Rheumatoid arthritis and therapeutics Flashcards
What is the definition of rheumatoid arthritis?
An asymmetrical polyarthritis of the small joints of the hands and feet
Who is most likely to develop RA?
Women, aged 30-50 with a family history
What are the signs and symptoms of Rheumatoid arthritis?
- Joint swelling
- Stiffness particularly in the morning
- Positive serology for anti-CCP and RF
- Raised inflammatory markers
- Extra-articular manifestations
How do glucocorticoids work?
Inhibit inflammation-associated molecules
What are the side effects of glucocorticoids?
- Hypertension
- Dyslipidaemia
- Body morphology changes
- Proximal myopathy
- Diabetes Mellitus
- Osteoporosis
- Cataracts
- Glaucoma
How do DMARDs work?
They supress the body’s overactive immune/inflammatory response
What does DMARDs stand for?
Disease modifying antirheumatic drugs
Give examples of DMARDs
- Methotrexate
- Leflunomide
- Sulphasalazin
What are some side effects DMARDs?
- GI disturbance
- Skin reactions
- Headache
- Peripheral neuropathy
- Thrombocytopenia
- Anaemia
How do biologic therapies work?
A targeted therapy that block aspects of the immune system to slow down
What are the side effects of biologic therapies?
- Increased risk of infection
- Blood abnormalities
- GI disturbance
- Skin reactions
What investigations are done before a patient begins biologic or tyrosine kinase inhibitor therapy?
- CXR (within the last 6 months)
- FBC / U&E/ LFT/ ESR/ CRP +/- Cholesterol
- HIV / Hep B / Hep C / Varicella
- T- SPOT (TB)
