arcalyst

A

CAPS

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97
Q

Approved Indications for Ilaris

A

CAPS, AOSD, FMF, HIDS, TRAPS

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98
Q

What IL-1 is healthcare administered

A

Ilaris

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99
Q

AEs for Kineret

A

most common- injection site reaction (can be late onset); infection; HA; nausea; fever; ISR: arthralgia

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100
Q

AEs for Ilaris

A

infection, nasopharyngitis, diarrhea, HA, nausea, WEIGHT GAIN, ISR, increased liver enzymes

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101
Q

AEs for Arcalyst

A

infection, URI, ISR, cough, sinusitis, bacterial meningitis, HLD, neutropenia

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102
Q

monitoring for Ilaris and Arcalyst

A

TB, CBC with diff, CRP, serum amyloid A, FLP for Arcalyst only

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103
Q

what are IL-6 Inhibitor drugs?

A

AK-6= actemra, kevzara

104
Q

Kevzara indications and dosing

A

just RA: 200mg q2w

105
Q

what are the 5 actemra indications

A

RA, GCA, SSc-ILD, pJIA, sJIA

106
Q

what indication of actemra is doses QW

A

SSc-ILD

107
Q

when does IL-6s need to have a dose reduction?

A

abnormal LFTs, neutropenia, thrombocytopenia

108
Q

monitoring for IL-6

A

TB, HBV, ALT/AST (baseline, in 4-8 wk, Q3m), lipid panel (baseline, 4-8 wk, q6m), gi perforation

109
Q

AEs for IL-6

A

URI, nasopharyngitis, HA, HTN, increased ALT, ISR, HLD, infusion rxn, GI perf, infection

110
Q

what are IL-13 inhibitor drugs?

A

13 ads a day on tv: Adbry

111
Q

what are approved indications for adbry and dosing?

A

AD: 600mg sq then 300mg qow

112
Q

stability of adbry

A

<14 days RT

113
Q

AEs Adbry

A

similar to dupixent (IL-4): ocular issues

114
Q

counseling on adbry

A

missed dosing (same as dupixent) and moving injections at least 1 inch apart

115
Q

what are the IL-17 drugs

A

17 tacos: Taltz, Cosentyx, Siliq

116
Q

what drug class is stelara

A

IL-12/23 (only one)

117
Q

what are the IL-23 Inhibitors?

A

23 dogs SIT: Skyrizi, Alumna, Tremfya

118
Q

what is indication for siliq and dosing?

A

PP:210mg wk 0, 1, 2 then 210 q2w

119
Q

which IL has a rems and which IL class is it? what is rems for?

A

Siliq- (IL 17) for suicidal ideation

120
Q

when can you change adbry dose?

A

at 16 wks of treatment with clear or almost clear skin, dose can be dropped to 300mg q4 wk if patient is <100kg

121
Q

stability of IL-17s

A

Siliq: <14 days at RT
Cosentyx; <4 days
Taltz: <5 days

122
Q

when should siliq be d/c’ed?

A

if no response in 12-16 weeks

123
Q

monitoring siliq

A

infection, CD exacerbations, suicidal thoughts, TB/CBC at baseline

124
Q

monitoring for IL-17s

A

TB/CBC baseline, IBD new onset

125
Q

AEs Cosentyx

A

infection (candida/staph), URI, HSV, diarrhea, impetigo, increased LFTs, neutropenia, IBD

126
Q

AEs for Taltz

A

ISR, fungal infection, URI, Nausea, neutropenia, IBD

127
Q

What Taltz indication doesn’t need a load?

A

nr-axSpA

128
Q

dosing for Taltz in PP

A

160mg once, 80mg weeks 2-12, then 80mg q4w

129
Q

dosing for taltz in AS and PsA

A

160mg once then 80mg q4w

130
Q

PP dosing in cosentyx

A

300mg x 5 weeks then 300mg q4w

131
Q

PsA, AS, and nr-axSpA dosing in cosentyx

A

150mg x 5 weeks then 150mg q4w

132
Q

What are approved indications for stelara

A

PP, PsA, CD, UC

133
Q

dosing for UC/CD

A

induction: single IV dose based on weight then 90mg q8w

<55kg: 260mg
>55-85kg: 390mg
>85kg: 520mg

134
Q

stability for stelara

A

PFS RT 30 days
reconstituted vials <7 hours

135
Q

what genetic component to stelara?

