Rheumatoid arthritis

Question 1

mechanism of rheumatoid arthritis

Answer 1

autoimmune disorder in which synovial membrane takes over cartilage

in end stages two bones fuse together

Question 2

rheumatoid arthritis meds

Answer 2

1. NSAIDs
2. glucocorticoids
3. dz modifying anti-rheumatic drugs (DMARDs)

Question 3

DMARDs

Answer 3

used w/in 3 mo of diagnosis

methotrexate
hydroxychloroquine

TNF blockers:
infliximab
adalimumab
etanercept

Question 4

methotrexate mechanism of action

Answer 4

common drug of choice - taken weekly

inhibits enzyme which allows folic acid to make DNA to decrease immune cell production/inflammatory response

Question 5

issues w/methotrexate

Answer 5

N/D (common)
GI ulcer
decreased bone barrow production
pneumonitis
hepatotoxic
renal failure
infection d/t suppressed immune fn
severe rash

Question 6

issues w/hydroxychloroquine

Answer 6

better tolerated, less effective
usually combined w.methotrexate
take w/food
retinal damage

Question 7

TNF alpha blockers

Answer 7

IV or subcutaneous
infliximab
adalimumab
etanercept

Question 8

issues w/TNF blockers

Answer 8

common:
injection site rxn
infections

rare:
severe allergic rxn
heart failure
hepatotoxic
cancer