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Pharmacotherapy 2 - Final Exam > RA Study Guide > Flashcards

RA Study Guide Flashcards

1
Q

1st Line RA tx

A

Non-biologic DMARDs

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2
Q

2nd Line RA tx

A

Biologic DMARDs

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3
Q

Preferred DMARD for RA

A

Methotrexate

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4
Q

Methotrexate MoA

A

Inhibits dihydrofolate redutase & production of cytokines to prevent joint destruction

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5
Q

Methotrexate Drawbacks

A

Contraindications (Hepatic dz; Preg; reduce with renal dz); Side effects (Hepatotoxic; Pulm fibrosis; Leukopenia, Thrombocytopenia)

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6
Q

Hydroxychloroquine Drawbacks

A

Slow onset (6 mo); Side effects (eye problems)&raquo_space; Eye exam Qyear required

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7
Q

Sulfasalazine Drawbacks

A

Monitoring (LFTs & CBC); Side effects (agranulocytosis; hepatotoxic; photosensitivity); slow onset (6 mo); Sulfa allergy

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8
Q

Preferred RA drug in Pregnancy

A

Sulfasalazine

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9
Q

Leflunomide (Arava) MoA

A

Prevents T cell response by inhibiting dihydrorotate dehydrogenase in mitochondria)

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10
Q

Leflunomide (Arava) Drawbacks

A

Avoid with heavy ETOH use; Side effects (Hepatotoxic, HTN, Abd pain); Monitor (LFTs, CBC, & Cr)

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11
Q

Non-biologic DMARDS for RA

A

Methotrexate; Hydroxychloroquine; Sulfasalazine; Leflunomide

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12
Q

Biologic DMARD classes

A

Tumor necrosis factor antagonists; Interleukin 1 receptor antagonist; Costimulation modulators; Anti-CD20 Monoclonal Ab; Anti-Interleukin 6 receptor Ab

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13
Q

Tumor Necrosis Factor Antagonists

A

Etanercept (Enbrel); Infliximab (Remicade); Adalimumab (Humira)

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14
Q

Costimulation Modulator (Prevents T-cell activation)

A

Abatacept (Orencia)

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15
Q

Anti-CD20 Monoclonal AB (B-cell depletion)

A

Rituximab (Rituxan)

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16
Q

Etanercept (Enbrel) Side Effects

A

Pancytopenia; Neurologic demyelinization; Reactivation of TB

17
Q

Etanercept (Enbrel) Advantages

A

Onset in 1-4 wks; used in combo with MTX

18
Q

Etanercept (Enbrel) Route

A

SC injection once or twice per week

19
Q

Infliximab (Remicade) Route

A

IV infusion

20
Q

Infliximab (Remicade) Drawbacks

A

Infusion rxn; Reactivation of TB

21
Q

Infliximab (Remicade) Advantages

A

Same as Enbrel; Onset in 1-4 wks; used in combo with MTX

22
Q

Rituximab (Rituxan) Route

A

IV infusion every 2 wks x 2

23
Q

Rituximab (Rituxan) Drawbacks

A

Same as Infliximab; Infusion rxn; Reactivation of TB

24
Q

Rituximab (Rituxan) Advantages

A

Onset in 4 wks; used in combo with MTX

25
Q

Abatacept (Orencia) Route

A

IV infusion

26
Q

Abatacept (Orencia) Drawbacks

A

HA, infusion rxn, immunosuppression

27
Q

Abatacept (Orencia) Advantages

A

Onset in 2 wks; Use if TNF tx fails; Can be used in combo

28
Q

Contraindicated Tx in Juvenile RA

A

Corticosteroids

29
Q

RA & Reproduction

A

Most agents teratogenic or abortifacients; stop meds 3 months before conception; Males & females should be counseled

Pharmacotherapy 2 - Final Exam (10 decks)

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