A

those deficient in IL12/23 –> risk of salmonella, mycobacteria, BCG virus

136
Q

BCG vaccine and stelara

A

not given within 1 year prior to stelara initiation and then 1 year after discontinutation

137
Q

PP stelara dosing

A

<100kg: 45mg week 0, 4, q12w
>100kg: 90mg week 0, 4, q12w

138
Q

monitoring stelara

A

baseline: TB, CDC
symptoms TB, infections, RPLS, squamous cell carcinoma

139
Q

approved indications for ilumya and dosing

A

PP: 100mg week 0, 4, and q12w

140
Q

approved indications skyrizi and dosing

A

PsA and PP: 150mg week 0 and 4 then q12w
CD: induction (IV): 600mg wk 0, 4, 8
maintenance: 360mg wk 12 then q8w with on body injector

141
Q

what do you check before starting skyrizi in CD patients

A

liver enzymes and bilirubin

142
Q

what are approved indications for Tremfya and dosing?

A

PsA and PP: 100mg week 0, 4, then q8q

143
Q

ADEs for IL-23s

A

all: infection, URI, HA, ISR
skyrizi: tines, herpes, zoster, cellulitis, osteomyelitis
Tremfya: HSV, tines, inc liver enzymes, gastroenteritis

144
Q

what are IL-23 inhibitor drugs?

A

23 dogs SIT: skyrizi, ilumya, tremfya

145
Q

what are the JAK inhibitor drugs?

A

CROOX: cibinqo, rinvoq, olumiant, opzelura, xeljanz

146
Q

dose reduction needed in JAKs

A

renal impairment, hepatic impairment, anemia, lymphopenia, neutropenia

xeljanz: CYP3A4 or 2C19 inhibs
cibinqo: CYP2C19 poor metabolizers

147
Q

counseling on xeljanx XR tab

A

shell in stool

148
Q

BBW in JAKs

A

infection, malignancy, thrombosis, PE, MACE, mortality

149
Q

monitoring in JAKs

A

LFTs, CBC, HBV, TB, fasting lipid panels, skin cancer

150
Q

General drug interactions with JAKs

A

xeljanz/rinvoq: avoid CYP3A4 inducers
olumiant: avoid OAT3 inhibitors
cibinqo: avoid CYP219 inducers

151
Q

generic xeljanz

A

tofacitinib

152
Q

generic rinvoq

A

upadacitinib

153
Q

generic oluminant

A

baricitinib

154
Q

generic cibinqo

A

abrocitinib

155
Q

generic opzelura

A

ruxolitinib

156
Q

xeljanz UC dose

A

IR induction: 10mg bid x 8 wks then 5 or 10mg bid maintenance

XR induction: 22mg daily x 8 wk then 11 or 22mg maintenance

157
Q

xeljanz RA/AS/PsA dose

A

5mg BID or 11 qd

158
Q

what indication of xeljanz has induction dose?

A

ulcerative colitis

159
Q

rinvoq dosing

A

RA/PsA/AD: 15mg qd
AS: 15mg or 30mg QD
UC: 45mg QD for 8 wk then 15mg qd; 30mg only in extensive disease

160
Q

what indication of rinvoq has induction dose

A

ulcerative colitis

161
Q

oluminant dosing

A

RA: 2mg qd
alopecia: 2mg qd; may inc to 4mg if inadequate response

162
Q

cibinqo dosing

A

100mg qd; if insufficient response in 12 weeks may increase to 200mg

163
Q

what is max dosing area of opzelura

A

20% BSA

164
Q

when should opzelura therapy be reassesed

A

at 8 wk with no s/s resolution

165
Q

monitoring for opzelura

A

skin exams for basal and squamous cell carcinoma, s/s infection

166
Q

what are the T-cell inhibitor drugs

A

orencia

167
Q

what are approved indications for orencia

A

RA, PsA, JIA

168
Q

which indication of Orencia has optional loading dose? and how does it work

A

RA- sq dosing; single infusion followed by first 125mg injection within 24 hours of infusion

169
Q

what is monitoring for t-cell inhibitors

A

s/s infection; worsening of respiratory status in COPD pt

170
Q

when do you avoid live vaccines for orencia

A

concurrently and within 3 months of discontinuing

171
Q

AEs for orencia

A

infection, HA, N, nasopharyngitis, HTN,
RARE: malignancies, COPD EXACERBATION

172
Q

what are the PDE-4 inhibitor drugs?

