Inflammatory Flashcards
1
Q
anakinra brand name
A
kineret
2
Q
brodalumab brand name
A
Siliq
3
Q
canakinumab brand name
A
ilaris
4
Q
dupilumab brand name
A
dupixent
5
Q
guselkumab brand name
A
Tremfya
6
Q
ixekizumab brand name
A
taltz
7
Q
rilonacept brand name
A
arcalyst
8
Q
risankizumab brand name
A
skyrizi
9
Q
sarilumab brand name
A
kevzara
10
Q
secukinumab brand name
A
cosentyx
11
Q
tildrakizumab brand name
A
ilumya
12
Q
tocilizumab brand name
A
actemra
13
Q
tralokinumab brand name
A
adbry
14
Q
ustekinumab brand name
A
stelara
15
Q
adalibumab brand name
A
humira
16
Q
certolizumab brand name
A
cimzia
17
Q
etanercept brand name
A
Enbrel
18
Q
golimumab brand name
A
simponi
19
Q
infliximab brand name
A
remicade
20
Q
belimumab brand name
A
benlysta
21
Q
rituximab brand name
A
rituxan
22
Q
abatacept brand name
A
orencia
23
Q
oegloticase brand name
A
krystexxa
24
Q
natalizumab brand name
A
tysarbi
25
omalizumab brand name
xolair
26
vedolizumab brand name
entyvio
27
abufrolumab brand name
saphnelo
28
apremilast brand name
otezla
29
baricitinib brand name
olumiant
30
tofacitinib brand name
xeljanz
31
upadacitinib brand name
rinvoq
32
abrocitinib brand name
cibinqo
33
ruxolitinib brand name
opzelura
34
ozanimod brand name
zeposia
35
teduglutide brand name
gattex
36
voclosporin brand name
lupkynis
37
avaocopan brand name
tavneos
38
TNF Inhibitor drugs
SERCH- Simponi, Enbrel, Remicade, Cimzia, Humira
39
B-Cell Inhibitor Drugs
Stop Ben's in a Tux: Benlysta, Rituxan
40
T cell Inhibitor Drugs
Orencia
41
PDE-4 Inhibitor Drugs
Otezla
42
JAK Inhibitor Drugs
JACK CROOX'ed: Cibinqo, Rinvoq, Oluminant, Opzelura, Xeljanz
43
S1P Receptor Modulator Drugs
Zeposia
44
GLP-2 Analog Drugs
Gattex
45
Calcineurin Inhibitor Drugs
Lupkynis
46
C5a Receptor Inhibitor Drugs
Tavneos
47
BBW for TNF inhibitors
malignancies, serious infections (TB)
48
AEs TNF Inhibitors
CHF, demyelinating diseases, HBV reactivation, infections, headache, nausea, ISR, cytopenia, lupus like syndrome
49
Stability of Humira
room temp for single period of <14 days
50
Latex in Humira
yes in needle cover, CF is also latex free
51
Baseline labs for TNFs
CBC with diff, TB, HBV, CMP
52
Monitoring for TNFs
CBC with diff, TB, CMP
53
What indications of Humira do not need loading dose? What is dose?
RA, PsA, AS: 40mg every other week
54
What is dose of Humira for uveitis and PP?
80mg initially then 40mg every other week (1 week after initial dose)
55
what is dose of Humira for HS?
160mg on day 1, then 80 mg every other week starting day 15 (or 40 mg every week)
56
what is CD/UC dose of Humira?
160mg on day 1, 80 mg on day 15, then 40mg every other week
57
what are the approved pediatric doses of Humira?
CD, UC, HS, Uveitis
58
What are the approved indications for Enbrel?
RA, PsA, AS, PP, JIA, PP (peds)
59
What adult indication of Enbrel has different dosing than the rest? and what is it?
PP: 50mg BID x 3 months then QW
60
what is the only TNF inhibitor that doesn't have a gastro indication?
enbrel
61
what is enbrels stability ?
room temp for single period of <14 days
62
what indication of cimzia doesn't need a load and what are the directions?
