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Pharm Test 3 > RA > Flashcards

RA Flashcards

1
Q

In the treatment of rheumatoid arthritis

a. methotrexate inhibits DNA synthesis in immune cells

A

A. False. This is leflunomide, Methotrexate MOA in RA unclear but:

  • Increases extracellular adenosine  increase adenosine A2A receptor signalling  decrease inflammation
  • Increases ROS in T-cells  apoptosis
  • Reduces expression of adhesion molecules  VCam- 1, I-Cam, E-selection
  • Decreases pro-inflammatory cytokines
  • Suppresses early T- and B-cell proliferation
  • Decrease antibody formation to TNF-α McABs
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2
Q

In the treatment of rheumatoid arthritis

b. leflunomide is safe to use during pregnancy

A

B. False. CI in pregnancy. Requires 2-year washout period

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3
Q

In the treatment of rheumatoid arthritis

c. infliximab binds to TNF-α

A

C. True. Infliximab has a high-affinity for TNF-α

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4
Q

In the treatment of rheumatoid arthritis

d. folic acid supplementation aggravates methotrexate-induced hepatotoxicity

A

D. False. Folic acid reduces methotrexate associated adverse effects

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5
Q

In the treatment of rheumatoid arthritis

e. sulfasalazine is hepatotoxic

A

E. True. Sulfasalazine is

  • Hepatotoxic
  • Myelotoxic
  • Hypersensitivity
  • Megaloblastic anaemia
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6
Q

Disease modifying agents in rheumatoid arthritis

a. methotrexate causes mucosal ulceration

A

A. True, Methotrexate causes:

  • Hepatotoxic
  • Mucosal ulceration & bleeding (Mouth ulcers common)
  • Nephropathy
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7
Q

Disease modifying agents in rheumatoid arthritis

b. leflunomide inhibits T-cell proliferation

A

B. True, inhibits mononuclear and Tcell proliferation  Active metabolite  Inhibits dihydroorotate dehydrogenase  No pyrimidine (uridine) synthesis  Decrease synthesis of DNA/RNA in immune cells

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8
Q

Disease modifying agents in rheumatoid arthritis

c. sulfasalazine increases TNF-α levels in arthritic joints

A

C. False. Sulfasalazine

  • Decrease RF
  • Inhibits T cell response
  • Decrease B cell antibody production
  • Decrease IL-1, IL6, IL12, TNF-α
  • MOA ≠ Cox inhibition
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9
Q

Disease modifying agents in rheumatoid arthritis

d. infliximab is safe to use in patients with latent tuberculosis

A

D. False. Infliximab increases infection risk

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10
Q

Disease modifying agents in rheumatoid arthritis

e. hydroxychloroquine is a folic acid antagonist

A

E. False. MOA unknown. Methotrexate is a folic acid antagonist n cancer

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11
Q

The following is/are true regarding rheumatoid arthritis:

a. NSAIDS prevent the formation of bone lesions

A

A. False. IL-6 receptor prevents osteoclastic activity

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12
Q

The following is/are true regarding rheumatoid arthritis:

b. Methotrexate is hepatotoxic

A

B. True, Methotrexate causes:

  • Hepatotoxic
  • Mucosal ulceration & bleeding (Mouth ulcers common)
  • Nephropathy
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13
Q

The following is/are true regarding rheumatoid arthritis:

c. Hydroxychloroquine increases the risk of ocular damage

A

C. True

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14
Q

The following is/are true regarding rheumatoid arthritis:

d. Leflunomide is safe to use during pregnancy

A

D. False.

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15
Q

The following is/are true regarding rheumatoid arthritis:

e. Infliximab increases circulating TNF-α levels

A

E. False, decreases by binding to both circulating and membrane bound

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16
Q

Treatment of rheumatoid arthritis

a. Rituximab stimulates antibodies by B-cells

A

A. False. Cause depletion of circulating B–cells by ADCC, CDC, Apoptosis

17
Q

Treatment of rheumatoid arthritis

b. Etanercept binds to TNF-α receptors

18
Q

Treatment of rheumatoid arthritis

c. Infliximab increases the risk for upper respiratory tract infections

A

C. True, UTIs and URTI

19
Q

Treatment of rheumatoid arthritis

d. Tocilizumab is safe to use in children

A

D. True. Treatment for juvenile RA of >2years

20
Q

Treatment of rheumatoid arthritis

e. Methotrexate adverse effects are reversed by folic acid

A

E. False. Reduced

21
Q

In the treatment of rheumatoid arthritis

a. Methotrexate inhibits the action of tumour necrosis factor

A

a. False. Methotrexate MOA in RA unclear but:
- Increases extracellular adenosine  increase adenosine A2A receptor signalling  decrease inflammation
- Increases ROS in T-cells  apoptosis
- Reduces expression of adhesion molecules  VCam- 1, I-Cam, E-selection
- Decreases pro-inflammatory cytokines
- Suppresses early T- and B-cell proliferation
- Decrease antibody formation to TNF-α McABs

22
Q

In the treatment of rheumatoid arthritis

b. Leflunomide is safe to use during pregnancy

A

b. False. CI and requires 2 year wash out period

23
Q

In the treatment of rheumatoid arthritis

c. Infliximab decreases circulating tumour necrosis factor

A

c. True, both circulating and bound

24
Q

In the treatment of rheumatoid arthritis

d. Hydroxylchoroquine inhibits COX II in the inflammatory joints

A

d. False, anti malarial drug

25
Q

In the treatment of rheumatoid arthritis

e. Rituximab decreases B-cell responses

26
Q

In the treatment of rheumatoid arthritis, methotrexate causes bone marrow suppression

27
Q

Prednisone decreases inflammation in rheumatoid arthritis

28
Q

Probenecid is used in the treatment of rheumatoid arthritis

A

False. Gout

29
Q

Match the mechanism of action with the rheumatoid arthritis agents

  1. methotrexate
    a. TNF-α inhibitor
    b. Inhibits DHFR
    c. B-cell inhibitor (CD20)
    d. dihydroorotate dehydrogenase
    e. Inhibits T cell response
A

b. Inhibits DHFR

30
Q

Match the mechanism of action with the rheumatoid arthritis agents

  1. etanercept
    a. TNF-α inhibitor
    b. Inhibits DHFR
    c. B-cell inhibitor (CD20)
    d. dihydroorotate dehydrogenase
    e. Inhibits T cell response
A

a. TNF-α inhibitor

31
Q

Match the mechanism of action with the rheumatoid arthritis agents

  1. rituximab
    a. TNF-α inhibitor
    b. Inhibits DHFR
    c. B-cell inhibitor (CD20)
    d. dihydroorotate dehydrogenase
    e. Inhibits T cell response
A

c. B-cell inhibitor (CD20)

32
Q

Match the mechanism of action with the rheumatoid arthritis agents

  1. sulfasalazine
    a. TNF-α inhibitor
    b. Inhibits DHFR
    c. B-cell inhibitor (CD20)
    d. dihydroorotate dehydrogenase
    e. Inhibits T cell response
A

e. Inhibits T cell response

33
Q

Match the mechanism of action with the rheumatoid arthritis agents

  1. leflunomide
    a. TNF-α inhibitor
    b. Inhibits DHFR
    c. B-cell inhibitor (CD20)
    d. dihydroorotate dehydrogenase
    e. Inhibits T cell response
A

d. dihydroorotate dehydrogenase

Pharm Test 3 (6 decks)

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