A

otezla

173
Q

what is generic for otezla

A

apremilast

174
Q

approved indications for otezla

A

Behcets, PP, PsA

175
Q

dosing for otezla

A

same for all indications: 6 day titration
1. 10 qd
2. 10 bid
3. 10 am, 20 pm
4. 20 bid
5. 20am, 30pm
6. 30 bid

176
Q

what does allergen does otezla contain

A

lactose

177
Q

when does otezla have to be dose adjusted

A

CrCl < 30mg/ml

178
Q

what drugs do you need to avoid with otezla

A

strong CYP450 inducers

179
Q

monitoring for otezla

A

renal fxn, changes in weight, depression, suicidal thoughts

180
Q

AEs for Otezla

A

HA, weight loss, GI ISSUES,
RARE: afib, depression, suicidal ideation

181
Q

what drugs are b-lymphocyte stimulator protein inhibitors

A

benlysta

182
Q

what is generic benlysta

A

belimumab

183
Q

what are approved indications for benlysta

A

SLE and Lupus Nephritis

184
Q

IV Dosing for benlysta

A

same regardless of indication
10mg/kg q2w x 3 doses then 10mg/kg q4w

185
Q

SC dosing for benlysta

A

SLE: 200mg QW
Lupus: 400mg QW x 4 doses then 200mg QW

186
Q

how long is benlysta IV infused over

A

1 hour

187
Q

who is benlysta not recommended for

A

severe active CNS lupus or severe active lupus nephritis

188
Q

who may have lower response rate for benlysta

A

african americans

189
Q

does benlysta have latex

A

ALL formulations are latex free

190
Q

monitoring for benlysta

A

infections, worsening depression, suicidal thoughts, new onset or deteriorating neurological symptoms

191
Q

AEs Benlysta

A

N/V/D, infusion rxn, pyrexia, insomnia, depression, migraine, limb pain

rare: PML, suicide ideation

192
Q

TB testing for benlysta

A

NONE

193
Q

what drug is integrin receptor antagonist

A

entyvio

194
Q

generic for entyvio

A

vedolizumab

195
Q

indications for entyvio

A

UC and CD

196
Q

dosing for entyvio

A

300mg at 0,2,6 then q8w

197
Q

when should entyvio be discontinued?

A

at 14 week if no therapeutic benefit

198
Q

how long should entyvio be infused over

A

30 minutes

199
Q

monitoring for entyvio

A

TB, LFTs, infection, infusion rxn, PML not reported but possible, new or worsening neurological symptoms

200
Q

AEs entyvio

A

HA, arthrglia, LFTs, flu, back/limb pain, fever

201
Q

what drugs are selective adhesion molecule inhibitor

A

Tysabri

202
Q

generic tysabri

A

natalizumab

203
Q

what are approved indications for tysabri

A

CD and MD

204
Q

dose for tysabri

A

300mg q4w

205
Q

how is tysabri given

A

IV

206
Q

how long is tysabri infused over

A

1 hour

207
Q

when should tysabri be discontinued

A

within 6 months if steroids cannot be tapered or if not therapeutic benefit in 12 weeks

208
Q

why is tysabri in REMS

A

risk of PML; touch program

209
Q

monitoring for tysabri

A

meningitis, encephliits, PML, baseline brain MRI,

210
Q

AEs for tysabri

A

HA, fatigue, depression, infusion rxn, PML

211
Q

BBW for tysabri

A

PML

212
Q

what are anti-CD20 monoclonal antibody dug

A

rituxan

213
Q

what are approved indications for rituxan

A

RA and pemphigus vulgaris

214
Q

what do you premeditate with for Rituxan infusion

A

antihistamine, APAP, methylprednisolone 100mg IV 30 min prior

215
Q

monitoring rituxan

A

HBV, CBC, renal fxn, fluid status, infusion rxn, CARDIAC monitoring if history of arrhythmias, vitals