PP- 400mg q2w
63
what is dose for CD for cimzia
400mg at 0,2,4 wks then 400 q4w
64
what is dose for RA/AS/PsA/nr-axSpA for cimzia
400mg at 0, 2, 4 wks then 400 q4w or 200mg q2w
65
storage for cimzia (PFS vs vials)
PFS: RT for <7 days; unopened vials: RT <6 months; reconstituted vials: RT <2 hr or in fridge < 24 hours
66
what are approved indications of simponi
RA, PsA, AS, UC
67
what simponi indication has a load? what is it?
UC: 200mg wk 0, 100mg wk 2, then 100mg q4w
68
what is dosing for simponi in RA, PsA, AS if SQ?
50mg q4w
69
what is dosing for simponi in RA, PsA, AS if IV?
2mg/kg at wk 0 & 4 then q8w
70
what indication of simponi does not have IV dosing?
UC
71
what is the only TNF inhibitor that has both SQ and IV dosing
simponi
72
what is the only TNF inhibitor that only has IV dosing
remicade
73
what is stability of simponi
SQ <30 days RT; vials <4 hours reconstituted
74
what amount of time is simponi aria infused over
30 mins
75
what TNF inhibitor needs to be protected from light?
simponi
76
what is the only TNF inhibitor you need to premedicate with and what is the regimen?
Remicade, benadryl/APAP/and/or steroids
77
what is RA dosing for remicade
3mg/kg at 0, 2, and 6 weeks then q8w
78
what is CD, UC, PP, PsA dosing for remicade
5mg/kg at 0, 2, and 6 weeks then q8w
79
what is AS dosing for remicade
5mg/kg at 0, 2, and 6 weeks then q6w
80
within what time range should remicade be infused after preparation?
3 hour
81
how is remicade billed?
by units; 1 vial= 100mg= 10 units
82
in what condition is the dose modified for remicade?
mod-severe CHF
83
how long is remicade infused over?
>2 hours
84
What are the IL-1 inhibitor drugs?
Kineret, Arcalyst, Ilaris (one big KAIL leaf)
85
What are the IL-4 inhibitor drugs?
DIL-4 PICKLE - Dupixent
86
what are the indications for dupixent?
nasal polyps, AD, EoE
87
what indication of dupixent needs a load and what is it?
AD: 600mg on day 1 then 300mg qow
88
How is dupixent dosed for EoE?
300mg QW
89
stability of dupixent
<14 days at RT
90
missed dosing for dupixent?
admin within 7 days then resume schedule; if not within 7 days, then wait for next dose,
91
what should always be monitored with dupixent?
ocular changes
92
AEs with dupixent
conjunctivitis, blepharitis, dry eyes, ISR, HSV,
93
Approved Indications for Kineret
RA, NOMID
94
dose for Kineret in RA
100mg QD (subq)
95
when does kineret dosing need to be adjusted? and what is it
CrCl <30ml/min down to QOD dosing
96
Approved Indications for Arcalyst
CAPS
97
Approved Indications for Ilaris
CAPS, AOSD, FMF, HIDS, TRAPS
98
What IL-1 is healthcare administered
Ilaris
99
AEs for Kineret
most common- injection site reaction (can be late onset); infection; HA; nausea; fever; ISR: arthralgia
100
AEs for Ilaris
infection, nasopharyngitis, diarrhea, HA, nausea, WEIGHT GAIN, ISR, increased liver enzymes
101
AEs for Arcalyst
infection, URI, ISR, cough, sinusitis, bacterial meningitis, HLD, neutropenia
102
monitoring for Ilaris and Arcalyst
TB, CBC with diff, CRP, serum amyloid A, FLP for Arcalyst only
103
what are IL-6 Inhibitor drugs?
AK-6= actemra, kevzara
104
Kevzara indications and dosing
just RA: 200mg q2w
105
what are the 5 actemra indications
RA, GCA, SSc-ILD, pJIA, sJIA
106
what indication of actemra is doses QW
SSc-ILD
107
when does IL-6s need to have a dose reduction?
abnormal LFTs, neutropenia, thrombocytopenia
108
monitoring for IL-6
TB, HBV, ALT/AST (baseline, in 4-8 wk, Q3m), lipid panel (baseline, 4-8 wk, q6m), gi perforation
109
AEs for IL-6
URI, nasopharyngitis, HA, HTN, increased ALT, ISR, HLD, infusion rxn, GI perf, infection
110
what are IL-13 inhibitor drugs?
