LG3.5 Pharmacology for DMARDS – Dr. Wightkin

Question 1

What has the stem name “-mab”?

Answer 1

Monoclonal antibody

Question 2

What has the stem name “-cept”?

Answer 2

Fusion protein

Question 3

What is the stem name “-nib”?

Answer 3

Kinase inhibitor

Question 4

What does DMARDS?

Answer 4

Disease-modifying Anti-Rheumatic Drugs

Question 5

What is the goal of DMARDS?

Answer 5

Therapy with DMARDS should be initiated with the goals of preventing or controlling joint damage, preventing loss of function, and decreasing pain.

Question 6

What is the MOI of Biological DMARD’s?

Answer 6

Target is TNF-alpha

Question 7

What is the function of TNF-alpha?

Answer 7

Activates leukocytes, endothelial cells, and synovial fibroblasts, including production of cytokinesm chemokines, adhesion molecules, and matrix enzymes, suppression of regulatory T-cell function, activation of osteoclasts, and respiration of cartilage and bone, mediates metabolic and cognitive dysfunction.

Question 8

What is the function of monoclonal antibodies?

Answer 8

binds to ligand or receptor

Question 9

What is the function of fusion proteins?

Answer 9

Binds ligand or false receptor

Question 10

What are fusion proteins?

Answer 10

Are proteins created through the joining of two or more genes that originally coded for separated proteins

Question 11

What is the function of kinase inhibitors?

Answer 11

A protein kinase inhibitor is a type of enzyme inhibitor that blocks the action of one or more protein kinases. Protein kinases are enzymes that add a phosphate group to a protein or other organic molecule. Phosphate groups can turn a protein off.

Question 12

What are concerns of the use of Biological DMARDs?

Answer 12

• Increased risk for tuberculosis and fungal infections.

- Can cause lymphoma in young patients.

Question 13

What are the two conventional DMARD’s?

Answer 13

Methotrexate and Leflunomide

Question 14

What is the MOI of Methotrexate?

Answer 14

• Dihydrofolate reductase
• Given IV
• Inhibits DNA and RNA synthesis, increases adenosine levels.
• Decreases intracellular tetrahydrofolate

Question 15

What is the MOI of Leflunomide?

Answer 15

• Active form is teriflunomide.
• inhibits pyrimidine nucleotides
• Specific for lymphocytes

Question 16

What are the adverse effects of Methotrexate?

Answer 16

GI intolerance, cirrhosis, bone marrow intolerance

Question 17

What are the adverse effects of Leflunomide?

Answer 17

Teratogen, Women have to eliminate with cholestyramine, which binds to bile

Question 18

What endemic Phoenix area fungal infection should be screened for prior to giving a patient with rheumatoid arthritis an inhibitor of tumor necrosis factor?
A) Mycobacterium tuberculosis
B) Candida albicans
C) Histoplasma capsulatum
D) Coccidioides immitis
E) Giardia lamblia

Answer 18

D) Coccidioides immitis

Question 19

What drug is NOT a DMARD?
A) Ibuprofen
B) Methotrexate
C) Leflunomide
D) Infliximab
E) Etanercept

Answer 19

A) Ibuprofen

Question 20

This drug inhibits the action of dihydrofolate reductase?

A) leflunomide
B) methotrexate
C) rituximab
D) naproxen
E) prednisone

Answer 20

B) Methotrexate

Question 21

What type of drug would Kalousekomab be?

Answer 21

Monoclonal antibody

Question 22

What type of drug would Mcqueenacept be?

Answer 22

Fusion protein

Question 23

What type of drug would Wightkininib be?

Answer 23

Kinase inhibitor