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RPM Pharm Quiz > MOS Pharm > Flashcards

MOS Pharm Flashcards

1
Q

glucocorticoid role

A

potent anti-inflammatory with rapid onset of action

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2
Q

glucocorticoid MOA

A

regulation of transcription: suppression of macrophage activation, cellular immunity, cytokine production, WBC trafficking to sites of inflammation

suppressive action on hypothalamic pituitary axis

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3
Q

glucocorticoid adverse effects

A

CNS effects, fluid retention, weight gain, hyperglycemia, cushings, HTN, infection, osteoporosis, cataracts, avascular necrosis, proximal myopathy

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4
Q

What to do before starting glucocorticoids?

A

PPD testing
review/update immunizations
consider bone health

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5
Q

Hydroxychloroquine action

A

anti-malarial agent
anti-inflammatory effects: inhibition of TLR, decreased cytokines, lymphocytes and NK cell activity
mild anti-coagulant

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6
Q

hydroxychloroquine indications

A

SLE, RA, Sjogren

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7
Q

hydroxychloroquine contra-indications

A

pre-existing retinopathy

G6PD deficiency

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8
Q

Hydroxychloroquine side effects/adverse effects

A

rash, GI

retinal toxicity, myopathy, cardiomyopathy

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9
Q

hydroxychloroquine is known to prevent what?

A

SLE flare ups

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10
Q

methotrexate moa

A

dihydrofolate reductase inhibition

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11
Q

methotrexate indications

A

rheumatic diseases, inflammatory myopathy or arthritis

Drug of choice RA

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12
Q

methotrexate side effects

A

nausea, fatigue, mucosal ulcerations, hepatotoxicity, bone marrow toxicity, pneumonitis

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13
Q

methotrexate warnings

A

teratogenic

drug interaction with sulfamethoxazole

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14
Q

leflunomide actions

A

dihydroorate dehydrogenase inhibitor
reduces de novo pyrimidine synthesis
reduces activated T cells

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15
Q

leflunomide indications

A

inflammatory arthritis, SLE

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16
Q

unique about leflunomide?

A

long half life

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17
Q

side effects and toxicities of leflunomide

A

side-effects: rash, alopecia, diarrhea

toxicities: liver, bone marrow

18
Q

azathioprine moa

A

immunosuppressant

19
Q

azathioprine indications

A

SLE, systemic vasculitis (maintenance therapy in ANCA vasculitis), inflammatory myopathy

20
Q

azathioprine side effects and toxicities

A

SE: GI, fever, rash, anaphylaxis
tox: infections, bone marrow, hepatotoxicity, malignancy

21
Q

draw backs and advantage of azathioprine

A

drug interactions: allopurinol, sulfasalazine, trimethoprim, ACEi
Advantage: Safe in pregnancy!

22
Q

mycophenolate mofetil moa and application

A

immunosuppressant

application in organ transplantation, SLE, scleroderma lung disease, inflammatory myopathy, vasculitis

23
Q

mycophenolate mofetil side effects and adverse effects

A

SE: dyspepsia, diarrhea, abdominal pain, headache, rash
adverse: infection, bone marrow suppression, malignancy

24
Q

cyclophosphamide moa and indications

A

alkylating agent

organ threatening manifestations of SLE, systemic vasculitis, systemics sclerosis-lung, and RA

25
Q

cyclophosphamide administration

A

oral: greater toxicity and efficacy

monthly IV is preferred, protects bladder from dysplasia (lupron preserves ovarian function in women)

26
Q

cyclophosphamide side effects and tox

A

SE: nausea, alopecia
Tox: infection risk, bone marrow, infertility, hemorrhagic cystitis, bladder malignancy, hem malignancy

27
Q

TNF alpha inhibitors (5)

A

etanercept, infliximab, adalimumab, certolizumab, golimumab

28
Q

TNF alpha inhibitor indications

A

RA, psoriasis, psoriatic arthritis, JIA, AS, Crohn’s

avoid in lupus! worsens disease

29
Q

TNF alpha inhibitor adverse effects

A

TB and hepatitis B re-activation

30
Q

TNF alpha inh cautions

A

pancytopenia, transaminitis, autoantibody formation,

NO LIVE VACCINES

31
Q

Rituximab MOA

A

monoclonal antibody CD20

MOA: B cell depletion

32
Q

rituximab indications

A

RA, ANCA vasculitis (GPA and MPA)

also, but less often: cryoglobulinemia, SLE, Sjogren

33
Q

rituximab adverse effects

A

infusion reactions, HTN, athralgias

INFECTIONS, NO LIVE VACCINES

34
Q

Tocilizumab moa

A

blocks IL6 signaling

35
Q

tocilizumab indications

A

RA, JIA, Giant cell arteritis

36
Q

tocilizumab adverse effects

A

infusion reactions, infections, cytopenia, dyslipidemia, GI perforation
NO LIVE VACCCINES

37
Q

belimumab moa

A

blocks action of B lymphocyte stimulator

38
Q

Belimumab indication

A

SLE which has been refractory to standard therapy

used for moderate, non-organ threatening disease, no role in first line therapy for renal or CNS

39
Q

belimumab adverse effects

A

hypersensitivity reactions, serious infections, depression

40
Q

IVIg indications

A

SLE

safe in pregnancy

RPM Pharm Quiz (2 decks)

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