13 ads a day on tv: Adbry
111
what are approved indications for adbry and dosing?
AD: 600mg sq then 300mg qow
112
stability of adbry
<14 days RT
113
AEs Adbry
similar to dupixent (IL-4): ocular issues
114
counseling on adbry
missed dosing (same as dupixent) and moving injections at least 1 inch apart
115
what are the IL-17 drugs
17 tacos: Taltz, Cosentyx, Siliq
116
what drug class is stelara
IL-12/23 (only one)
117
what are the IL-23 Inhibitors?
23 dogs SIT: Skyrizi, Alumna, Tremfya
118
what is indication for siliq and dosing?
PP:210mg wk 0, 1, 2 then 210 q2w
119
which IL has a rems and which IL class is it? what is rems for?
Siliq- (IL 17) for suicidal ideation
120
when can you change adbry dose?
at 16 wks of treatment with clear or almost clear skin, dose can be dropped to 300mg q4 wk if patient is <100kg
121
stability of IL-17s
Siliq: <14 days at RT
Cosentyx; <4 days
Taltz: <5 days
122
when should siliq be d/c'ed?
if no response in 12-16 weeks
123
monitoring siliq
infection, CD exacerbations, suicidal thoughts, TB/CBC at baseline
124
monitoring for IL-17s
TB/CBC baseline, IBD new onset
125
AEs Cosentyx
infection (candida/staph), URI, HSV, diarrhea, impetigo, increased LFTs, neutropenia, IBD
126
AEs for Taltz
ISR, fungal infection, URI, Nausea, neutropenia, IBD
127
What Taltz indication doesn't need a load?
nr-axSpA
128
dosing for Taltz in PP
160mg once, 80mg weeks 2-12, then 80mg q4w
129
dosing for taltz in AS and PsA
160mg once then 80mg q4w
130
PP dosing in cosentyx
300mg x 5 weeks then 300mg q4w
131
PsA, AS, and nr-axSpA dosing in cosentyx
150mg x 5 weeks then 150mg q4w
132
What are approved indications for stelara
PP, PsA, CD, UC
133
dosing for UC/CD
induction: single IV dose based on weight then 90mg q8w
<55kg: 260mg
>55-85kg: 390mg
>85kg: 520mg
134
stability for stelara
PFS RT 30 days
reconstituted vials <7 hours
135
what genetic component to stelara?
those deficient in IL12/23 --> risk of salmonella, mycobacteria, BCG virus
136
BCG vaccine and stelara
not given within 1 year prior to stelara initiation and then 1 year after discontinutation
137
PP stelara dosing
<100kg: 45mg week 0, 4, q12w
>100kg: 90mg week 0, 4, q12w
138
monitoring stelara
baseline: TB, CDC
symptoms TB, infections, RPLS, squamous cell carcinoma
139
approved indications for ilumya and dosing
PP: 100mg week 0, 4, and q12w
140
approved indications skyrizi and dosing
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
what do you check before starting skyrizi in CD patients
liver enzymes and bilirubin
142
what are approved indications for Tremfya and dosing?
PsA and PP: 100mg week 0, 4, then q8q
143
ADEs for IL-23s
all: infection, URI, HA, ISR
skyrizi: tines, herpes, zoster, cellulitis, osteomyelitis
Tremfya: HSV, tines, inc liver enzymes, gastroenteritis
144
what are IL-23 inhibitor drugs?
23 dogs SIT: skyrizi, ilumya, tremfya
145
what are the JAK inhibitor drugs?
