RA Pharmacotherapy Flashcards
What does PQRSTA stand for?
P - precipitating Q - quality R - region/radiating S - severe T - temporal A - any associated Sx
What allergy is important for RA management?
sulfa
3 disease severity scales most common in US
CDAI
PAS
DAS
A ACR/EULAR score of ___ or higher is classified as definite RA
6
Early RA is < __ months
6
established RA is >= 6 months
Failure of __ or more synthetic DMARDS is poor RA prognosis
2
What is main goal of RA therapy?
complete disease remission or low disease activity
“treat to target”
__ is joint reconstruction or replacement
arthroplasty
__ is joint examination with possible removal of bone fragments or cartilage
arthroscopy
__ is bone or joint fusion
arthrodesis
Which drug class needs DEXA and FRAX assessment at regular monitoring interval?
corticosteroids
Which class can cause TB?
TNF alpha inhibitors
Abatacept dose for pt < 60kg?
500mg
Abatacept dose for pt 60-100kg
750mg
abatacept dose for pt > 100kg
1000mg every 2 weeks for 2 doses after the initial dose
Abatacept should not be given with what other drug class?
TNF alpha inhibitors
Premedicate with what 3 things with rituximab?
diphenhydramine
glucocorticoid
acetaminophen
DMARD monotherapy should be started within __ months of RA diagnosis
3
What is preferred DMARD for early RA?
MTX
What is preferred for combo therapies for mod to high RA?
synthetic DMARDs
Monotherapy is ineffective for mod to high RA
a. true
b. false
a true
Which is more effective for early RA?
DMARD (MTX) + biologic or biologic monotherapy?
DMARD (MTX) + biologic
Can JAKi be used for early RA?
no
Can all therapies be d/c for established RA?
no
Avoid which RA drug class in HF pts?
TNF alpha inhibitors
3 main high risk conditions for RA therapy?
CHF
Hep B/C
malignancies
Which is preferred for pts with Hep C DMARDs or TNF alpha inhibitors?
DMARDs
When should live vaccines be given to RA pts?
BEFORE DMARD therapy!!
killed vaccines (pneumococcal, IM influenza, hep B) and recombinant (HPV) can be given during therapy
Two main leflunomide AEs?
hepatitis, jaundice
