Rheumatoid Arthritis Flashcards
What medication classes are used for treatment of Rheumatoid Arthritis?
adjunct therapies- NSAIDs, Corticosteroids
DMARDs, biologic response modifiers (biologic DMARDs), targeted synthetic DMARDs
What are the corticosteroid adverse effects?
short term- hyperglycemia, mood changes, gastritis, elevated BP
long term- Aseptic necrosis, cataracts, obesity, growth failure, osteoporosis
What are the traditional DMARDs?
Methotrexate*, Sulfasalazine, Hydroxychloroquione, Leflunomide
*DMARD of choice
What is the dosing for Methotrexate?
7.5 mg weekly
*up to 15-20 mg
What needs to be taken with Methotrexate?
1 mg/day of folic acid to reduce AE’s
What are the Adverse effects of methotrexate?
bone marrow suppression, nausea, vomiting, diarrhea, stomatitis/mucositis, teratogenic, hepatotxicity
What medications are not recommended in a sulfa allergy?
sulfasalazine, celecoxib
What unique adverse effect is associated with hydroxychloroquine?
retinal toxicity
What is the MOA of Anakinra (Kineret)?
recombinant human IL-1 receptor antagonist
-have to have failed a DMARD
What is the MOA of Abatacept (Orencia)?
selective co-stimulation modulator & inhibits t-cell activation
-have to have failed a DMARD
What are the IL-6 receptor inhibitors?
tocilizumab (Actrema), sarilumab (Kevzara)
What are the adverse effects for IL-6 inhibitors?
lipid abnormalities
black box warning - serious infections
What is the anti-CD20 antibody?
Rituximab (Rituxan)
What JAK inhibitors are used in RA?
tofacitinib (Xeljanz), Baricitinib (Olumiant), Upadacitinib (Rinvoq)
What medications used in RA are TNF inhibitors?
Etanercept (Enbrel), Infliximab (Remicade), Adalimumab (Humira), Golimumab (Simponi), Certolizumab (Cimzia)