CROOX: cibinqo, rinvoq, olumiant, opzelura, xeljanz
146
dose reduction needed in JAKs
renal impairment, hepatic impairment, anemia, lymphopenia, neutropenia
xeljanz: CYP3A4 or 2C19 inhibs
cibinqo: CYP2C19 poor metabolizers
147
counseling on xeljanx XR tab
shell in stool
148
BBW in JAKs
infection, malignancy, thrombosis, PE, MACE, mortality
149
monitoring in JAKs
LFTs, CBC, HBV, TB, fasting lipid panels, skin cancer
150
General drug interactions with JAKs
xeljanz/rinvoq: avoid CYP3A4 inducers
olumiant: avoid OAT3 inhibitors
cibinqo: avoid CYP219 inducers
151
generic xeljanz
tofacitinib
152
generic rinvoq
upadacitinib
153
generic oluminant
baricitinib
154
generic cibinqo
abrocitinib
155
generic opzelura
ruxolitinib
156
xeljanz UC dose
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
xeljanz RA/AS/PsA dose
5mg BID or 11 qd
158
what indication of xeljanz has induction dose?
ulcerative colitis
159
rinvoq dosing
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
what indication of rinvoq has induction dose
ulcerative colitis
161
oluminant dosing
RA: 2mg qd
alopecia: 2mg qd; may inc to 4mg if inadequate response
162
cibinqo dosing
100mg qd; if insufficient response in 12 weeks may increase to 200mg
163
what is max dosing area of opzelura
20% BSA
164
when should opzelura therapy be reassesed
at 8 wk with no s/s resolution
165
monitoring for opzelura
skin exams for basal and squamous cell carcinoma, s/s infection
166
what are the T-cell inhibitor drugs
orencia
167
what are approved indications for orencia
RA, PsA, JIA
168
which indication of Orencia has optional loading dose? and how does it work
RA- sq dosing; single infusion followed by first 125mg injection within 24 hours of infusion
169
what is monitoring for t-cell inhibitors
s/s infection; worsening of respiratory status in COPD pt
170
when do you avoid live vaccines for orencia
concurrently and within 3 months of discontinuing
171
AEs for orencia
infection, HA, N, nasopharyngitis, HTN,
RARE: malignancies, COPD EXACERBATION
172
what are the PDE-4 inhibitor drugs?
otezla
173
what is generic for otezla
apremilast
174
approved indications for otezla
Behcets, PP, PsA
175
dosing for otezla
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
what does allergen does otezla contain
lactose
177
when does otezla have to be dose adjusted
CrCl < 30mg/ml
178
what drugs do you need to avoid with otezla
strong CYP450 inducers
179
monitoring for otezla
renal fxn, changes in weight, depression, suicidal thoughts
180
AEs for Otezla
HA, weight loss, GI ISSUES,
RARE: afib, depression, suicidal ideation
181
what drugs are b-lymphocyte stimulator protein inhibitors
benlysta
182
what is generic benlysta
belimumab
183
what are approved indications for benlysta
SLE and Lupus Nephritis
184
IV Dosing for benlysta
same regardless of indication
10mg/kg q2w x 3 doses then 10mg/kg q4w
185
SC dosing for benlysta
SLE: 200mg QW
Lupus: 400mg QW x 4 doses then 200mg QW
186
how long is benlysta IV infused over
1 hour
187
who is benlysta not recommended for
severe active CNS lupus or severe active lupus nephritis
188
who may have lower response rate for benlysta
african americans
189
does benlysta have latex
ALL formulations are latex free
190
monitoring for benlysta
infections, worsening depression, suicidal thoughts, new onset or deteriorating neurological symptoms
191
AEs Benlysta
N/V/D, infusion rxn, pyrexia, insomnia, depression, migraine, limb pain
rare: PML, suicide ideation
192
TB testing for benlysta
NONE
193
what drug is integrin receptor antagonist
entyvio
194
generic for entyvio
vedolizumab
195
indications for entyvio
UC and CD
196
dosing for entyvio
300mg at 0,2,6 then q8w
197
when should entyvio be discontinued?