216
Q

AEs rituxan

A

ALOT, edema, cytopenia, night sweats, hyperglycemia, hypotension, anxiety, throat irritation, infusion rxn, mucocutaneous rxn, PML

217
Q

urate oxidase enzyme drugs

A

krystexxa

218
Q

krystexxa indications

A

gout

219
Q

krystexxa dosing

A

8mg q2wk

220
Q

Rituxan RA dose

A

1000mg day 1 and 15 then 1000 q16-24 wk

221
Q

how long is krystexxa infused over

A

120 minutes

222
Q

what do you premeditate with for krystexxa

A

antihistamine, steroids

223
Q

what is krystexxa contraindicated in and why

A

G6PD deficiency- risk of hemolysis and methemoglobinemia

224
Q

what monitoring is needed on krystexxa

A

UA levels prior to infusion

225
Q

AEs for krystexxa

A

bruising, antibody formation, infusion rxn, erythema, pruritus,

226
Q

BBW for krystexxa

A

anaphylactic infusion, G6PD deficiency

227
Q

what drug should not be used with krystexxa

A

PO urate lowering agents prior to initiation and do not initiate during treatment

228
Q

what is flare prophylaxis regimen with krystexxa

A

NSAID or colchicine beginning 1 week prior to initiation and continue for 6 months

229
Q

generic xolair

A

omalizumab

230
Q

indications for xolair

A

chronic idiopathic urticaria, nasal polyps, severe asthma

231
Q

urticaria dose for xolair

A

150 or 300mg q4w

232
Q

how long do xolair injections take

A

5-10 seconds- viscous solution

233
Q

monitoring for xolair

A

baseline serum total IgE, signs infections, hypersensitivity reaction

234
Q

how to observe patient post xolair injection

A

2 hours after the first 3 injections and 30 minutes after each subsequent injection

235
Q

AEs for xolair

A

HA, injection site reaction,
RARE: antibody development, malignant neoplasm, serum sickness, severe thrombocytopenia

236
Q

BBW for xolair

A

anaphylaxis

237
Q

what drug class is xolair

A

Anti-IgG Monoclonal antibody

238
Q

what drug class is methotrexate

A

dihydrofolate reductase inhibitor

239
Q

brand names for methotrexate

A

otrexup, rasuvo, reditrex

240
Q

indications for injectable methotrexate

A

RA and PP

241
Q

injectable methotrexate doses

A

RR: 10-25 QW
PP: 7.5-20 QW

242
Q

when do you d/c injectable methotrexate

A

significant decline in blood counts

243
Q

pregnancy category with methotrexate

A

category X

244
Q

what do you need to restrict with methotrexate use

A

alcohol

245
Q

which formulation of SQ methotrexate is PFS

A

reditrex

246
Q

SQ Methotrexate monitoring

A

CBC initial and q4-8w, acute neurotoxicity

247
Q

AEs with methotrexate

A

infection, alopecia, rash, photosensitivity, pruritis, thrombocytopenia, increased LFTs, blurred vision, arthralgia, renal failure

248
Q

BBW with SQ methotrexate

A

BM suppression, aplastic anemia, GI toxicity with NSAIDs, pneumonia, renal/liver/stomach toxicity

249
Q

indication for Gattex

A

SBS

250
Q

dose for Gattex

A

0.05mg/kg once daily

251
Q

how is gate administered

A

SQ- room temp vial

252
Q

what is REMs for Gattex for

A

increase awareness of neoplastic growth, colon polyp growth, GI obstruction, biliary/pancreatic disorders

253
Q

monitoring for Gattex

A

colonoscopy, bilirubin, alk phosphate, lipase, amylase, fluid status in CHF

254
Q

what drugs are GLP-2 analogs

A

Gattex

255
Q

What drugs are S1P Receptor Modulator

A

Zeposia

256
Q

generic for zeposia

A

ozanimod

257
Q

indications for zeposia

A

UC

CSP Inflammatory (3 decks)

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