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7262 MS Block 1 > RA/Gout Med Chem > Flashcards

RA/Gout Med Chem Flashcards

1
Q

What RA drug class is minocycline?

A

nonbiological DMARD

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2
Q

What RA drug class is azathioprine?

A

nonbiological DMARD

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3
Q

What RA drug class is gold?

A

nonbiological DMARD

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4
Q

What RA drug class is penicillamine?

A

nonbiological DMARD

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5
Q

What is the nonbiological DMARD methotrexate MOA?

A

inhibits DNA synthesis

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6
Q

What is the target of methotrexate?

A

dihydrofolate reductase (DHFR)

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7
Q

Main AE of methotrexate?

A

hepatotoxicity

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8
Q

What is the drug food interaction between cola and MTX?

A

increased MTX serum levels

MTX has limited solubility at pH below 7

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9
Q

What is the DDI between penicillin and MTX?

A

decreases elimination of MTX

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10
Q

What is the DDI between cyclosporine and MTX?

A

potentiates MTX’s hematologic effects

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11
Q

Do nsaids increase MTX toxicity?

A

yes

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12
Q

How does probenecid affect MTX?

A

inhibits MTX excretion

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13
Q

What are the 2 main contraindications for MTX use?

A

liver disease

immunodeficiency

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14
Q

What is the active form of leflunomide?

A

teriflunomide

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15
Q

What is the target of the nonbiological DMARD leflunomide?

A

dihydroorotate dehydrogenase (DHODH)

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16
Q

Leflunomide inhibits the denovo synthesis of ____.

A

pyrimidine

cytosine, thymine

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17
Q

What is the half life of teriflunomide?

A

14-18 day

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18
Q

2 main AEs of leflunomide?

A

infection

liver toxicity

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19
Q

What is the DDI between leflunomide and warfarin?

A

increased risk of bleeding

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20
Q

Which nonbiological DMARD cause increased levels of repaglinide, rosuvastatin, pioglitazone, and rosiglitazone?

A

leflunomide

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21
Q

2 main contraindications of leflunomide?

A

pregnancy

hepatic impairment

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22
Q

What is recommended a a binding agent for leflunomide toxicity?

A

cholestyramine

23
Q

Which nonbiological DMARD has the possible target of toll-like receptor 9 (TLR9) family receptors?

A

hydroxychloroquine

24
Q

Does hydroxychloroquine have rapid or slow GI absorption?

A

rapid

half life 32-50 days, but fast absorption means Sx of overdose can occur as early as 30mins

25
Q

Hypersensitivity to ___ compound is a CI for hydroxychloroquine

A

4-aminoquinoline

26
Q

Which nonbiological DMARD can cause increased serum digoxin concentrations?

A

hydroxychloroquine

27
Q

Which portion of the TNF alpha inhibitor infliximab is from human IgG1?

A

Fc

28
Q

Which portion of infliximab is murine?

A

Fab

29
Q

What is the target of rituximab?

A

CD20 protein on cell

anti-CD20 antibody

30
Q

Which med targets CD80/86 on APCs?

A

abatacept

31
Q

Which cell targets CD20 of B cells?

A

rituximab

32
Q

Which med targets IL6 signaling?

A

tociluzumab

33
Q

Which med targets IL1 signaling?

A

anakinra

34
Q

Which TNF alpha med targets soluble TNF receptors?

A

etanercept

infliximab, adalimumab, certolizumab, golimumab are anti-TNF alpha antibodies

35
Q

2 main DDIs of etanercept?

A

anakinra
live vaccines

increased risk of infection

36
Q

2 main AEs of etanercept?

A

injection site rxn

infections

37
Q

Which TNF Alpha inhibitor is CI in heart failure?

A

infliximab

do not give doses greater than 5mg/kg

38
Q

Which class of meds inhibits the formation of uric acid

A

xanthine oxidase inhibitors

39
Q

Does colchicine have an effect on serum uric acid level?

A

no

40
Q

What is the target of colchicine?

A

tubulin

arrests neutrophil motility, decreases inflammation

41
Q

What CYP metabolizes colchicine?

A

CYP3A4

DDI with 3A4 inhibitors: azoles, macrolides, protease inhibitors

42
Q

Colchicine has DDIs with inhibitors of?

A

P-gp

3A4

43
Q

Why shouldn’t urate reducing therapy be initiated during an acute gout attack?

A

may prolong attack by changing equilibrium of body rate

44
Q

Which xanthine oxidase inhibitor can cause hypersensitivity syndrome?

A

allopurinol

allopurinol hypersensitivity syndrome (AHS)

exfoliative dermatitis, vasculitis, fever, liver dysfunction, eosinophilia, acute interstitial nephritis,; most likely to occur in pts with renal disease along with diuretic therapy; may be fatal

45
Q

Which XOI is NOT purine like?

A

febuxostat

46
Q

Which XOI causes increased serum conc. of one metabolite of theophylline?

A

febuxostat

47
Q

What is the target of probenecid?

A

urate anion exchange transporter (URAT1)

48
Q

Probenecid is used to reduce hyperuricemia in pts who excrete < ___ mg of uric acid per day

A

600

49
Q

What is the main CI for probenecid?

A

do not use during acute, gouty attack

50
Q

What is the target of pegloticase?

A

uric acid

51
Q

How does pegloticase lower uric acid level?

A

enhances uric acid degradation

52
Q

What does pegloticase convert uric acid too?

A

allantoin

more excretable metabolite

53
Q

What is major CI of pegloticase?

A

G6PD deficiency

7262 MS Block 1 (11 decks)

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