Rheumatoid Arthritis

Question 1

RA Symptoms

Answer 1

1. Pain
2. Swelling
3. Stiffness
   Results from chronic inflammation of synovial lining of joints

Question 2

RA Pathophysiology

Answer 2

1. Macrophages produce cytokines (TNF and IL 1) which activate synovial fibroblasts in synovium
2. leads to recruitment of other inflammatory cells that release digestive enzymes
3. Leads to bone and cartilage degradation by invading inflammatory tissue

Question 3

Rationale for aggressive treatment early in disease

Answer 3

Joint damage is most rapid early in the disease and cannot be reversed

Question 4

NSAID MOA

Answer 4

1. Eliminate pain and inflammation
2. Do not slow progression of the disease
3. Inhibits COX 1 and COX 2, therefore arachadonic acid cannot be converted into inflammatory modifiers

Question 5

Indomethacin (Indocin) Class

Answer 5

Non-selective NSAID. Inhibits both COX 1 and COX 2

Question 6

Indomethacin (Indocin) MOA

Answer 6

1. Eliminate pain and inflammation

2. Do not slow progression of the disease

Question 7

Indomethacin (Indocin) Therapeutics

Answer 7

1. RA

2. Acute gouty arthritis

Question 8

Indomethacin (Indocin) SE

Answer 8

Gastric and Duodenal ulcers

Question 9

Naproxen (Aleve) Class

Answer 9

Non-selective NSAID, inhibits both COX 1 and COX 2

Question 10

Naproxen (Aleve) MOA

Answer 10

1. Eliminate pain and inflammation

2. Do not slow progression of the disease

Question 11

Naproxen (Aleve) Therapeutics

Answer 11

1. RA

2. Acute gouty arthritis

Question 12

Naproxen (Aleve) SE

Answer 12

Gastric and Duodenal ulcers

Question 13

COX-2 Inhibitors Class

Answer 13

Selective COX 2 inhibitor

Question 14

COX 2 Inhibitor MOA

Answer 14

1. Eliminate pain and inflammation

2. Do not slow progression of the disease

Question 15

COX 2 Inhibitor Therapeutics

Answer 15

Superceding conventional NSAIDs for RA

Question 16

Cox 2 Inhibitor SE

Answer 16

50% fewer gastric and duodenal ulcers than traditional NSAIDs

Question 17

DMARD MOA

Answer 17

1. Drugs that retard or halt disease progression

2. Effects take 2 wks to 6 months to start acting

Question 18

Glucocorticoids (Corticosteroids) Class

Answer 18

DMARD

Question 19

Glucocorticoids (Corticosteroids) MOA

Answer 19

1. Inhibits phospholipase A2 (inhibiting release of arachidonic acid and, thus, formation of prostaglandins)
2. Inhibits cytokine production (which prevents induction of COX-2)