at 14 week if no therapeutic benefit
198
how long should entyvio be infused over
30 minutes
199
monitoring for entyvio
TB, LFTs, infection, infusion rxn, PML not reported but possible, new or worsening neurological symptoms
200
AEs entyvio
HA, arthrglia, LFTs, flu, back/limb pain, fever
201
what drugs are selective adhesion molecule inhibitor
Tysabri
202
generic tysabri
natalizumab
203
what are approved indications for tysabri
CD and MD
204
dose for tysabri
300mg q4w
205
how is tysabri given
IV
206
how long is tysabri infused over
1 hour
207
when should tysabri be discontinued
within 6 months if steroids cannot be tapered or if not therapeutic benefit in 12 weeks
208
why is tysabri in REMS
risk of PML; touch program
209
monitoring for tysabri
meningitis, encephliits, PML, baseline brain MRI,
210
AEs for tysabri
HA, fatigue, depression, infusion rxn, PML
211
BBW for tysabri
PML
212
what are anti-CD20 monoclonal antibody dug
rituxan
213
what are approved indications for rituxan
RA and pemphigus vulgaris
214
what do you premeditate with for Rituxan infusion
antihistamine, APAP, methylprednisolone 100mg IV 30 min prior
215
monitoring rituxan
HBV, CBC, renal fxn, fluid status, infusion rxn, CARDIAC monitoring if history of arrhythmias, vitals
216
AEs rituxan
ALOT, edema, cytopenia, night sweats, hyperglycemia, hypotension, anxiety, throat irritation, infusion rxn, mucocutaneous rxn, PML
217
urate oxidase enzyme drugs
krystexxa
218
krystexxa indications
gout
219
krystexxa dosing
8mg q2wk
220
Rituxan RA dose
1000mg day 1 and 15 then 1000 q16-24 wk
221
how long is krystexxa infused over
120 minutes
222
what do you premeditate with for krystexxa
antihistamine, steroids
223
what is krystexxa contraindicated in and why
G6PD deficiency- risk of hemolysis and methemoglobinemia
224
what monitoring is needed on krystexxa
UA levels prior to infusion
225
AEs for krystexxa
bruising, antibody formation, infusion rxn, erythema, pruritus,
226
BBW for krystexxa
anaphylactic infusion, G6PD deficiency
227
what drug should not be used with krystexxa
PO urate lowering agents prior to initiation and do not initiate during treatment
228
what is flare prophylaxis regimen with krystexxa
NSAID or colchicine beginning 1 week prior to initiation and continue for 6 months
229
generic xolair
omalizumab
230
indications for xolair
chronic idiopathic urticaria, nasal polyps, severe asthma
231
urticaria dose for xolair
150 or 300mg q4w
232
how long do xolair injections take
5-10 seconds- viscous solution
233
monitoring for xolair
baseline serum total IgE, signs infections, hypersensitivity reaction
234
how to observe patient post xolair injection
2 hours after the first 3 injections and 30 minutes after each subsequent injection
235
AEs for xolair
HA, injection site reaction,
RARE: antibody development, malignant neoplasm, serum sickness, severe thrombocytopenia
236
BBW for xolair
anaphylaxis
237
what drug class is xolair
Anti-IgG Monoclonal antibody
238
what drug class is methotrexate
dihydrofolate reductase inhibitor
239
brand names for methotrexate
otrexup, rasuvo, reditrex
240
indications for injectable methotrexate
RA and PP
241
injectable methotrexate doses
RR: 10-25 QW
PP: 7.5-20 QW
242
when do you d/c injectable methotrexate
significant decline in blood counts
243
pregnancy category with methotrexate
category X
244
what do you need to restrict with methotrexate use
alcohol
245
which formulation of SQ methotrexate is PFS
reditrex
246
SQ Methotrexate monitoring
CBC initial and q4-8w, acute neurotoxicity
247
AEs with methotrexate
infection, alopecia, rash, photosensitivity, pruritis, thrombocytopenia, increased LFTs, blurred vision, arthralgia, renal failure
248
BBW with SQ methotrexate
BM suppression, aplastic anemia, GI toxicity with NSAIDs, pneumonia, renal/liver/stomach toxicity
249
indication for Gattex
SBS
250
dose for Gattex
0.05mg/kg once daily
251
how is gate administered
SQ- room temp vial
252
what is REMs for Gattex for
increase awareness of neoplastic growth, colon polyp growth, GI obstruction, biliary/pancreatic disorders
253
monitoring for Gattex
colonoscopy, bilirubin, alk phosphate, lipase, amylase, fluid status in CHF
254
what drugs are GLP-2 analogs
Gattex
255
What drugs are S1P Receptor Modulator
Zeposia
256
generic for zeposia
ozanimod
257
indications for zeposia
UC
